Getting Started - An Overview of Potential Benefits
If you are confused and a bit bewildered after researching VA benefits, you are certainly not alone. Much of the information on the Internet, for example, is simply wrong, misleading or both. One of our goals at EVLAG is to ensure you have absolutely accurate information when you investigate your entitlement to VA benefits so you can make the best decisions for you and your loved ones regarding care options. So, let’s get started!
Title 38 of the United States Code authorizes the Department of Veterans Affairs to administer two disability programs for Veterans, their surviving spouses and other family members: Compensation and Pension.
Compensation is awarded to veterans whose disability is a direct result of an event that occurred while on active duty military service. The concept is that the disability has impaired the veterans from earning a living at the same wage rate as a totally healthy person. The VA therefore “compensates” the veteran for loss of earning caused by the disability. Compensation is awarded on a scale from 0% impairment to 100% impairment. The percentages are based on a "schedule" of diagnostic descriptions found in 38 C.F.R. Part 4.
Pension furnishes a guaranteed monthly income to veterans who served during a wartime period and meet other important eligibility requirements. The veteran does not have to have seen active combat; you simply must have served a minimum time during the period and have a honorable or equivalent discharge. This important program is often (mistakenly) called “Aid and Attendance.” Here is a list of the recognized wartime periods:
Other Disability Programs
Medicaid Diversion Programs
Background. The Long-term Care Community Diversion Program is a Medicaid waiver program designed to provide community-based services to people who would otherwise qualify for Medicaid nursing home placement. Medicaid is a program equally funded by the various states and the federal government through the Center for Medicare and Medicaid Services. Each state must file a waiver with the CMS indicating how the program will be implemented in their state and who will be covered. Medicaid is usually the second most expensive state government initiative, the largest being the cost of state government itself. Politically, the states want to provide as much coverage as possible for its citizens needing assistance but must always be aware of the cost of these services. Rather than channel everyone needing facility-based care to Skilled Nursing Homes, which is an expensive option, Medicaid Diversion can offer care at the assisted living level, for example, at a much lower cost to the states.
Services. The services provided by the Diversion Program include a variety of long-term care services and Medicaid-covered medical services. The actual menu of services and support will vary from state to state due to the waiver process described above. The objective of the Diversion Program is to provide frail elders with safe, appropriate community-based care alternatives in lieu of nursing home placement, at a cost less to the state than Medicaid nursing home care. There is no monetary compensation given by Medicaid Diversion to you if you are in your own home. Monetary compensation is given only if you are receiving care in an assisted living or similar facility. However, there are services offered to you in your own home by the Medicaid Diversion such as a home health aide (caregiver) to assist you with activities of daily living, for an hour or two per day ( maximum of 15 hours per week), they will provide you with supplemental drinks and incontinence supplies (diapers), social worker services and more. These programs are administered by your local state Medicaid office. In some cases, Medicaid Diversion benefits and VA benefits can be received simultaneously.
If you have investigated Medicaid benefits previously, you may have been told your loved one is not eligible. However, you may not have been discussing the Medicaid Diversion program available in your state and eligibility may occur in the future when assets are exhausted. Plan ahead!
Caution! Having said that, be aware that good, solid planning needs to be observed when and if Medicaid Diversion becomes a possible option for senior care now or in the future. For example - and this is very important - not every assisted living or similar facility will accept Medicaid residents. Why? Because it is a financial decision. The per diem (Medicaid daily rate) offered to the facility is usually much less than the facility could charge on a simple "street rate" basis, so there is no incentive for "selling" a room at a lower than necessary rate. Because of this, assisted living and memory care level facilities usually fall into one of three categories.
At EVLAG, one of our jobs is to help you understand these options during your own discovery process when you are seeking the appropriate level of care. We are more than just a source for information regarding VA programs. Our goal is to help you absorb the high cost of care. Both VA Benefits and Medicaid Diversion can help!
Title 38 of the United States Code authorizes the Department of Veterans Affairs to administer two disability programs for Veterans, their surviving spouses and other family members: Compensation and Pension.
