Medicaid Recipient’s Right to Choose Medicaid Provider Without State Interference

A recent Florida case concerned competing Medicaid rights—a Medicaid recipient’s right to choose a Medicaid provider without state interference, and a state’s right to maintain quality medical treatment for some of its most vulnerable citizens. Miracles House operates two group homes that offer healthcare services to the permanently disabled.

In Florida, the Agency for Health Care Administration regulates assisted living facility licenses and oversees the quality of care at those facilities. Florida’s Agency for Persons with Disabilities is responsible for monitoring group homes and issuing licenses to group-home operators. Miracles had licenses to operate its facilities.

 

Medicaid Providers Requirements

Miracles was a Medicaid provider. Qualified Medicaid providers must maintain a facility license and enter into a Medicaid Provider Agreement with Florida’s Agency for Persons with Disabilities. These qualified providers have “Medicaid Provider Authorization,” which allows them to obtain a Medicaid provider number and receive Medicaid reimbursement for certain healthcare services. If a Medicaid provider loses its Medicaid Provider Authorization—such as by the suspension of its license or termination of its Medicaid Provider Agreement—the provider loses the right to furnish Medicaid services and receive payment from Medicaid.

In July 2017, Florida’s Agency for Health Care Administration suspended Miracles’ Assisted Living License because of deficient patient care. Because of this, the Agency for Healthcare Administration suspended Miracles’ Assisted Living License and closed another of its facilities.

But Miracles held two licenses—the suspended Assisted Living License and the Group Home License. So, even though it lost its Assisted Living License, it retained its Group Home License—allowing it to continue operating both of its group homes.

Plaintiffs emphasized the separateness of the group homes and Amazing Wonders, arguing that the problems at Amazing Wonders didn’t impact the quality of care administered at Miracles’ group homes. Plaintiffs argued that the events at Amazing Wonders shouldn’t affect Miracles’ status as a qualified Medicaid provider in its group homes.

Defendants said that they effectively treated the facilities as one in the same, arguing that Amazing Wonders’ deficiencies reflect Miracles’ medical competence and qualifications—or lack thereof. According to the Defendant, the problems at Amazing Wonders, and subsequent suspension of Miracles’ Assisted Living License “led [the Agency for Health Care Administration] to conclude that Miracles was no longer fit to perform Medicaid services in a professionally competent, safe, legal and ethical manner under 42 C.F.R. § 431.51(b)(1).” In other words, the state determined that Miracles’ ownership of an assisted living facility with such extensive deficiencies undermined Miracles’ fitness to provide Medicaid services even at entirely separate entities.

The Agency for Health Care Administration terminated Miracles’ Medicaid Provider Authorization, and it no longer qualified as a Medicaid Services Provider, prompting the Agency for Persons with Disabilities to terminate its Medicaid Provider Agreement with Miracles.

In short, Plaintiffs alleged that Defendants “imposed a sanction of exclusion from Medicaid on Miracles House without a finding of a ‘violation’ by Miracles House and without providing Miracles House the opportunity for a pre-deprivation hearing as state law requires.” It asked the Court for a temporary restraining order and a preliminary injunction restraining Defendants, his employees, agents, and successors in office from terminating the Medicaid provider agreements of Plaintiff Miracles House.

Plaintiffs claimed that the state terminated Miracles’ Medicaid Provider Authorization and Provider Agreements for reasons unrelated to its fitness to perform safe, effective medical services—a violation of the free-choice-of-provider provision.

United States District Judge Federico A. Moreno wrote in his opinion that the federal Medicaid statute includes a free-choice-of-provider provision. Courts agree that the free-choice-of-provider provision creates a private right, but only Medicaid recipients—not Medicaid providers—can enforce that right.

Defendants argued that because Miracles House, Inc. is a (former) Medicaid provider, it lacked standing to assert a claim. The Court agreed. However, the individual Miracles Plaintiffs in this action—as Medicaid recipients—did have standing to pursue the requested relief under the free-choice-of-provider provision.

Medicaid’s free-choice-of-provider provision guarantees Medicaid recipients “the right to choose among a range of qualified providers without government interference.” However, this right to choose is limited to qualified providers. And states have the right enforce minimum standards of care for Medicaid providers.

Here, the Plaintiffs’ motion for emergency temporary restraining order and preliminary injunction was denied, and the Defendants’ partial motion to dismiss Miracles House for lack of standing was granted. Miracles House, Inc. v. Senior, 2017 U.S. Dist. LEXIS 186336 (S.D. Fla. November 9, 2017).

