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Initial Budgeting Considerations: • Awards which are a combination of pension and Aid & Attendance must be verified by documentation from the VA of the breakdown of the payment. • Awards which are made up entirely of Aid & Attendance do not need additional verification of expenses. • Awards which have already been reduced to $90 (for example, a transfer to a new facility or from out of state) do not need verification of expenses.

Budgeting After Medicaid Approval: The reduced VA pension of $90 (sometimes referred to as “Veteran’s Personal Needs”) is the only amount of Veteran’s Pension which is completely exempt in the budget, including post- liability budgeting. No other amount should be included in this amount when it is entered into the eligibility system. • For institutionalized single veterans or widow/ers, or those asking for a voluntary reduction to $90, there may be months after Medicaid approval where the pension amount is not yet reduced. o Medicaid is always the payer of last resort, and any third-party (TPL) liability must be billed before Medicaid. o Aid & Attendance is a form of TPL which is paid to the member for the purposes of reimbursement of medical expenses. Medical expenses may make a person qualify for Aid & Attendance, or they may be paid for by Medicaid; but not both. o When the reduction is pending, any funds above $90 which are received should be offset by verified non-Medicaid covered medical expenses provided by the member and entered in the eligibility system as normal. o If there are any excess (above $90) funds which are not offset by non- Medicaid covered expenses, or proof of the medical expenses is not provided; then the funds are a contribution from a third party which is available for paying medical expenses. The excess should be included in the income as a contribution for any months where the member is not receiving a reduced pension. • This will properly include the TPL in the liability for a long-term care member, and will also protect the member from becoming over resources if there is a delay before the VA is able to change their award amount • For members who do not receive a reduced pension amount, and are covered by Medicaid, an updated breakdown of the pension/Aid & Attendance and any medical expenses upon which it was figured will continue to be required when continuing eligibility is to be determined or re-determined.