Veteran Caregivers and Spouses: Benefit Clarification

Q. My 76-year old father, Larry, served during the Vietnam War, and suffers from Parkinson’s Disease and Post Traumatic Stress Disorder (PTSD). My mother, Anne, is his caregiver. They live on Social Security checks and his pension, and I help them out whenever I can. In my opinion, there have to be more benefits that they can take advantage of, especially for an honorably-discharged retired veteran and his spouse. If I am correct about this, what are the VA benefits for veterans and their caregivers, and how do we take advantage of them? It seems so confusing, and I have heard so much conflicting information. Thanks for your help!

A. Currently, there are more than 25 million veterans who, such as your father, served our country during wartime and may be eligible for some form of veteran’s benefits. However, many veterans aren’t aware of, or taking advantage of, the benefits available to them and their spouses.

For most veterans and their caregivers, eligibility may be the key question, but there are several other areas of confusion and misinformation that could significantly impact the finances of people seeking to obtain Veterans benefits. Below is some clarification:

Medical Care is free for some: The VA operates the nation’s largest healthcare system, with more than 1700 hospitals and clinics, caring for more than 6.3 million veterans annually. Those who qualify based on household income and assets receive free care. Others use their VA benefits to supplement private health insurance and cover co-payments required with private policies.

Tricare for Life

TRICARE For Life (TFL) is health insurance coverage (arguably the best health insurance coverage available in the United States because you pay nothing out of pocket for services covered by both Medicare and TFL) for retired service members that, sadly, many retired service members and their widowed spouses are not aware of. TFL is a Medicare wraparound coverage for those who have Medicare Part A and Medicare Part B and are eligible for TRICARE. Coverage is available worldwide.

With TFL, participants have the freedom to seek care from any doctors — preferably ones who participate in Medicare — not just at military hospitals or clinics which have severely limited availability. In fact, you will have much greater out of pocket expenses with TFL if you get care from Veteran’s Administration providers (or providers who opt-out of Medicare), because they are not permitted to bill Medicare.

Enrollment is automatic so long as you pay Medicare Part B premiums. One of the reasons that so many eligible veterans are not aware of this benefit is because there is no enrollment process and there is no TFL wallet card. To use the coverage, you simply show the doctor your Medicare card and your military ID.

According to the TFL website:

● Your medical provider files your claims with Medicare.
● Medicare pays its portion and sends the claim to the TRICARE For Life claims processor.
● TRICARE For Life then pays the provider directly for TRICARE-covered services.

TFL meets the requirements for minimum essential coverage under the Affordable Care Act. What this means, in part, is that you do not need any supplemental health coverage if you have TFL. This includes the Federal Employee Health Benefit (FEHB) program if you happen to be a retired federal employee in addition to a military veteran. To suspend your FEHB coverage and use TRICARE For Life, simply call the Office of Personnel Management’s Retirement Information line at 1-888-767-6738 to get an FEHB suspension form.

With TFL, you don’t pay any extra fees — you must simply pay Medicare Part B monthly premiums. Your Part B premium is based on your income.

– For medical procedures covered by Medicare but not TFL (e.g. chiropractic services) you will be responsible for Medicare deductibles and cost shares.

– For medical procedures covered by TFL but not Medicare you are responsible for any TFL deductibles and cost shares.

– For medical procedures not covered by either TFL or Medicare (e.g. cosmetic surgery) you are responsible for the entire amount.

For more details about TFL and eligibility requirements, please visit the TRICARE website.

Mental Health Benefits

In recent years, mental health benefits for veterans have been expanded. While the system is not perfect, the VA does provide a significant healthcare benefit that should not be overlooked.

Veterans Aid & Attendance: One little-known element of the VA program is that when a veteran turns 65 they are considered 100% disabled in the eyes of the VA. This means that they could be eligible for Aid & Attendance (A & A) pension benefits if they have a health condition that requires the aid and assistance of another person to help the veteran with some of the veteran’s activities of daily living.

