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NEVADA STATE DIVISION OF SOCIAL SERVICES VETERAN ADMINISTRATION (VA) UNUSUAL MEDICAL EXPENSE (UME) BUDGET — 2024 A. $ ______________ Maximum VA Annual Rate (from award letter) (–) B. $ ______________ Gross Annual Income (use reported income from VA award letter) C. $ ______________ Countable Annual VA Benefits If the amount in "C" is zero or a negative figure, stop here: the entire VA "payment" to the customer is UME and must be excluded in both financial eligibility and patient liability. If the amount in "C" is greater than zero, a portion of the VA payment is countable income. Divide amount in "C" by 12 to reach the monthly countable VA benefit. D. $ ______________ Countable Monthly VA Payment If the amount in "D" is less than the maximum Aid and Attendance (A&A) or House Bound (HB) benefit rate, stop here: this figure must be excluded in both financial eligibility and patient liability (PL). If the amount in "D" is greater than the maximum A&A or HB benefit rate, this figure includes a Base Pension which must be counted in both financial eligibility and patient liability. Proceed as follows: E. $ ______________ Monthly Countable VA Income (amount in "D" above) (–) F. $ ______________ Maximum A&A if HB Rate (excluded in financial eligibility and PL) G. $ ______________ Base Pension (counted in financial & PL) VA AMOUNTS FOR 2024: Maximum VA Annual Rate for A&A Veteran with a spouse = $32,729.00 ($1,806.16 Base + $921.25 A&A x 12) Maximum VA Annual Rate for A&A Veteran = $27,609.00 ($1,379.25 Base + $921.50 A&A x 12) Maximum VA Annual Rate for HB Veteran with a spouse = $25,348.00 ($1,806.16 Base + $306.16 HB x 12) Maximum VA Annual Rate for HB Veteran = $20,226.00 ($1,379.25 Base + $306.25 HB x 12) Maximum VA Annual Rate for A&A Widow = $17,743.00 ($925.16 Base + $553.42 A&A x 12) Maximum VA Annual Rate for HB Widow = $13,568.00 ($925.16 Base + $205.50 HB x 12) APPENDIX F MAABD BUDGETS Division of Social Services Medical Assistance Manual 08 Aug MTL 08/25 VETERAN ADMINISTRATION (VA) UNUSUAL MEDICAL EXPENSE (UME) BUDGET