 

Contact Us

If you have questions about Florida Medicaid, Attorney John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will get in touch with you.

 

Bill of Rights for Florida Nursing Home Residents Bill Considered

A new version of a constitutional Bill of Rights for Florida nursing home residents and assisted living facilities was recently approved by a review committee.

The Declaration of Rights Committee approved the proposal (P88) by a vote of 5-2, sending it to the full Constitution Revision Commission for consideration.

However, the Bill of Rights for Florida Nursing Home Residents was criticized by the Florida Health Care Association, which represents nursing homes, assisted living facilities, and others who care for the elderly and people with disabilities. The association took issue with payments by Medicaid.

“In reality, it is nothing more than an avaricious ploy by trial lawyers to profit from increased lawsuits against nursing centers,” said Emmett Reed, the association’s executive director, in a statement.

The proposal was proposed by Commissioner Brecht Heuchan after a South Florida nursing home lost air conditioning during Hurricane Irma in September 2017. That resulted in 14 residents’ deaths (although not all the deaths at the Rehabilitation Center at Hollywood Hills were connected to the lack of AC at the building). Nonetheless, Broward County authorities deemed 12 of the deaths to be homicides.

This prompted Florida Governor Rick Scott to demand that all nursing homes and assisted-living facilities in the state install sufficient backup generators and have 96 hours of fuel on site to keep temperatures safe in case of power failure. That proposal resulted in months of lawsuits and negotiations by the industry before reaching an agreement in February 2018.

 

Details of the Bill of Rights for Florida Nursing Home Residents

The Bill of Rights includes a provision for a “right to a safe, clean, comfortable, and homelike environment.” This would protect residents from “extreme climatic conditions and natural disasters,” a nod toward the deaths that occurred during Hurricane Irma. The bill also contains a “right to know and hold accountable all persons or entities who either directly or indirectly own or operate the facilities.”

But the Florida Health Care Association believes that the Bill of Rights for Florida Nursing Home Resident’s “undermine(s) the hard work of thousands of health care professionals who provide outstanding care for some of Florida’s most vulnerable citizens. Existing state and federal laws guarantee the rights of nursing center residents, and these laws have been working well to support the advances in quality that are being made in Florida nursing centers today.”

Reed also remarked that Florida “is among the best in the nation in nursing and Certified Nursing Assistants staffing ratios; that reforms in 2001 led to more systemic approaches to delivering care … and that new federal rules announced in November make major updates in residents’ rights, care planning, quality assurance, and assessments.”

After the review meeting, Commissioner Heuchan said he would still consider changes to the language but believes that the current version is “a step in the right direction.”

“People that live in nursing homes have (fewer) rights than people who don’t,” he told panel members. “It’s unconscionable.”

In the end, the effort to put the Bill of Rights for Florida Nursing Home Residents on the ballot was withdrawn by the sponsor as in their view the compromises needed to get the proposal passed were too much.  To learn more you can read this Miami Herald article now.

 

Contact Us About the Florida Nursing Homes Resident’s Bill of Rights

If you have questions about Florida Medicaid, Attorney John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner.

Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will get in touch with you.

Work Requirements for Medicaid Beneficiaries in FL Unlikely

Work requirements for Medicaid beneficiaries did make it through a Florida House committee on a 14 to 4 vote in the just-ended legislative session. The Trump administration recently showed a positive reaction to work requirements for Medicaid beneficiaries. However, the Florida Legislature did not enact this type of requirement in the current legislative session.

 

Work Requirements for Medicaid Beneficiaries: Florida’s House Speaker Says No

Florida House Speaker Richard Corcoran, R-Land O’ Lakes, told The News Service of Florida that the state’s $26 billion Medicaid program is comprised mostly of children and seniors. The work requirements proposed in other states are designed to address able-bodied adults who qualify for Medicaid under the Affordable Care Act (known as “Obamacare”).

“I think that’s geared toward Obamacare expansion, not to our plan since we didn’t expand,” Corcoran said of imposing work requirements. “We don’t have childless able-bodied working age adults in our system, so I don’t know how that would transpose to us. If you look at our Medicaid population, mostly children, mostly seniors, and single pregnant moms, I don’t think that is necessarily something that we would do.”

 

Florida’s Medicaid Program Nation’s Fourth Largest

Florida currently has roughly 4 million people enrolled in its Medicaid program. That makes it the fourth largest in the nation in terms of population, according to Medicaid Director Beth Kidder. Estimated spending on the Medicaid program will be just under $27 billion in 2018—that would be the fifth-largest program in the nation in terms of spending.

