Nursing home Medicaid is a program funded by the federal government and administered by the Georgia Department of Community Health to provide nursing home care for those who have a medical need for such care. VA Pension is a program that provides monthly cash payments to veterans and their surviving spouses to pay for long term care in an assisted living, independent living, nursing home, or through at home care.
It can often be hard to determine which program to seek out. Nursing home Medicaid pays the entire amount of the nursing home bill over the applicant’s income. VA Pension only pays a specific amount of funds a month, but they can be used for a much broader range of long term care options. The examples below show some of the choices.
Example 1, High income, Low need for care.
Virginia is the widow of a World War II veteran. She needs assisted living, which runs $4,300 a month. Her current income is $3,200. If she receives VA benefits for surviving spouses, she would receive $1,159 a month. This would bring her total monthly income to $4,359 a month. Since her new income is above the cost of assisted living, she is better off paying for an assisted living of her choice.
Example 2 High Income, High needs.
Robert is a single veteran of the Korean War who needs nursing home care. His income before the VA pension is $5,000 a month, and the private pay rate at the nursing home is $5,500 a month. Robert could go on Medicaid to cover the nursing home expense. If he went on Medicaid, Medicaid would pay for Robert’s nursing home but require him to pay all but $50 of his monthly income as a patient cost share. Robert is better receiving the $1,788 a month from VA pension to pay for his nursing home. If Robert went on Medicaid, he would be left with only $50 a month, but if he went on VA Pension, he would be left with $1,288 a month.
Example 3: Low income, High needs.
Thomas is a veteran of the Vietnam War, and needs nursing home care that costs $5,500 a month. His monthly income is $1,200. If he were to receive the VA pension of $1,788, his income of $2,988 would still be less than what is needed for the nursing home costs. Thomas is better suited to go on Medicaid as Medicaid will pay for the full cost of care.
The decision of whether to apply for VA Pension or nursing home Medicaid is a complex fact driven process. Those making this choice should seek the advice of an experienced Georgia elder law attorney who can explain the benefits available under each option and the qualification requirements.