En español | The crushing cost of long-term care in a nursing home or assisted living facility, or for a caregiver within your own home, can quickly deplete your retirement savings. But many veterans are eligible for a valuable benefit, Aid and Attendance, that can help offset those costs for life. The application process for the Department of Veterans Affairs’ (VA) benefit program can be long and complicated, but you could receive as much as $2,200 per month to help pay for care if you're eligible.
Beth Agnello's dad, Les, served in the Navy during World War II, attended college on the GI Bill, and then spent more than 40 years teaching physics and physical education in Richmond, California. He and his wife, Gene, moved to a retirement community when they were in their mid-80s.
Les started showing signs of cognitive impairment, and after Gene had a stroke in April 2010 they both needed extra help and moved to an assisted living facility. Suddenly, their living expenses exploded — topping $4,000 per month. The facility's director knew that Les was a WWII veteran and told Beth that he was likely to qualify for the VA's Aid and Attendance benefit to help cover the cost of care.
Beth went to a local Veterans Service Organization (VSO) office for help — VSOs are organizations that assist veterans with VA claims — and ended up working with an expert from the American Legion who knew how to navigate the complicated application process. Gene died in December 2010, but Les remained in assisted living. After mounds of forms and several long letters to and from the VA, Les started to receive Aid and Attendance benefits about six months later. It paid more than $1,600 per month for 10 years, until he died in February 2020 at age 98.
Between his teacher's pension and his Aid and Attendance benefits, he was able to cover the cost of care — first in California, then when he moved to a more expensive facility in North Carolina to be near Beth — without having to deplete his small nest egg. He had enough money left over that he could attend minor league baseball games of his beloved Winston-Salem Dash with her until the year before he died.
Many wartime veterans get older and need help with the activities of daily living, but are unaware of benefits they are eligible for or are intimidated by the time-consuming application process. “People just don't know that this benefit exists,” says Matthew Margolis, an estate planning and elder law attorney in Park Ridge, Illinois. He helps clients figure out if they're eligible for Aid and Attendance or other long-term care benefits.
The benefits can be incredibly valuable, providing a monthly payout for as long as the veteran (or surviving spouse) needs care. In 2020, veterans with one dependent (usually a spouse) who need care can receive up to $2,266 per month in Aid and Attendance benefits (which is more than $27,000 per year), or up to $1,911 per month without a dependent, depending on their income and cost of care. Surviving spouses of eligible veterans can receive up to $1,228 per month if they need care after the veteran dies. You can use the benefits in a nursing home, assisted living facility or for care in your own home if you meet the eligibility requirements and need help with activities of daily living.
Who qualifies for Aid and Attendance benefits?
To qualify for Aid and Attendance, the veteran must be at least 65 years old or have a permanent and total disability and meet the service, asset, income and medical requirements. The surviving spouse of an eligible veteran can also receive the benefit if he or she needs care.
Service requirement: The veteran must have had at least 90 consecutive days of service, with at least one day of active service during these times of war:
- WWII: Dec. 7, 1941, to Dec. 31, 1946
- Korean conflict: June 27, 1950, to Jan. 31, 1955
- Vietnam War era: Aug. 5, 1964, to May 7, 1975
- Gulf War: Aug. 2, 1990, until the present
For a list of full requirements go to the Eligibility for Veterans Pension page at VA.gov. The veteran doesn't need to have retired from the military but can't have a dishonorable discharge.
Asset requirements: The VA changed the asset calculation a few years ago to make it more simple to apply. In 2020, the veteran (and spouse, if married) must have less than $129,094 in assets, including bank accounts, investment accounts, IRAs, other retirement accounts, and the cash value of life insurance, excluding the veteran's home. This asset level is adjusted for the cost of living each December.
Income requirements: The income criteria is complicated. “Basically, they need to be in a situation where their monthly cost of care exceeds their monthly income,” says Margolis. See VA Pension Rates for Veterans for more information about the calculation.
Medical requirements: A doctor usually must certify that you need help with activities of daily living such as bathing, eating and getting dressed. Nursing home patients need to provide extra paperwork from the facility about the costs and type of care they receive.
How to get help with the application process
The application process can be daunting. “There is nothing about the process that is seamless,” says Beth, who has an MBA and is now a financial planner. “But help is out there; don't give up.”
Margolis says the time to complete the process can range from a month or two up to about seven to nine months. If benefits are approved, they can be paid out retroactively from the month after the VA received your application, he says.
The application plus supplemental forms can be more than 50 pages long, says Victoria Collier, an elder law attorney who is accredited with the VA and co-owner of Patriot Angels, which specializes in helping veterans with Aid and Attendance and other long-term care benefits (you can search for an accredited attorney and other representatives through the VA's Accreditation Search). Its clients start to receive benefits an average of 118 days after applying, says Collier. It charges $795 for its services.
You can find a VSO in your area that provides free assistance here, which is how Beth found the expert from the American Legion. Some estate planning attorneys also help people with Aid and Attendance benefits as part of their elder law services. A financial planner or geriatric care manager may also recommend a specialist who can help. Byron Cordes, a geriatric care manager in San Antonio, is helping people search for long-term care facilities and caregivers. He refers veterans who seem to meet the criteria to an elder law attorney who has expertise in these benefits. “In Texas, it can pay almost half of the nursing home costs,” he says.
Beware of salespeople who claim they'll help you qualify for Aid and Attendance benefits if you purchase high-commission products. The VA added a three-year lookback period in October 2018, so any money you give away or use to buy certain trusts or financial products within that time period can delay your eligibility for benefits.