Kerri Wyland, a spokeswoman for Governor Rick Scott, sidestepped an answer as to whether the governor would support work requirements for Medicaid beneficiaries or co-payments for the Medicaid program. “This would require legislative action. Governor Scott will review any bill that reaches his desk,” she remarked.

Last month, the Trump administration sent a letter to state Medicaid directors announcing a policy to authorize work requirements for Medicaid beneficiaries for states with what are known as “Medicaid 1115 waivers.” Florida has such a waiver.

“Subject to the full federal review process, CMS (the federal Centers for Medicare & Medicaid Services) will support state efforts to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility or coverage for certain adult Medicaid beneficiaries in demonstration projects authorized under section 1115 of the Social Security Act,” the letter said.

“Such programs should be designed to promote better mental, physical, and emotional health in furtherance of Medicaid program objectives. Such programs may also, separately, be designed to help individuals and families rise out of poverty and attain independence, also in furtherance of Medicaid program objectives.”

States would have the ability to identify activities other than employment that promote health and wellness. These activities might include community service, caregiving, or job training.

 

Work Requirements for Medicaid Beneficiaries is a Priority for Republicans

Requiring work thresholds for Medicaid eligibility has been a long-standing priority for conservatives. The Trump administration announcement reverses previous policies that prevented states from requiring Medicaid beneficiaries to work to qualify for program benefits.

Although House Speaker Corcoran announced that his chamber won’t move forward with the work requirement in 2018, the Republican-led chamber did look at the idea last year. Representative Travis Cummings, R-Orange Park, introduced a bill in 2017 that would have required all Medicaid beneficiaries who are part of the state’s “managed medical assistance” program to satisfy to the same work requirements that apply to families who receive temporary cash assistance.

Cummings’ bill also would have required Medicaid enrollees to pay monthly premiums to stay enrolled in the managed medical assistance program, which involves enrolling in managed-care plans.

 

Contact Us About Medicaid Eligibility

If you have questions about Florida Medicaid Attorney, John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning, and elder law practitioner.

Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will get in touch with you.

 

Nursing-Home Group Priorities

Nursing Home Group priorities of the Florida Health Care Association discussed the group’s priorities for the 2018 legislative session before it began. Their list included topics like generator requirements and increased Medicaid funding.

For the 2018 legislative session, the Florida Health Care Association planned to request that lawmakers earmark more money to care for Medicaid-funded residents and protection of the Certificate of Need process which restricts the overall number of nursing homes in Florida.

 

Nursing Home Group Priorities Targets Generators Needed to Handle Emergencies

After last September’s Hurricane Irma resulted in several deaths at a Broward County nursing home, long-term care facilities have gained attention for their emergency procedures.

The state and industry groups have been fighting in court over proposed state rules that would require nursing homes and assisted-living facilities to have generators and fuel supplies so that their buildings will stay cool during power outages.

Florida Health Care Association chief lobbyist Bob Asztalos commented that the cost to retrofit all nursing homes will vary drastically at each location based on the size and age of a building. Asztalos would like to see additional state funding to help satisfy the generator requirement.

“Our hope is that we can work, the governor and us together, and get to a place on the rule and resolve this through the rulemaking process,” said Asztalos. “If not, we will work with Democrats, Republicans, the House and Senate to try to get legislation.”

FHCA wants the state legislature to approve generator rules recently promulgated by the Agency for Health Care Administration and Department of Elder Affairs. These rules also ensure vulnerable seniors are kept safe during emergencies by bolstering resident-focused procedures to make certain that their health and well-being is watched during disasters.

The result from the just closed session and signed by the Governor was a new requirement in law for all nursing homes to have generators for air conditioners in place with fuel by July 1, 2018.  The fuel requirement was for at least 72 hours.  For assisted living facilities with 17 or more beds the requirement is for 48 hours of fuel.

 

Quality Long Term Care for Frail Elders and Those with Disabilities

Another nursing home group priority of FHCA is also asking state lawmakers to support a Senate’s budget increase of $130.4 million in Medicaid funding for skilled nursing centers to improve the quality of long-term care for infirm seniors and individuals with disabilities.

That request includes $8.4 million in General Revenue to offset Medicaid costs of equipping centers with generators over a three-year payback period, as well as $22.7 million General Revenue for increased direct care spending for recruiting and retaining qualified caregivers under the Prospective Payment System (PPS), and $17.7 million General Revenue for increased quality incentives under the PPS.

