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Hang with me on this as it’s not straightforward, A&A best used as
1. extra $ to stretch out a spend down for those in a NH with too much assets to qualify for LTC Medicaid. Like they get 2K in SSA mo income + have 40K in savings & in a 9,300 mo NH so the VA $2300 enables a single vet to stay in a private pay bed for 3-5 months longer. The # of LTC Medicaid beds tend to be limited in a NH so coming in private pay gives oodles more options.
2. to pay for AL as AL is much less than a Nh. Often their SS income + the A&A comes to or is close to their monthly AL bill.
3. to pay for in home caregivers.
It will never pay for NH costs as they are well over A&A $ even if elder got the max SS retirement income or VA pension. They would stop A&A so LTC Medicaid could step in BUT bc they were on A&A they get a mo stipend of $90 a month that is all theirs.
The frustrating part of VA A&A is that it does the approval glacially, so often by the time it comes through, the elder is way past the whole idea of being OK to be home or in AL or even MC…. well that ship has sailed.
Your Dad needs to be in and stay in this NH because for most States it is ONLY being in an SNF that LTC Medicaid will cover costs in full. Most MC run on the AL system but with a locked & monitored ward, it’s not full on skilled nursing care.
And also frustrating is as VA moves glacially, it does a huge retro payment of the benefits. So someone like your dad appears - often months later - to have all these a$$ets from the retro VA $ payment which seems to make them ineligible for LTC Medicaid as LTC tends to have nonexempt assets at $2,000 for most States. But that retro $ is illusionary, because VA will do a clawback of all the months paid to him while he was also having his costs paid by LTC Medicaid. No double dipping. $ clawed back.
This is mucho importante bc if he or you were to spend the $ or put it into something irrevocable, it will jeapordize his LTC Medicaid eligibility. NAL but that pooled trust idea will not work, as VA will want the $ back. The $ is usually best off by sitting in the account it was direct deposited into and wait till VA does its clawback. Someone in billing at the NH or its parent company will be familiar with this.
Medicaid totally will pay 100% of your dad’s custodial care costs in the NH (if Nh has a bed available) as long as he is medically and financially “at need”. Again, For most States, it will NOT pay for AL or MC. You get him moved to a lower level of care, it will be a beast to get him back into a SNF short of his taking a super bad fall then being hospitalized and then being discharged for rehab more than likely into in new and different SNF.
For LTC Medicaid, they require a copay or Share of Cost paid to the NH. If dad isn’t yet doing this, it will happen and back to the date of his LTC application. For example, if a mom who gets $2345 a mo SS in TX is in a NH but had been on A&A prior, will be required to do a SOC of $2270 to the NH every month. She gets to keep a mere $75 a month as her TX personal needs allowance. The VA A&A excluded from counting as its going to be clawed back. But bc this mom was on A&A, the VA pays her a stipend of $90 a month which she gets to keep & not part of her required SOC. So this mom has $165 a mo to pay for her on site beauty shoppe, clothing and toiletries replacement, whatever she might want to have. $165 in fun $. Now I know that sounds pitiful, it’s not as many States have the PNA at $40.
You as dads POA do need to make sure his bank account stays under the 2K asset limit (or whatever your State has for asset max). & again till VA figures out the $ is to be clawedback, it stays there but you basically ignore it.
*PNA acct is set up for the small amount of SS taken out for personal needs. My State $50 a month. Not sure if you can get both what SS allows and A&A. A question to ask. Be aware that there is an asset cap, my state $2000, and that PNA is part of that $2000 and can take you over so it needs to be spent.
I believe he will get to keep about 100.00 from the VA benefits for personal needs but, that will be all.
Contact his social worker and get this taken care of quickly or he may have to pay one or the other back whatever they have paid for his care/needs.