Will the VA pay for a nursing home?

A fellow caregiver asked...

My 83 year old father is a veteran and will soon need nursing home care due to dementia. My mother is still healthy. They have little money and no savings. They live in a house that I own. My father gets a veterans pension check, social security check and a retirement pension check. Will the VA pay for a nursing home for him? If not and Medicaid pays, will they take his SS check and VA pension check, leaving my mother very little to live on?

Expert Answer

It is possible that the Department of Veterans Affairs (VA) may provide nursing home care for your father. Anyone who served on active duty in the military may be eligible for at least some VA benefits, and the VA maintains its own nursing homes around the country. The problem is that space in VA nursing homes is very limited, so there is a complicated priority system that determines who gets a place in one of the homes. The system divides veterans into different groups, depending on the level and origin -- whether it's service-connected -- of any disability, and their income. Veterans with severe service-connected disabilities get first priority; veterans with less severe service-connected disabilities. But evenh if your father does not have a service-connected disability, he might find a place in a VA nursing home if the waiting list in your region of the country is not too long.

The first step in finding out how your father would be rated by the VA and whether he would be eligible for VA nursing home care is to help him enroll with the VA medical system. The VA will then decide what priority group he's in and whether nursing home care is available to him. You can help him apply by obtaining an Application for Health Benefits form (VA Form 10-10EZ), available online. Or you can call the VA toll-free at 877-222-8387 and ask for a form to be mailed. To learn more about eligibility for veterans nursing home care, visit the health care pages on the VA website[va.gov].

If your father isn't eligible for a VA nursing home, or if there is no VA nursing home spot available for him, he can apply for Medicaid coverage of nursing home care. Whether he's eligible for Medicaid nursing home coverage depends on his income and assets. It sounds like he might be able to qualify only if he spends a certain amount of his monthly income to pay for his own nursing home care, with Medicaid paying the rest. If so, Medicaid has special rules that would allow your mother -- known in Medicaid lingo as the "community spouse" (because she continues to live in the "community") to keep some of your father's income, in addition to any income she receives in her own name (such as Social Security retirement or dependents benefits). If your father qualifies for Medicaid coverage of nursing home care by paying some of his own monthly income, these Medicaid rules would permit your mother to keep a "maintenance needs allowance" of between $1,821 and $2,739 per month, which would include both her own income and enough money from your father's income to reach that total. The exact amount of this allowance depends on the state where you live.