The result from the just-finished legislative session and signed by the Governor was indeed a $130 million increase in Medicaid funding for nursing homes. Seems like a victory for their efforts to enact their nursing home group priorities this year.

Contact Us

If you have questions about Florida Medicaid, Attorney John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will get in touch with you.

 

Qualifying for Medicaid When You Exceed the Limits

Qualifying for Medicaid for nursing home care can be complex. For those Florida residents who are age 65 and over who don’t meet the eligibility requirements for Florida Medicaid Long Term Care Eligibility for Seniors, there are other ways to qualify for Medicaid. Here are some details on these options.

 

Medically Needy Pathway to Qualifying for Medicaid

An individual may still be eligible for Medicaid services even if he or she is over the income limit if he or she has high medical bills that meet a threshold.

These bills include health insurance costs, such as Medicare premiums and bills to cover medical services. The Medically Needy Program, which is also known as a “Share of Cost” Program or a “Spend-Down” Program, is based on a person’s “excess income.” That’s their income over the Medicaid eligibility limit (also called their “share of cost”) that’s used to pay their medical bills.

After a person has paid down their excess income to the Medicaid eligibility limit, Medicaid will apply for the month. This program gives them a way to spend down extra income to qualify for Medicaid.

However, the Medically Needy Pathway doesn’t help a person in spending down extra assets for Medicaid qualification. So, if an individual satisfies the income requirements for Medicaid eligibility but not the asset requirement, this program can’t help him or her in “spending down” extra assets. However, the individual can “spend down” assets by spending excess assets on non-countable assets—like home modifications, such as the addition of wheelchair ramps or stair lifts, prepaying funeral and burial expenses, and paying off debt.

Medicaid Planning

Most people considering Medicaid are “over-income” or “over-asset” or both, but they still can’t afford their cost of care.  For those in this situation, there’s Medicaid planning that can help you in qualifying for Medicaid.

Medicaid planning attorney John Frazier can assist families in devising strategies to help them become Medicaid eligible.

 

Contact Us

If you have questions about Florida Medicaid and Medicaid planning, Attorney John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer, click here now to send in a contact form, and we will get in touch with you.

 

 

What is Informed Consent?

Informed consent is necessary in Medicaid Planning. The State of Florida Department of Children and Families, Department of Elder Affairs requires an assessment for all those applying for or receiving assistance for long term care (LTC). This includes the Institutional Care Program (ICP). Every individual who applies for the program must give his or her consent to this assessment.

 

Informed Consent

Generally, informed consent means that the person who is to undergo a medical procedure or, in this case an assessment, has been given an explanation and understands the risks of the outcome.

Florida’s general informed consent law requires that for a patient to give valid, informed consent to any medical treatment, the health care professional must conform to “an accepted standard of medical practice among members of the medical profession” and provide information the details the following:

  • the nature of the procedure;
  • the medically acceptable alternatives to the procedure; and
  • the procedure’s substantial risks.

To evaluate a senior’s needs for eligibility for the Institutional Care Program, they must sign an informed consent form.

 

Granting Permission to the Agency

By signing Form 2040, the applicant is specifically giving the agency permission to the following:

  • An assessment to identify the individual’s need for long term care and to determine if his or her needs can be satisfied in the community or in a nursing facility; and
  • Access to the person’s medical records by DC&F and DOEA staff. This also means that they have permission to speak to the individual’s doctor and other health professionals, as well as family members, close friends, and social services professionals about the person’s situation.

The information DC&F requests is used to determine eligibility for health coverage, to ascertain the patient’s state of disability, and to carry out treatment, payment, or health care operations.

The informed consent is time-limited and is valid for only a specific period of time. The patient has the right to revoke or cancel the authorization at any time.

 

Unable to Give Informed Consent

If a person can’t provide informed consent due to incapacity, the hospital or doctor will consult with his or her health care surrogate or agent who’s been entrusted to make the decisions on behalf of the incapacitated person.

It’s important to sign a healthcare power of attorney to designate a trusted person to act on your behalf if you’re incapacitated and can’t give your informed consent. Without this document, the State of Florida provides a list of individuals who can make decisions for you: your guardian is first, then, your health care surrogate, your spouse, then your children, your parents, and then siblings.

 

Questions about Informed Consent and Medicaid Forms?

If you have questions about informed consent or Florida Medicaid assessments, contact attorney John Frazier, a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will call you.

