Overview of Veterans’ Benefits
- Non-Service Connected Pension
- Medical Care
- Geriatric Services
- Prescription Benefits
Overview of Veterans’ Benefits
A person who has served in the United States Armed Forces may be entitled to receive compensation from the Veterans’ Administration for service-connected disabilities that occurred or were aggravated during a period of military service. A veteran may also be entitled to receive a non-service connected pension. In addition, a veteran may be entitled to receive health care services from the Veterans Health Administration that is a branch of the Veterans’ Administration. This department is separate from the Veterans’ Benefits Administration. It is important to remember that a person is not automatically entitled to medical care because he or she is a veteran. The Veterans’ Health Administration’s medical care is primarily related to medical care for health problems that occurred as a result of military service. Also, a veteran must not have been dishonorably discharged in order to receive benefits.
Veterans’ compensation is based on an impairment of earning capability that is related to a service-connected disability. It is important to remember that the disability does not have to be related to combat. VA compensation and pension benefits cost of living allowance (COLA) is paid based on the Social Security Administration (SSA) COLA. The 2019 Veterans’ Administration compensation rate for a veteran who is not married with a 10 percent disability rat- ing is $$140.05 per month. The Veterans Administration compensation rate for a veteran who is not married with a 100 percent disability rating is $3,057.13 per month. A veteran may be eligible for an increased or a special monthly compensation that may be greater than these amounts if the veteran is in need of aid and attendance of another to care for him or her. The Veterans Administration may re-evaluate a service-connected condition. If the extent of the disability has increased or decreased, the percentage of disability may be changed.
Non-Service Connected Pension
A non-service connected pension is available each month to a permanent and totally dis- abled veteran and his or her spouse or dependent when the veteran is 65 years or older, honorably discharged after at least 90 days of active duty with one day being during a wartime and experiencing financial need. This benefit is also available to the surviving spouse of a deceased wartime veteran. There is no requirement that the veteran over age 65 prove that
his or his spouse is actually disabled. It is presumed that because the age of the veteran is over 65 that the veteran is disabled. A veteran who is younger than age 65 must demonstrate that he or she is permanently and totally disabled in order to receive this financial assistance. This disability for a person under age 65 must be an impairment that renders it impossible for the average person to follow a substantially gainful occupation. This impairment must be one that is reasonably certain to continue throughout life.
There are three types of monthly non-service connected pensions that are paid by the Veterans Administration to offset the cost of necessary health care. They are called Low Income Pension, Housebound Benefits and Aid and Attendance benefits. An extra benefit amount is if the claimant is “permanently housebound.” This is demonstrated by the person being substantially confined to his or her dwelling and that this condition will continue throughout his or her lifetime. More income is available to a person who is confined to assisted living due to medical reasons giving rise to an inability to perform at least two activities of daily living.
It is not necessary that the veteran have been in combat or even in the country where the war was fought to receive these benefits. In general, wartime is considered the period of World War I, World War II (December 7, 1941 – December 31, 1946), the Korean War (June 27, 1950-January 1, 1955), Vietnam War (August 5, 1964 – May 7, 1975), and the Gulf War (August 2, 1990 through a date to be set by law by Presidential Proclamation). However, anyone who enlists after September 7, 1980 generally has to have served at least 24 months or the full period for which a person was called or ordered to active duty in order to receive any benefits based on that period of service.
Once the disability and wartime service test is met, the veteran or his or her spouse must meet a three part means test qualification before receiving a VA pension. Two components of the means test are the veteran and his or her spouse’s gross income and net worth. The third aspect is determining the allowable deductions from gross income in order to compute income for VA purposes.
First, the payments to the potential claimant, his or her spouse, and dependent children from all sources are considered. This includes recurring income such as social security and pensions, as well as irregular income for the next twelve months. The unreimbursed medical expenses are then excluded from income. Unreimbursed medical expenses include but are not limited to Medicare Part B, Medigap premiums and Medicare Part D premiums and prescription drug payments as well as caregiver expenses or recurring assisted living expenses. The gross income less the unreimbursed medical expenses will determine the claimant’s Income for VA Purposes (IVAP). The goal is for the IVAP to be $0. This is because there is a reduction against the Monthly Maximum Pension Rate (the income limit) for every dollar of IVAP.
