Can I Receive VA Aid & Attendance and Medicaid at the Same Time?
Yes you can, so long as you are not an unmarried Medicaid recipient residing in a skilled level care nursing home. You could be a married Medicaid recipient who is residing in a nursing home and still receive A&A, or you could be single or married and receiving Medicaid through a “waiver” program such as Home and Community Based Services (HCBS). HCBS can be delivered through at-home programs or through an assisted living facility that accepts state Medicaid reimbursements.
Do not assume just because an assisted living facility is Medicaid-approved they will accept you as a Medicaid patient even after you have been approved for Medicaid. Most assisted living facilities have a “private pay” or “spend down” requirement of one to three years. Meaning you must private pay for a number of months before they will accept the Medicaid rate of reimbursement. Clearly the state rate of reimbursement for assisted living is much lower than the private pay rate, thus the requirement. If you anticipate the possibility of running out of funds while residing at a Medicaid-approved assisted living facility, ask about the “spend down” or “private pay” requirement before you enter the facility.
You should apply for A&A before you apply for Medicaid. You must disclose on an A&A application if you have applied for Medicaid. A&A is less likely to be quickly awarded if the VA believes you may receive Medicaid. If Medicaid is awarded after the VA award, you must inform the VA about your Medicaid award. However, the VA will not stop A&A payments until you are an unmarried Medicaid recipient residing in a skilled level care nursing home.
Significant financial oversight must be exercised when receiving both Medicaid and A&A. If a Medicaid recipient were to save the A&A benefit and thus allow their resources to exceed $2,000 in any one month after all bills are paid, they would lose their Medicaid benefit. If they gave the money away that gift would be a recognized as a transfer and subject to the same consequences. Therefore, the Medicaid recipient must spend their A&A award for their own benefit in the month in which they receive it.
This article is based on Colorado law which follows federal statutes. Most states follow federal statutes. You can access the following information through the Colorado Secretary of State’s website.
Department of Veterans Affairs (VA) Payments:
The portion of the pension payments for Aid and Attendance (A&A) and unreimbursed medical expenses (UME), as determined by the VA, shall not be considered as income when determining eligibility.
- The portion of the pension payments for A&A and UME, as determined by the VA, shall not be used as patient payment to the medical facility
a. for a veteran or surviving spouse of a veteran in a medical facility other than State Veterans Home; or
- for a veteran or surviving spouse of a veteran in a State Veterans Home with dependents
- For a veteran or surviving spouse of a veteran in a State Veterans Home with no dependents the portion of the pension payments for A&A and UME, as determined by the VA, shall be used as patient payment to the medical facility.
Consideration of Income When Qualifying for VA Benefits
Unearned income is the gross amount received in cash or kind that is not earned from employment or self-employment.
Unearned income includes, but is not limited to, the following:
- Pensions and other period payments, such as:
vi) Veterans benefits other than A&A and UME.
Consideration of Resources When Qualifying for VA Benefits
Resources are counted in determining eligibility for the Aged, Blind and Disabled,
and Long-Term Care institutionalized and Home and Community Based Services categories of Medical Assistance.
Income Requirements to Receive Monthly VA Aid and Attendance Benefits
Earned income is countable as income in the month received and a countable resource the following month.