How to Apply for VA Long Term Health Benefits

As discussed in Part I of Practically Unheard of Home Health Care Benefits, this is a continuation of the complex process of claiming your benefits. Obviously, until you have an understanding of the actual application process, you should not attempt making an application -- if you expect to be successful in navigating this complex system.

By carefully studying and understanding the decision process, you can shorten the waiting period for your award and eliminate the worry about being denied. In Part I, we discussed:

• Do You Qualify?
• Dates of Eligibility
• Income Means Terminology
• Exclusions and Deductions to Income
• VA's Calculation Formula
• Maximum Adjusted Pension Rate
• Additional Criteria for Approval
• Special Long Term Care Cases
• Proper Documentation
• What Needs to Be Done Prior to the Application
• Know What Assets May Disqualify
• The Rating System

Now, here is the rest of the facts you need to know:

Applying for Aid and Attendance and Housebound benefits can be a time consuming and complicated process. It is important, before filing a claim, how to:

• Understand the rating process;
• Have evidence of prospective, recurring medical expenses;
• Have in place, signed VA powers of attorney; and
• To have a full understanding of the actual application process.

Other things you need to know before sending your application in:

• Generally, Aid and Attendance and Housebound benefits are lesser known benefits than another program - Compensation. The Compensation Program is better known and widely used by veterans who were disabled during their time of service. The reason you need to know this, is that is that both programs are submitted on the same application.
• Not all veterans can get into the health care system because of funding limitations. Receiving VA medical care is now limited to income means-tested veterans and veterans with service-connected disabilities. However, this is a very generous means test, in terms of annual income and allowable medical deductions. Additionally, there are exceptions to the annual means test caps.
• Next, you need to understand where to make your application. First time applications are mailed to the regional office in the state in which the applicant lives. Some states have more than one regional office and you must determine the correct office for your application.
• Be aware that a "triage" team at your regional office looks over your application for accuracy and completeness. If you have left anything unsigned, unchecked, or blank -- the application will be sent back to you for resubmission.
• Be aware that if you do not include a copy of your discharge papers, this will add a couple of months to approval of your application.
• Additionally, even if you have successfully presented your papers, you must also have a proof of relationship, and proof of POA, or guardianship. (Having these included in the application will ensure a quicker approval time).
• The average time for processing a claim is 177 days or roughly six months. However, thoroughly researching what you need to do prior to making the application could cut this time frame down considerably.

Veteran with No Dependent $27,790 or less

Veteran with 1 Dependent $33,350 or less

Veteran with 2 Dependents $35,216 or less

Veteran with 3 Dependents $37,082 or less

Veteran with 4 Dependents $38,948 or less

Each additional Dependent $1,866

NOTE: This is income after allowed deductions have been calculated. Just because your income is above, does not mean that the copay will be significant, it is very low compared to civilian co-pays.

Disabled care recipients have two ratings:

• Housebound -- This is an additional benefit that is based on certain disabilities and conditions. The amount is usually less than a Aid and Attendance benefit.
• Aid and Attendance - This additional benefit is for services provided to the veteran (or veteran's spouse) and it is based on need.

Veteran Medical Center Fast Fact:

Despite some recent bad press about some aging Veterans Medical Facilities -- The VA is one of the best health care services in America , based on treatment outcome and patient satisfaction. Yes, it's an overburdened system, and it's not perfect -- but it is still a sound, efficient, and caring system once you are in it.

The non-licensed in-home attendant can be anyone receiving pay for providing services. Examples:

• Anyone hired by the family to live in the home to help with daily non-medical and medical aid;
• Family members providing these same services; and
• Friends providing these same services. 

A special provision for calculating pension income, allows household income to be reduced by 12 months worth of future, recurring medical expenses.

Normally, income is only reduced by medical expenses incurred in the month of application.

These allowable, annualized medical expenses are such things as insurance premiums, the cost of home care, the cost of paying any person to provide care, the cost of adult day care, the cost of assisted living and the cost of a nursing home facility.

In most cases, these expenses are only deductible if there is a rating.

This special provision can allow veteran households earning more than the annual MAPR to qualify for pension.

As an example, a veteran household earning $6,000 a month could still qualify for pension if the veteran is paying $4,500 to $6,000 a month for nursing home costs.

The applicant must submit appropriate evidence for a rating and for recurring costs in order to qualify for this special provision.

NOTE: The VA normally does not tell applicants about this special treatment of medical expenses or how to qualify for it.

Evidence of medical expenses is very important. The VA has certain rules and at all times the care provider must strictly adhere to them. You will also need to be able to supply an annual prediction of such expected expenses at the time of application.

Sometimes your situation dictates that you need expert help. Low income claims, 100% disabled, blind, etc. usually will not require the assistance of someone outside your family or yourself.

However, because the Veterans Pension application process is complex, others with higher income and complicated situations need to consult an expert in the field, especially if you are turned down and still feel that you are entitled to these benefits.

A word of caution though, there are lawyers and legal consultants that advertise heavily to provide these services. Many of them will have you believe that you absolutely need "outside" help or that you need to purchase a book, DVD, or other material to make your application. There is just way too much useful and informative information out there, both from the VA, other government agencies, online, and books -- to make purchasing information necessary. Don't pay for what you can do yourself!

Veteran for Free Prescriptions

No dependents $10,929 or less

1 dependent $14,313 or less

2 dependents $16,129 or less

3 dependents $18,045 or less

4 dependents $19,911 or less

Each additional dependent $1,866

NOTE: This is income after allowed deductions have been calculated. Just because your income is above, does not mean that the copay will be significant, it is very low compared to civilian co-pays.

The purpose of this hub and the previous one is to alert readers about certain veterans benefits and the ins and outs of obtaining them.

There are many fine websites and agencies you can contact for much more detailed information. It's not my intent to re-invent the wheel, just to expand knowledge about what's available to you and your loved ones if they are veterans.

The VA's own website, linked below is an excellent starting point, but be aware not everything you will need to know will be found on their link. Do your homework before you attempt to apply.