Compensation is awarded to veterans whose disability is a direct result of an event that occurred while on active duty military service. The concept is that the disability has impaired the veterans from earning a living at the same wage rate as a totally healthy person. The VA therefore “compensates” the veteran for loss of earning caused by the disability. Compensation is awarded on a scale from 0% impairment to 100% impairment. The percentages are based on a "schedule" of diagnostic descriptions found in 38 C.F.R. Part 4.
Pension furnishes a guaranteed monthly income to veterans who served during a wartime period and meet other important eligibility requirements. The veteran does not have to have seen active combat; you simply must have served a minimum time during the period and have a honorable or equivalent discharge. This important program is often (mistakenly) called “Aid and Attendance.” Here is a list of the recognized wartime periods:
- World War I April 6, 1917 – November 11, 1918
- World War II December 7, 1941 – December 31, 1946
- Korean Conflict June 27, 1950 – January 31, 1955
- Vietnam Era February 28, 1961 - August 4, 1964 (in-country only)
- Vietnam Era August 5, 1964 – May 7, 1975 (all veterans)
- Southwest Asia August 2, 1990 – to be set by law or proclamation (Afghanistan, Iraq, Kuwait, etc.)
Other Disability Programs
Medicaid Diversion Programs
Background. The Long-term Care Community Diversion Program is a Medicaid waiver program designed to provide community-based services to people who would otherwise qualify for Medicaid nursing home placement. Medicaid is a program equally funded by the various states and the federal government through the Center for Medicare and Medicaid Services. Each state must file a waiver with the CMS indicating how the program will be implemented in their state and who will be covered. Medicaid is usually the second most expensive state government initiative, the largest being the cost of state government itself. Politically, the states want to provide as much coverage as possible for its citizens needing assistance but must always be aware of the cost of these services. Rather than channel everyone needing facility-based care to Skilled Nursing Homes, which is an expensive option, Medicaid Diversion can offer care at the assisted living level, for example, at a much lower cost to the states.
Services. The services provided by the Diversion Program include a variety of long-term care services and Medicaid-covered medical services. The actual menu of services and support will vary from state to state due to the waiver process described above. The objective of the Diversion Program is to provide frail elders with safe, appropriate community-based care alternatives in lieu of nursing home placement, at a cost less to the state than Medicaid nursing home care. There is no monetary compensation given by Medicaid Diversion to you if you are in your own home. Monetary compensation is given only if you are receiving care in an assisted living or similar facility. However, there are services offered to you in your own home by the Medicaid Diversion such as a home health aide (caregiver) to assist you with activities of daily living, for an hour or two per day ( maximum of 15 hours per week), they will provide you with supplemental drinks and incontinence supplies (diapers), social worker services and more. These programs are administered by your local state Medicaid office. In some cases, Medicaid Diversion benefits and VA benefits can be received simultaneously.
If you have investigated Medicaid benefits previously, you may have been told your loved one is not eligible. However, you may not have been discussing the Medicaid Diversion program available in your state and eligibility may occur in the future when assets are exhausted. Plan ahead!
Caution! Having said that, be aware that good, solid planning needs to be observed when and if Medicaid Diversion becomes a possible option for senior care now or in the future. For example - and this is very important - not every assisted living or similar facility will accept Medicaid residents. Why? Because it is a financial decision. The per diem (Medicaid daily rate) offered to the facility is usually much less than the facility could charge on a simple "street rate" basis, so there is no incentive for "selling" a room at a lower than necessary rate. Because of this, assisted living and memory care level facilities usually fall into one of three categories.
- The Facility will simply not accept Medicaid residents. If you are a current resident, expend all of your resources, and are forced to apply for Medicaid, you will be asked to move to another facility. Obviously, whether or not a facility will accept Medicaid is an important question to ask when interviewing a facility.
- The second option is what we call the "Compassionate Option." A facility may allow a resident who has been in the facility for some period of time paying the full "street" rate (usually two years) to apply for Medicaid and remain a resident. Hooray for them and their attitude!
- The other option is simply that the facility will take Medicaid from the beginning. There may be a number of reason the facility may choose to offer this as an initial option.
At EVLAG, one of our jobs is to help you understand these options during your own discovery process when you are seeking the appropriate level of care. We are more than just a source for information regarding VA programs. Our goal is to help you absorb the high cost of care. Both VA Benefits and Medicaid Diversion can help!