NEW DEPARTMENT OF VETERANS AFFAIRS (VA) RULES FOR NEEDS-BASED BENEFITS

♠ Posted by Marc J. Soss in Aid and Attendance Benefits,new VA regulations 2018,VA Benefits,VA Look Back Benefits Period,VA Medical Care,Veteran Affairs Regulations

On October 18, 2018, over three (3) years after the Department of Veterans Affairs (“VA”) originally proposed them, new regulations to qualify for needs based benefits go into effect. The new regulations contain “net worth” limitations, look-back periods, penalties and definitions for those applying for benefits. The new regulations are a substantial change from current regulations which do not contain a prohibition on transferring assets prior to applying for benefits. Net Worth Limitations: An eligible applicant must have a net worth equal to or less than the prevailing maximum community spouse resource allowance (CSRA) for Medicaid ($123,600 in 2018). The term “net worth” amount includes both the applicant's assets and income and will increase annually at the same percentage as Social Security. The veteran's primary residence (even if the veteran lives in a nursing home) and the veteran's personal effects will not be considered assets under the new regulations. However, if the veteran's residence is sold, the proceeds will be considered assets unless a new residence is purchased within the same calendar year. Look-Back Period and Penalty: The regulations establish a thirty-six (36) month look-back period, beginning on the date on which the VA receives either an original or new pension claim after a period of non-entitlement, for the transfer of assets. The regulations include five (5) year penalty period for assets transferred at less than market value to qualify for a VA pension. There are exceptions for transfers made as the result of fraud, misrepresentation or to a trust for a child who is not able to support themselves. Deductible Medical Expense: The regulations define what the VA considers to be a deductible medical expense for all of its needs-based benefits. The definition includes: payments for items or services that are medically necessary; that improve a disabled individual's functioning; or that prevent, slow, or ease an individual's functional decline. This includes care by a health care provider, medications and medical equipment, adaptive equipment, transportation expenses, health insurance premiums, products to help quit smoking, and institutional forms of care.

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COMMON FLORIDA MEDICAID MYTHS - DON'T ALWAYS LISTEN TO YOUR FRIEND

♠ Posted by Marc J. Soss in 2017 retirement planning,2017 social security rates,Aid and Attendance Benefits,asset protection planning,estate planning,florida estate planning,Florida Guardianship Attorney,Medicaid eligibility

Medicaid is both a federal and state level program through which health care assistance is offered it’s to members. Each state administers their program differently than the next. Your Home in Florida: A Florida residents can own a personal residence (home) and still qualify for Medicaid. Medicare Covers Long-Term Nursing Care: The Florida Medicare program covers skilled nursing care, but only for a limited period of time following a three-day hospital stay. Medicare is only meant to help a person with activities of daily living, such as bathing, eating, and using the bathroom, and can’t be used to cover long-term health care expenses. Transfers Made Within five years of Applying Will Make You Ineligible: Medicaid will consider any uncompensated or below-market transfer (“transfers”) when the office reviews an application. Only certain transfers will be considered when determining whether a penalty period will apply. Medicaid benefits are not available during a penalty period. You Must Spend of All of Your Assets to Qualify: Florida does place a cap on the amount of gross income and assets a person can own and qualify for Medicaid. A person with too many assets or income is ineligible to receive Medicaid benefits. A single person applying for Medicaid benefits may only have $2,000 of countable assets. The other spouse may possess up to $120,900 of countable assets. There are also many exempt assets or noncountable assets that a person or couple may own, including a home. Florida’s Medicaid Rules are the Same as the Rules in Other States: Each state participates in Medicaid funding, it is a federal program, and has its rules on how these funds are administered. A person that lives in another state may not have to meet Florida’s requirements for Medicaid. Further, the rules can change on an annual basis.

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2016 CHANGES TO AID AND ATTENDANCE BENEFITS ELIGIBILITY

♠ Posted by Marc J. Soss in Aid and Attendance Benefits,Assisted Living,elder planning,Veteran assistance program,Veteran Benefits

Unknown to many veterans, the Veteran's Administration (VA) offers a pension benefit, known as “Aid and Attendance,” to low-income veterans (or their spouses) who are in nursing homes or who need help at home with everyday tasks (dressing, bathing, etc.).  In 2015, it could provide a wartime veteran with up to $21,466 a year ($1,788 per month) to cover care at home or in assisted living. A veterans surviving spouse was also eligible for Aid & Attendance benefits up to $14,353 per year ($1,196 per month). While the benefit is currently underused, new regulations have made it available to even fewer veterans. The new regulations specify asset limits for qualification and impose a look-back period and transfer penalties similar to Medicaid’s.

The regulations set an asset limit of $119,220 in 2016 (the same amount that a Medicaid applicant’s spouse may retain) for eligibility. This number will include both the applicant's assets and income and will be indexed to inflation in the same way that Social Security increases. The VA will not reduce the applicant’s assets by the amount of any mortgages or encumbrances on their primary residence or provide a hardship exception. Fortunately, an applicant's home (subject to a two acre lot size limit) will not count as an asset. The home exception will apply regardless of whether the applicant is residing in a nursing home, medical foster home, or an assisted living or similar residential facility that provides custodial care, or resides with a family member for custodial care. However, if the home is sold the sale proceeds will count as assets.

The regulations also establish a three-year look-back provision. This will adversely impact an applicant who has transferred assets within three (3) years of applying for benefits.  Those who violate the regulation can be subject to a ten (10) year penalty period (the penalty period will in months by dividing the amount transferred by the applicable maximum annual pension rate). An applicant can avoid the penalty if they can “present clear and convincing evidence that the transfer was not made in order to qualify for Aid and Attendance benefits.” Under the prior regulations, there was no penalty if an applicant divested themselves of assets before applying.

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