The veteran’s net worth is also a factor in determining eligibility for improved pension. The term net worth for VA purposes includes all property owned by the claimant and his or her spouse, except for a personal residence, personal effects and an automobile for personal use. Until October 18, 2018, assets exceeding $80,000 would normally be found to be sufficient for a person to be able to support himself or herself and the spouse. However, net worth below $80,000 could still be a bar depending on the veteran’s age. Countable assets for a couple of $40,000 and $20,000 for an individual are normally found to be reasonable. This test is subjective depending on the age of the applicant. Also, assets could be gifted by the applicant before applying for assistance. However, new rules that became effective October 18, 2018, changed all of this.
The Department of Veterans Affairs has issued new rule changes regarding the eligibility for a wartime veteran and his or her spouse’s non-service connected pension. To qualify the veteran must have 90 days or more of active duty, one day of which was during wartime. These new rules began October 18, 2018. The new rule provides that the claimant and his or her spouse cannot have countable assets in excess of $123,600 and his or her annual income. An exception is the claimant’s primary residence that does not exceed two acres unless the additional acreage is not marketable. It does not matter that the claimant does not reside in his or her primary residence or is renting the primary residence. However, the rental income will be counted for VA purposes. The new rules establish a 36 month look–back period. The transfer of a covered asset during the 36 month period will trigger a penalty period up to 5 years. In calculating the length of the penalty period, the value of the covered asset is divided by the annual pension rate for a veteran in need of aid and attendance with one dependent divided by 12. The penalty period begins on the first day of the month that follows the date of transfer. The penalty period can last up to five years. Fortunately, the new rule provides
that if some or all of the claimant’s covered assets are returned to the claimant before the date of the claim for VA assistance or within 60 days after the date of the disqualification notice, then VA will recalculate or eliminate the penalty period. In addition, the purchase of an annuity after October 18, 2018, within 36 months of the date of the application for VA assistance will give rise to this penalty period. Certain purchased annuities that can be liquidated are not considered a transfer that will be penalized.
Also, the pension benefit is reduced to $90 a month if the veteran is in a nursing home and being provided Medicaid services.
The Veterans Administration does provide health care services to veterans. These include hospital care at a Veterans Administration medical center and nursing home care at a Vet- erans Administration nursing center. However, a veteran is required to make a co-payment that is based on the inpatient Medicare deductible rate, which is adjusted annually. These co-payment rates are explained in Chapter 2 of this book. In order to receive these health care benefits, the veteran must be enrolled in the Veterans Administrations health care system. Nursing home care is not provided to all enrolled veterans. Nursing home care is only provided to veterans needing nursing home care for a service-related condition to veterans with a service-connected disability rating of 70 percent or more and veterans who have a service- connected disability of 60 percent and are unemployable. There are also state-run veteran nursing homes. The VA provides funds to states to help them build the homes and pays a portion of the costs for veterans eligible for VA health care. The states, however, set eligibility criteria for admission. A service-connected disability is a disability that the Veterans Administration has officially ruled was incurred or aggravated while on active duty in the military and in the line of duty. When the Veterans Administration rules that the illness or condition is directly related to active military service, a disability rating is assigned.
An enrolled veteran may also be entitled to receive certain geriatric services. He or she may receive either an inpatient or outpatient evaluation of a veteran’s ability to care for his or her therapeutic day care programs that provide medical and rehabilitation services; respite care; nursing, physical therapy, and other services provided in the veteran’s home and hospice and palliative care.
The Veteran Administration’s prescription benefit ensures that Veterans receive safe, effective, medically necessary medications that represent a good value. If a Veteran is being treated by a VA primary care provider, he or she will be provided all necessary medications for you treatment. Some out-patient Veterans may receive their VA medications free of charge based on their service-connected disabilities. While others, who do not have service-connected disabilities, are charged a copayment for each 30 day supply of medications VA provides. Prescription co-payments are charged only for outpatient treatment.
If a veteran decides to participate in the Medicare plan, his or her Veteran Administration prescription drug coverage will not be affected by the Medicare Prescription Drug Act. This is because the Veteran Administrations prescription drug coverage is considered creditable coverage. If a veteran dis-enrolls or loses his or her Veterans Administration Drug coverage, the veteran will generally have 62 days to sign up for a Medicare plan without being subject to a penalty.