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MaineCare and the VA Aid & Attendance Program
If you qualify for Aid and Attendance, you should consider how the Aid and Attendance funds are viewed in by Medicaid in Maine (MaineCare). The website for the Stateof Maine is http://www.maine.gov. First, it is important to understand what you have been award. A veteran or surviving spouse may not be qualified for any pension under the VA rules until they meet the medical and financial criteria for Aid and Attendance. However, once they meet the criteria, the award they are granted is comprised of Basic Pension (Maximum Annual Pension Rate (MAPR)) and Aid and Attendance. This is important because Basic Pension is taxable and counts against you for MaineCare - while the Aid and Attendance portion does not, unless you are in a nursing home on Medicaid (see below). Follow this link to the A&A Table on this website or check the figures on www.VA.gov.
MaineCare and the VA’s Aid and Attendance Pension: Under State of Maine Regulation 10-144, Chapter 332
3430.06PORTIONS OF EARNED AND UNEARNED INCOME
V.VA benefits have special treatment.
A.Excluded as income is that portion of a VAbenefit (Pension or Compensation) which is paid to disabled veterans, their spouses, widows or parents as an Aid and Attendance, Housebound Allowance or payments resulting from Unusual Medical Expenses.
There are two exceptions to this rule:
1.Benefits in excess of $90 per month are counted in determining the cost of care for a resident of a State Veteran’s Nursing Home if the resident is a veteran with no dependents or surviving spouse with no dependants.
2.There is no exclusion of benefits when determining the cost of care in a Residential Care Facility, Cost Reimbursed Boarding Home or Adult Family Care Home or State Funded Assisted Living Facility.
We were unable to locate a meaningful discussion on the treatment of funds from Aid and Attendance which were not spent in the month of receipt. However, the following section on Lump Sum payments would seem to indicate that the State of Maine does NOT have an exclusion for assets from Aid and Attendance:
3330.12LUMP SUM PAYMENTS Income that has accumulated and is received in one payment by the individual is considered a lump sum. This includes Workers’ Compensation, Retroactive Social Security payments, Unemployment Benefits received retroactively due to the result of a hearing, and Veteran's Benefits. Gifts, inheritances, lottery winnings and insurance settlements are also considered to be a lump sum payment. SSI is excluded income.
Lump sum payments are counted as income in the month received, and any remaining the next month are counted as an asset, except for SSI or Social Security retroactive payments which are excluded as an asset for 6 months. After that, any portion remaining becomes a countable asset.
Interesting Maine Regulation:
1240ASSIGNMENT OF RIGHTS TO MEDICAL PAYMENTS (REFERRAL TO TPL)
I.Who must comply:
A.As a condition of eligibility, certain individuals must assign to the Department of Human Services their rights to payment for medical care from any third party and cooperate in obtaining these medical payments. This is done by a referral to Third Party Liability (TPL).
….. An individual who does not comply with this requirement is not eligible for Medicaid. In (1) above it is the parent or other specified relative applying on behalf of the child under age 18 who is not eligible, not the child. ...... 1241 cont.
II.What is required:
The individual must:
A.Assign rights to payment for medical care;
B.cooperate with the Third Party Liability Unit in obtaining medical payments; or
C.relinquish medical payments received directly from a third party resource which were intended to cover services paid by Medicaid.
D.An individual may not be denied or terminated if the individual refuses to assign to the Department of Human Services any rights to Veteran's Aid and Attendance Benefits. Aid and Attendance Benefits are provided by the Veteran's Administration to assist individuals in payment of increased medical services.
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if you need assistance scheduling your phone appointment
Call 508 485-0039 Or 833 VA AWARD
Elder Resource Benefits Consulting 365 Boston Post Road #390 Sudbury, Ma 01776
For representation before the VA, ERBC refers to Servaes Consulting Group, LLC so you can be assisted by a VA Accredited Agent.
Neither Elder Resource Benefits Consulting nor the Servaes Consulting Group, LLC is affiliated with the Department of Veterans Affairs or any other government agency. Elder Resource Benefits Consulting and the Servaes Consulting Group, LLC are not Veterans Services Organizations.