Page 44
44
Rule 7.23: Treatment of VA Contract Patients in Nursing Facilities.
A. Certain veterans qualify for VA contract payments which cover nursing home care for one to six months; however, veterans with a service-connected disability may not be subject to the six-month limit.
B. Treatment of these individuals is as follows:
1. Eligibility for Medicaid benefits other than nursing home reimbursement can begin prior to the date a VA contract expires, depending on the date the application is filed and provided the individual is eligible on all other factors.
2. Reimbursement cannot begin until the date the VA contract expires.
3. The VA money paid to the nursing home is not counted as income to the Medicaid applicant.
a) Although a VA contract payment is a third party medical payment, it is not a payment subject to recovery by Medicaid.
Source: Social Security Act §1902 (r)(2); 42 CFR § 435.601(b) (Rev 1994).
Rule 7.24: Reduced VA Pension for Veterans and Surviving Spouses in Nursing Homes.
A. Federal law limits the maximum pension that can be paid to or for veterans, who have neither a spouse nor a child, or surviving spouses (widows or widowers) without children who are covered by Medicaid for services furnished by a nursing facility to a maximum of $90.
1. The reduced pension of $90 or less is VA Aid and Attendance in all cases, and is not income for eligibility purposes.
2. Federal law also prohibits counting the reduced pension toward the veteran’s cost of care (Medicaid Income); therefore, the Personal Needs Allowance (PNA) for all clients receiving a reduced pension is equal to the pension payment received to ensure that no part of the reduced pension is counted as income.
3. When a client who is eligible for long term care nursing home coverage under an Income Trust becomes entitled to the $90 reduced pension and the client continues to need the Income Trust to remain eligible, the $90 reduced pension is not counted as income to the Income Trust client.
Source: Social Security Act §1902 (r)(2); 42 CFR § 435.601(b) (Rev 1994); Miss. Code Ann. §43-13-121.1 (Rev. 2005).
Rule 7.25: Treatment of VA Benefits Allocated to Spouse Receiving IBON.