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They even have home-based Primary Care, so his healthcare team comes to the house to check up on him. The team is extensive: Nurse, social worker, PT, OT, dietician, psychologist and Speech therapist, if needed. The only downside is that we have never met his doctor, but the Nurse practitioner is always available by phone.
A&A seems to work well if they have do in-home care as the $ can pay a lot of the caregiver costs from the $1800/$1150/$2127 and they can determine who the caregiver is and pay them directly;
it can work well to pay towards AL costs as those tend to run $2500-$4500 a mo, so between their A&A$ and their other income/assets to make up the difference, the monthly on a AL can be paid;
it can work well for elders in a MC or NH with $$$, as it gives them additional $ each month which can be used for months of private pay so they can stretch out their assets longer. This works especially well if they need to do a sizeable spend down to get financially eligible for LTC Medicaid.
But you cannot get VAA&A and LTC Medicaid simultaneously.
And that is the rub as it’s only LTC Medicaid that will cover the entire room & board costs in a facility. So unless they have $$$, going LTC Medicaid route is better than filing for A&A. If that happens, the A&A stops and they instead get $90 a month from the VA as a personal needs fund & the VA$90 is not included in their monthly income tally for the required copay for Medicaid.
Unless they are in a VA only LTC facility.