My Mom is on Medicaid in a nursing home. The $90 VA benefit might increase her bank account enough that it could cause her to exceed her $2000 Medicaid asset limit. (Her bank account is quite a bit lower than that due to life insurance value.) She gets to keep $60 of income due to state Medicaid law and uses that or a little more than that for personal care, but if she had more she could have a phone and maybe use the beauty shop more often. But I can't let the $90 VA benefit impact her Medicaid eligibility.
However as Medicaids LTC program usually does NOT cover AL, being able to get VA A&A is really good as between the VA A&A $$ and whatever retirement income they get, it can make paying the 3k-4K a mo for AL more affordable & for longer period of time.
But when they go into LTC at a NH, it’s better to drop VA A&A and instead go totally onto Medicaid as Medicaid pays all room & board costs which can run 5k-12/15k a mo. So between Medicare and Medicaid everything covered in theory. If their having to do a spend-down before NH Medicaid eligible, A&A is good to add into the $ for spend down phase till they get down to the 2k impoverishment required for LTC Medicaid.
It’s instead a $90mo “Allowance”. The VA version allowance of the Medicaid $60 for TX personal care allowance. It is not income for the month received. Just like the $ 60 PNA is not Income for the month received. It is an allowance. It does NOT get included in the copay or SOC (share of cost) required to be paid to the NH.
HOWEVER, the month after both the VA $90 and the Medicaid PNA $60 are received, it becomes an asset. Remember Asset maximum is 2k. So you cannot just let the $150 a mo build up in mom’s checking account or the NH trust fund (if you as dpoa went that route and let NH become payee, you don’t have to, I didn’t for my mom but had the trust account with like $150-$200 for incidentals). BUT You have to make sure that each & every month her assets are under 2k.
Why? Well TX has an annual recertification for LTC Medicaid. I had no idea and was totally unprepared with all paperwork packed away, that was a fun weekend.... Anyways the first recertification letter and questionnaire came a year after the month before my mom was approved. And questionnaire required 4 last months of bank statements and balance of any NH trust fund account. If any of those 4 months had shown her to be over 2k, it can turn into eligibility issue for Medicaid. So you have to spend her $150 in some way. For us, it was a beauty shoppe appointment with payment deducted from the NH trust fund account. I let the rest of the $ build in her checking account as I lived out of state so would instead do a bigger spend at Target, HEB every 3 months or so instead.
Often the NH charge for cable and the amount is magically $60!!!, so the entire Medicaid PNA stays at the NH unless you opt out of cable in writing to the NH. Your lucky as your mom has an extra $90 to spend. She can use it for anything for herself, so a life insurance payment is ok, buying a pair of those ugly but beloved by grannies SAS shoes is ok; but buy buying a graduation gift for grandkids is not.
- For a non-SSI Medicaid recipient in an institutional living arrangement who has a VA pension capped at $90 per month, the total PNA may be up to $150 ($90 VA plus up to $60 PNA).
- The Texas Medicaid Regulations are silent on the impact A&A benefits have on countable resources and therefore appear to be included in the total resource (asset) limitation
I am pretty sure that this would be a double dip and could cause some problems. If you are the POA and are the one applying can't you ask the VA and your Medicaid contact? This would ensure you know their rules for your area.