Facts About Medicaid Income Eligibility in Florida

The Facts About Medicaid income eligibility in Florida include several strict requirements, including the following:

  • Medicaid applicant’s own monthly income can’t exceed $2,205 (in 2017), but there’s no limit on the applicant’s well spouse (“Community Spouse” or the spouse not receiving care);
  • A married applicant may be allowed to credit some part of his or her monthly income above the $2,205 limit for the support a community spouse if that spouse’s monthly income is less than approximately $2,000; and
  • Any excess income of the applicant after an allowance for the community spouse support must be paid to the assisted living facility or used to fund a Medicaid Trust that he or she creates. That trust income is used to support the recipient during his or her lifetime.

 

More Facts About Medicaid Income Eligibility = Asset Eligibility

The key to coordinating the complex world of Medicaid is to work with an experienced Medicaid attorney.

A Medicaid applicant should partner with a qualified estate planning attorney to properly plan for program eligibility.

In the event that the transfers are intended primarily to achieve Medicaid eligibility and are disallowed, those transferred assets will impact Medicaid eligibility and benefits. Many transfers of assets within five years of a Medicaid application (known as the Medicaid “look-back period”) are presumed to have been intended primarily to achieve Medicaid eligibility.

That’s why it’s vital to map out a complete estate plan as soon as possible based on the facts about Medicaid income eligibility.

 

Florida’ Strict Medicaid Limits

In our state, the Medicaid programs have strict limits on the assets that an applicant can have.

  • An applicant can’t own more than $2,000 of assets in addition to any assets that aren’t counted because the law considers them either exempt or not available;
  • A married applicant’s community spouse can’t retain more than $120,900 of assets;
  • The definition of “assets” includes all assets that are titled in applicant’s name or jointly titled with another person, like the family home.

 

Questions?

If you have questions about facts of Florida Medicaid income eligibility and estate planning, attorney John Frazier is a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will call you.

Deposits Needed into Qualified Income Trust Accounts

Deposits needed into a Qualified Income Trust (QIT) allows a person to become eligible by placing their income into an account each month that the individual needs Medicaid. The amount of money to be deposited in the trust each month must be enough so that remaining income is within program standards.

Since the income deposited and withdrawn from the QIT is used to calculate an individual’s patient responsibility, the wise thing to do is to deposit a bit more income to have a small cushion, rather than risking depositing too little and not qualifying for Medicaid.

Upon determining that a person has a patient responsibility, he or she is responsible for paying that amount.

 

Funds Remaining in the QIT Go to the State

Any funds remining in the QIT at death are to be paid to the State (up to an amount of the total Medicaid benefits the State paid on behalf of that person).

When the patient passes away, the QIT trustee or other agent acting on behalf of the patient should contact the long-term care facility to determine if there’s any refund for the month of death due to the trust.

Again, any remaining balance in the QIT as of the date of death—plus any refund from the nursing home facility—must be paid to the State.

Usually all that is needed is a brief cover letter that states that the payment is for a QIT with the Medicaid recipient’s name, social security number, and/or Medicaid ID number. You should enclose a copy of the QIT bank statement covering the date of death to confirm the check is for the balance. In addition, include any documentation of refunds received from the long-term care facility.

 

Contact Us

If you have questions about payment of QIT funds to the State and Florida Medicaid, contact attorney John Frazier, a skilled Medicaid planning (with over 2,000 cases completed that helped preserve their family’s savings), estate planning and elder law practitioner. Please contact John for a free telephone consultation at 727-586-3306 extension 104. If you prefer click here now to send in a contact form, and we will call you.

 

Aid and Attendance Facts

Aid and Attendance facts needed? You are at the right place. There are numerous VA benefits available to our veterans. The most common ones are education, home mortgages and health care benefits. One of the least known is the VA’s Aid and Attendance (A&A) benefit.

VSO (Veterans Service Organizations) may provide very minimal Aid and Attendance facts regarding the provisions of that disability pension since they are often focused on other major benefits the VA offers. Due to this lack of focus, information and communication along with the frustrations some veterans or surviving spouses experience when dealing with government bureaucracy may cause eligible individuals to not fully receive the benefits they earned and are entitled to receive.

If you are a veteran or you are a surviving spouse of someone who was in the military in a period of war (note: the veteran was discharged “other than dishonorable”; only needed to serve one day during the period of war – did not actually have to have seen action in the war or be in the war zone during this period of war – as well as include 90 days of active duty service and needs help with at least one activity of daily living) then you may be able to receive Aid & Attendance benefits.