The full A & A benefit can provide more than $25,000 annually for an eligible married veteran, more than $21,000 annually for a single veteran, and almost $14,000 annually for the surviving spouse of a qualified veteran. See current figures here.

Eligibility criteria includes:

◾Those over 65 do not have to be disabled. However, the veteran or spouse must be in need of regular aid and attendance due to inability to dress oneself, feed oneself, loss of coordination or other conditions, as described on our website, and there must be actual ongoing caregiving services being received from someone else.

◾The veteran must have served on active duty for at least 90 days, at least one day of which occurred during a period designated as wartime (see our website for a listing of official periods of wartime).

◾There is an income requirement in order to obtain this benefit, but the Veterans Administration does not look at the veterans total income. Rather, the Veterans Administration looks at the veterans total income minus regularly occurring healthcare expenses, such as expenses for an in-home caregiver or the expense of an assisted living facility. More information about this income requirement can be found here.

◾The Veteran must have little or no countable assets in order to qualify for this benefit. This is where our asset protection services come into play. We can protect 100% of a veteran’s assets under the current law and apply for the Aid and Attendance benefits very quickly. However, this law is going to change in the near future, as the Veterans Administration has already issued proposed regulations that will impose a three-year a look-back period on transfers made in order to gain eligibility for this benefit, whereas right now there is no look-back period.  So if you are a wartime veteran or spouse of a wartime veteran who thinks you may be eligible for this benefit, the time to plan and apply, with our help, is now.

There must have been a non-dishonorable discharge as well.

If you would like to sign up to receive my Aid & Attendance 4-Part Mini Series via e-mail, please click here.

Burial Benefits for veterans are available for VA cemeteries and private cemeteries: The Veterans Administration offers a number of burial and memorial benefits to veterans who were honorably discharged, as follows:

◾National and State Cemetery Benefits: Eligible veterans can be buried in one of the 131 national or 93 state VA cemeteries at no cost to the family. This includes a gravesite; opening and closing of the grave; perpetual gravesite care; a government headstone or marker; a United States burial flag that can be used to drape the casket or accompany the urn (after the funeral service, the flag is given to the next-of-kin as a keepsake); and a Presidential memorial certificate, which is an engraved paper certificate signed by the current President expressing the country’s grateful recognition of the veteran’s service. National cemetery burial benefits are also available to spouses and dependents of veterans.

◾Private Cemetery Benefits: Benefits available include a free government headstone or marker, or a medallion that can be affixed to an existing privately purchased headstone or marker; a burial flag; and a Presidential memorial certificate. There are no benefits offered to spouses and dependents that are buried in private cemeteries.

◾Burial Allowances: In addition to the many burial benefits, some veterans may also qualify for a $747 burial and funeral expense allowance (if hospitalized by VA at time of death), or $300 (if not hospitalized by VA at time of death), and a $747 plot-interment allowance to those who choose to be buried in a private cemetery. To learn more about eligibility, see benefits.va.gov/benefits/factsheets/burials/burial.pdf.

Certain forms may need to be completed which are always better done in advance. For a complete rundown of burial and memorial benefits, eligibility details and required forms, visit www.cem.va.gov or call 800-827-1000.

Applying for Veteran’s Benefits

Applying for veteran’s benefits, such as Veteran’s Aid and Attendance, can be confusing and arduous. Here at the Farr Law Firm, we work with veterans and their spouses to evaluate whether they qualify for the Veterans Aid and Attendance Benefit and/or Medicaid, and we deal with all the paperwork. As an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Veterans Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs — and this interaction between the programs is of crucial importance because most veterans who start off needing Aid and Attendance will eventually need Medicaid, so all asset protection planning that is done to make a veteran eligible for Aid and Attendance must take future Medicaid benefits into account. Please call us at any time to make an appointment for a consultation:

Fairfax Veteran’s Planning: 703-691-1888
Fredericksburg Veteran’s Planning: 540-479-1435
Rockville Veteran’s Planning: 301-519-8041
DC Veteran’s Planning: 202-587-2797

P.S. Another benefit of being a veteran is a 10% discount off all services at the Farr Law Firm. We hope to see your family soon!