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Do VA Benefits Cover Assisted Living?

Many seniors in The Villages may consider assisted living for their long-term care, although figuring out how to pay for their room, board, and care can be confusing. Assisted living monthly fees can be expensive, even for communities that offer all-inclusive care packages. Many ask if VA benefits cover assisted living.

Military veterans aged 65 and older number 8,770,000, many of whom use at least one VA benefit program. However, the US Department of Veterans Affairs benefits don’t directly cover assisted living costs, although some VA benefits can help seniors pay for long-term care and assisted living. This post will cover how you can use your benefits to cover assisted living and other options for senior living care.

How Does The VA Benefits Cover Assisted Living?

The average cost of assisted living can range from $3,500 upwards of $8,000 per month. The number of occupants and the size of the living space affect the price. For instance, an individual living in a studio apartment would pay less than a couple living in a larger apartment. Military veterans like you may be looking for financial assistance to pay their assisted living fees or wondering if their VA benefits can cover some of their senior living.

Military veterans have health care through the VA, but those who meet income thresholds can also apply for Medicare coverage and, after they turn 65, Medicaid, as well. Some Medicare benefits can be used to pay for home health care, or you may be eligible for a Medicaid waiver in your state. Recipients can use Medicaid waives to pay for assisted living or an in-home health care attendant if they meet certain income and functional requirements for that benefit. These waivers aren’t available in all states but can help you avoid accommodations in a nursing home.

Many assisted living communities offer care beyond simple healthcare. However, finding the right VA benefits to cover assisted living can be tricky. The Aid and Attendance and Household benefits may be used for assisted living fees.

Aid and Attendance

The Aid and Attendance benefit helps veterans and their spouses who need extra assistance with the tasks of daily living, from personal care and grooming to eating, getting dressed, and completing household tasks. In addition, homebound veterans may receive additional funds on top of this benefit and their regular pensions. Aid and Attendance benefits are for veterans with both physical and mental health conditions, which can be helpful for veterans experiencing cognitive decline. Surviving spouses may also take advantage of one of these benefits.

A veteran who qualifies for a regular VA pension also financially allows for both the Aid and Attendance benefits, so this can make a big difference in whether or not you can pay for your chosen assisted living facility. However, there are additional eligibility requirements beyond just finances for both the Aid and Attendance benefits, though if you need assisted living services, you will likely meet the functional requirements to receive the benefit.

Veteran Directed Care

Veteran Directed Care allows veterans of all ages to receive Home & Community-Based Services if they need help with the tasks of daily living, such as fixing meals and eating, bathing, dressing, grooming, and mobility. It’s a program also open to veterans whose caregivers cannot fully care for them or who are isolated or homebound.

The program gives veterans a budget for these services, which you or a designated representative either manages in the event you cannot advocate for yourself. A VA counselor can help you find a caregiver in your community to help you in your home or long-term care community.

Who Qualifies for VA Aid and Attendance and Veteran Directed Care?

Generally speaking, all military veterans on active duty for at least 90 days, one of which was during a period of active war, and discharged from service for any condition other than dishonorable, have Aid and Attendance and VDC benefits available to them and their spouse. However, there are also functional/clinical requirements, which we will explain in further detail below.

Aid and Attendance Eligibility

A few different circumstances qualify you for the Aid and Attendance benefit. These include

You are bedridden
You have a mental or physical condition that requires you to stay in a nursing home
You cannot complete daily activities without someone else’s help
If you are blind in both eyes or have a concentric contraction of your eyes

Qualifications for the Household benefit, which can also be used to help pay for assisted living accommodations, include:

You have a single permanent disability that the VA classifies as “fully disabling,” which renders you unable to leave home.
You fit the above condition and have other disabilities that are at least 60% disabling, as per the VA standards.
You can demonstrate, or your surviving spouse can verify, that you cannot pay for assisted living without assistance. The VA requires several documents stating your financial situation.

Like all VA benefits, the VA prioritizes those with service-connected disabilities for approval for Household and Aid & Attendance benefits. If you have a severe service-related disability or permanent medical condition and are low-income, then you’ll have top priority.

How to Apply for Aid and Attendance

You, your surviving spouse, or your designated representative can apply for VA benefits through the regional VA office. Representatives here can guide you through the application process, including determining which benefits you’re eligible for, plus help you gather the documents needed to support your application and claim.

For example, you’ll be asked for a letter from your primary care physician or specialist doctor that states your current condition and how it qualifies you for benefits. You’ll also need your VA health system ID number to access your medical records. Suppose you’re currently employing a caregiver or physical therapist or working with a home care agency. In that case, that individual or those individuals will also be required to draft a letter stating how well you can carry out daily tasks independently.

Veteran Directed Care Eligibility

Veteran Directed Care is part of the VHA Standard Medical Benefits Package; therefore, all veterans enrolled in this package are eligible for Veteran Directed Care. As long as you meet the clinical assessment requirements and the benefits package is available in your area, then you’re eligible.

Other Veterans Benefits for Seniors

If you cannot pay for assisted living on your own, even with your VA benefits, there are other options for long-term care.

VA Community Living Centers

Community Living Center (CLC) is a VA nursing home with over 100 facilities across the country. These facilities are designed to feel more like a home environment than traditional nursing homes’ clinical feel. There are community spaces for family visits or events, and residents are encouraged to decorate their rooms with personal furnishings and items. Pets are also allowed, which can help veterans be more comfortable in the environment.

Stays can be short-term, for those recovering from illness or an injury, or long-term, for those unable to live independently in their homes. You’ll receive a nursing-home level of care, including help with personal care, skilled nursing, and medical treatment.

State Veterans Homes

State Veterans Homes are similar to the CLCs, except that state governments run them. These facilities provide a nursing home level of care and are available for permanent residence, a temporary stay, or daycare while a caregiver works. Many states created these homes to help prevent veteran homelessness or subpar care. The VA doesn’t administer these homes, but representatives of the Department of Veterans Affairs inspect facilities annually to ensure that they comply with department standards.

DO VA BENEFITS COVER ASSISTED LIVING?