We are not talking about someone with major disabilities. We are talking about someone who needs assistance with getting their meals, dressing, bathing, maybe taking their medications, etc. We are not talking about someone who is bedridden and needs major care and/or medical care. As a general rule, if you are 65 or older, that should be sufficient.

This benefit is, according to the VA, is one of the most under-utilized benefits. Most veterans are simply not aware of the benefits available to them under the A&A umbrella. They don’t know the Aid and Attendance facts. 

Many are intimidated by the application process and afraid to be refused. This is where an accredited VA attorney and Aid and Attendance lawyer can help.

More Aid and Attendance Facts: What are the Disability Requirements for Aid and Attendance?

Veterans, spouses of veterans or surviving spouses can be eligible for Aid and Attendance benefits if they meet the following disability requirements:

  • The aid of another person is needed in order to perform the activities of daily living and is 65 or older
  • The claimant is bedridden
  • The claimant is in a nursing home due to mental or physical incapacity
  • The claimant is blind

Veterans who entered active duty before September 8, 1980 (October 16, 1981 for officers):must have served at least 90 days of active military service, ONE day of which was during a period of war, AND the discharge must be “other than dishonorable”.

Veterans who entered active duty on or after September 8, 1980 (October 16, 1981 for officers):must have served at least 24 continuous months of active military service (or the period for which they were ordered to active duty if less than 24 months), ONE day of which was during a period of war, AND must NOT have been dishonorably discharged.

Most wartime veterans who satisfy these requirements will be eligible for the A&A Special Pension that provides up to:

Veteran Married to Veteran $2,903.00 per Month
Married Veteran $2,169.00 per Month
Single Veteran $1,830.00 per Month
Widowed Spouse $1,176.00 per Month

Note: These amounts apply only to 2018; benefits are adjusted each year based on increases in the cost of living.

Because of the A&A Special Pension, many veterans may be able to live out their lives in Medicaid or VA nursing homes. Instead, assisted living will be an affordable option.

If you want to learn if you or your loved one may qualify, contact accredited VA Attorney Frazier for a free telephone initial consultation at:

727-260-2581

After 5PM: 813-431-3193

A Case Study on Aid & Attendance

Case Study on Aid & Attendance a Veterans Benefits

Problem: Christian is a 72-year-old veteran of the U.S. Air Force, who served during the Vietnam War. Due to serious health problems, Christian now needs to live in an assisted living facility, which costs $3,500 per month. Christian meets all eligibility requirements for the VA Aid & Attendance program, but he only receives $2,000 per month in social security. Additionally, Christian has $20,000 in his checking account. Christian’s funds will not last long, because of the cost of the assisted living facility.

Case Study on Aid & Attendance Solution: Because of his military service, his medical condition, and his low asset level, Christian is eligible for VA Aid & Attendance. The maximum 2009 pension rate for Christian is $1,644 per month. The $3,700 monthly cost of the ALF effectively nullifies his income as an unreimbursed medical expense under the VA rules. Accordingly, Christian will receive an additional $1,644 per month from the VA.

Case Study on Aid & Attendance Result: Because of Christian’s eligibility for Aid & Attendance, the out of pocket expense for the ALF is now only $54 per month as calculated $2,000 x $1644 = $3554 – $3,500 = $44.

Veterans who served in the U.S. Armed Forces during specific periods of war–including wars in Afghanistan and Iraq–qualify for a little-known special care pension called Aid and Attendance (A&A). This pension is also available to widows and widowers of wartime veterans. Applying for the pension can be tricky, considering that so few care administrators nationwide are aware that A&A even exists.

This benefit provided by the Veteran’s Administration (VA) is the “Improved Pension Disability Pension with Aid and Attendance entitlement” is often called just the Aid and Attendance VA Benefit.

The VA Aid & Attendance program is designed to provide monetary assistance to those veterans who served our country during a time of war and are now in need of aid or assistance with activities of daily living. This aid or assistance can be provided at home, in an assisted living facility, or a nursing home and can be provided by friends, family, or healthcare professionals. As a practical matter, Aid & Attendance is often of most help to residents of Assisted Living Facilities.

If you are a veteran and need help with such daily activities as cooking, cleaning, dressing, driving, mobility, or other assistance, this benefit may provide the funds you need to pay for help.

Please contact Attorney Frazier who is an experienced Florida Aid and Attendance lawyer today for your free telephone initial consultation at:

Office: 727-260-2581

After 5PM: 813-431-3193