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My My father came to live with me in Florida August of 2022 because he needed assistance with his ADL. He was diagnosed with parkinson's disease and dementia. I was overwhelmed and needed help and found out about the v.A.In attendance and applied back in october 2023.
He collapsed in February of 2024 And entered a rehab facility and applied for medicaid. He received Long-term Medicaid on April 30th. They back paid for his time there.
He received his first payment for his V. A aid in attendance on May 1st. The plan was to move him to an assisted living facility which I have been in search of Since he received his First payment of veterans benefits. The problem I'm encountering is that most of them want to place him in their memory care, which is outside of his budget.
Also my My father tells all the assistant living reps Who come to assess him to assess him that he is now happy and adjusted where he is and doesn't want to move.
I spoke to a Florida medicaid lawyer, and they suggested I created a pooled trust fund for his veterans benefits and lump sum payment to go into and it will satisfy florida medicaid requirements.
But he stated they are unfamiliar with veterans affairs rules. Will the VA allow a pooled trust fund for my father?
The sad thing is if he wasn't receiving these v. A benefits he would be allowed to stay in the nursing home due to hislow income and medicaid. This program we thought was going to be such a blessing is turning into
a curse

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Loni, you need to read up on A&A. Its a pension for Vets who have served during Wartime only. Spouses can receive it too. Its based on income and health needs. The money is directly deposited into the Vets banking to be used as he/her sees fit. It can go towards the cost of an aide, Assisted living or medications. Becsuse Medicaid and A&A are government programs you can't use both. So A&A drops because Medicaid pays more for care.
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Reply to JoAnn29
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You need a Certified Elder Care attorney who is familiar with Medicaid AND VA Aid and Attendance benefits. Once Medicaid kicks in, VA benefits cease and desist. Do not rely on a forum of internet people to do anything more than advise you to get an informed attorney! You can call your VA Officer to get answers directly too.
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Reply to lealonnie1
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Not understanding your aid and attendance. Usually that is what is paid to a person like yourself to care for him. It's not an income he gets from VA. If the facility accepts his VA Usually that means the facility has a contract with the VA. and I believe that's who pays his bill. If not then he would be under just medicaid/medi-cal. Not sure what Florida rules are however you can contact the ombudsman for that facility and they may be able to point you in the right direction. You may also contact medicaid just for information. Do not state you are calling for your dad unless he is sitting right there. As they will give you the sorry we can't give you any info.
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Reply to LoniG1
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lealonnie1 Aug 18, 2024
Aid and Attendance benefits were paid to my father, a wartime vet, for his need to live in Assisted Living requiring help with 2 or more ADLs daily. It was paid directly to him based on he and mom living there together, and then directly to mom as his widow once he passed away. So it was indeed an income he got directly from the VA. Had he needed medicaid, A&A wouldve been taken away.
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Have you looked into a Veterans Home we have several here in Oklahoma they are very nice.
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Reply to Soldier4Christ
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Tammy67: Retain a different attorney. You cannot double dip.
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Reply to Llamalover47
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I haven't applied for the VA benefits for my mom for the same reason. She may intitled to my fathers benefits but that would put her over the minimum income limit. A social worker at the hospital was trying to tell me that was not true, but I know it is.
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JoAnn29 Jul 12, 2024
You call Medicaid to see if thats true. I think they are very aware that A&A will be dropped once Medicaid is involved. In the meantime, Mom has extra money for her care.
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LSS You don’t. Both JoAnn and ITRR are spot on as to why. Joann is especially accurate to the that atty is wrong! And although seems a butt rash now - over time it’s good he has had VA A&A.

Hang with me on this as it’s not straightforward, A&A best used as
1. extra $ to stretch out a spend down for those in a NH with too much assets to qualify for LTC Medicaid. Like they get 2K in SSA mo income + have 40K in savings & in a 9,300 mo NH so the VA $2300 enables a single vet to stay in a private pay bed for 3-5 months longer. The # of LTC Medicaid beds tend to be limited in a NH so coming in private pay gives oodles more options.
2. to pay for AL as AL is much less than a Nh. Often their SS income + the A&A comes to or is close to their monthly AL bill.
3. to pay for in home caregivers.
It will never pay for NH costs as they are well over A&A $ even if elder got the max SS retirement income or VA pension. They would stop A&A so LTC Medicaid could step in BUT bc they were on A&A they get a mo stipend of $90 a month that is all theirs.

The frustrating part of VA A&A is that it does the approval glacially, so often by the time it comes through, the elder is way past the whole idea of being OK to be home or in AL or even MC…. well that ship has sailed.
Your Dad needs to be in and stay in this NH because for most States it is ONLY being in an SNF that LTC Medicaid will cover costs in full. Most MC run on the AL system but with a locked & monitored ward, it’s not full on skilled nursing care.

And also frustrating is as VA moves glacially, it does a huge retro payment of the benefits. So someone like your dad appears - often months later - to have all these a$$ets from the retro VA $ payment which seems to make them ineligible for LTC Medicaid as LTC tends to have nonexempt assets at $2,000 for most States. But that retro $ is illusionary, because VA will do a clawback of all the months paid to him while he was also having his costs paid by LTC Medicaid. No double dipping. $ clawed back.

This is mucho importante bc if he or you were to spend the $ or put it into something irrevocable, it will jeapordize his LTC Medicaid eligibility. NAL but that pooled trust idea will not work, as VA will want the $ back. The $ is usually best off by sitting in the account it was direct deposited into and wait till VA does its clawback. Someone in billing at the NH or its parent company will be familiar with this.

Medicaid totally will pay 100% of your dad’s custodial care costs in the NH (if Nh has a bed available) as long as he is medically and financially “at need”. Again, For most States, it will NOT pay for AL or MC. You get him moved to a lower level of care, it will be a beast to get him back into a SNF short of his taking a super bad fall then being hospitalized and then being discharged for rehab more than likely into in new and different SNF.

For LTC Medicaid, they require a copay or Share of Cost paid to the NH. If dad isn’t yet doing this, it will happen and back to the date of his LTC application. For example, if a mom who gets $2345 a mo SS in TX is in a NH but had been on A&A prior, will be required to do a SOC of $2270 to the NH every month. She gets to keep a mere $75 a month as her TX personal needs allowance. The VA A&A excluded from counting as its going to be clawed back. But bc this mom was on A&A, the VA pays her a stipend of $90 a month which she gets to keep & not part of her required SOC. So this mom has $165 a mo to pay for her on site beauty shoppe, clothing and toiletries replacement, whatever she might want to have. $165 in fun $. Now I know that sounds pitiful, it’s not as many States have the PNA at $40.

You as dads POA do need to make sure his bank account stays under the 2K asset limit (or whatever your State has for asset max). & again till VA figures out the $ is to be clawedback, it stays there but you basically ignore it.
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Reply to igloo572
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Your lawyer is wrong. You cannot have both Aid and Attendence and Medicaid. Since Medicaid is the higher pay, thats what he will need to go with. The A & A will stop. As said he will get a small amount for his Personal Needs* You need to talk to a VA representative. I would not spend any of the A&A he has received so far. It may have to be paid back.

*PNA acct is set up for the small amount of SS taken out for personal needs. My State $50 a month. Not sure if you can get both what SS allows and A&A. A question to ask. Be aware that there is an asset cap, my state $2000, and that PNA is part of that $2000 and can take you over so it needs to be spent.
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Reply to JoAnn29
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You CAN NOT double dip. Get rid of the VA benefits and keep him where he is.

I believe he will get to keep about 100.00 from the VA benefits for personal needs but, that will be all.

Contact his social worker and get this taken care of quickly or he may have to pay one or the other back whatever they have paid for his care/needs.
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