Learn How for Pay for Skilled Medical Care Expenses Without Going Broke

Yes, There Are Asset & Income Protection Strategies to Help You Pay for Skilled Care & Home Assistance Services and Then Qualify for Medicaid

Long Term Care and You: Ensuring Your Loved One Gets the Care They Deserve During Tough Economic Times

The decision to move a loved one into a long term care facility or assisted living residence or bringing an aide into the house to provide needed health care services and assistance is unsettling for many families. Life has changed or is changing for everyone involved and a fear of the unknown frightens everyone and becomes overwhelming.  Individuals play out numerous “what if’s” in their mind and start talking to friends, neighbors and others grasping for what to do before they make a decision. This is common and very understandable, I know.  I see hundreds of new families each year. A diagnosis of Alzheimer’s, Dementia, ALS, stroke, Parkinson’s, Huntington’s, and many diseases and conditions affect our loved ones as they get older. Many times, despite a wish to stay at home to be cared for, families find it is in the best interest of a loved one to place them in a secure daily assistance facility that can better care for them.

Choosing the proper care facility is also stressful. Many individuals and their families are not familiar with a nursing home or any type of professional care residence like assisted living. Individuals and their families know the importance of selecting a facility that can provide quality care, with a convenient location, that suits their finances but don’t know where to turn. What can they afford? How long before the care starts to eat away or destroys a lifetime of income and savings? Will the government help at all or will everything ($) be lost? Fortunately, Fredrick P. Niemann, a trusted and experienced Elder Law and Elder Care Medicaid Attorney with over 40 years of diverse legal experience, and his team at Hanlon Niemann & Wright are here to help.

TESTIMONIAL
I wanted to thank you, Mr. Niemann for all your help. You made everything very easy on me during a very difficult time. I know that the three grandchildren by Uncle Bill’s daughter were greatly appreciative of the amount they were sent as they were not expecting to receive anything. Your intervention really helped with that as well. Anyway, just wanted to let you all know that your work is appreciated.
– Carol Graham

TESTIMONIAL
Just wanted to take a minute to personally thank you for everything.  It’s been a long road but, you and your staff were a pleasure to deal with and made the Medicaid process seem less painful.

I could not have gone through it alone.  No one should attempt applying for Medicaid without an attorney.  The process definitely needs professional guidance to avoid problems that may arise.

I can’t  thank you enough,  not only for your expertise but, for your hand holding and patience with me during this difficult time.   Thank you.
Christine LaSpina, Red Bank, NJ

Benefits of Using an Elder Care Attorney to Qualify for NJ Medicaid Eligibility

Allow Me to Educate You On the Topic of Long-Term Care and Assist You in Choosing the Proper Facility for Your Loved One

When caring for someone who requires long term care, it is essential that you educate yourself on the topic of planning for eligibility to receive government benefit programs that can help pay for that care. Trust me, some basic knowledge of the subject can save you a lot of money and time.

Respectfully, you can and you must familiarize yourself with Medicaid, the Veteran’s Aid and Attendance Benefit, and other government financial assistance programs created to help you and your loved one. If eligible, these programs can help offset all or a significant portion of your medical bills and long term care costs. Allow me to teach you some of the legal solutions that exist to help you avoid emptying your bank account for the care of a loved one. Please call me today, Fredrick P. Niemann, Esq., an experienced NJ Elder Care, Medicaid Lawyer today, toll-free at (855) 376-5291 or email me at fniemann@hnlawfirm.com. I’m here as a resource to you and to answer your questions.

How to Pick the Right Assisted Living Residence or Nursing Home for Long Term Care

Paying for Long Term Care: What Are Your Options?

There are generally three ways in which to pay for the long-term care of a loved one:

  • Long Term Care Insurance – One popular option that most families fail (or are unable) to take advantage of is long-term care insurance that typically pays all or a portion of the daily rate for in-home and nursing home care of persons with debilitating cognitive and/or health conditions. The importance of acquiring long-term care insurance at an early age cannot be stressed enough. If you do not acquire insurance before being diagnosed with a debilitating illness, you will likely be out of luck when applying in the future as the insurance carriers typically will not insure anyone who has already been diagnosed with a disease or pre-existing condition. Like car insurance, rates go up based on your risk/claim experience, meaning if you wait to apply until an older age, you will likely be facing higher rates. 
  • Private Payment – Often a more common option for most individuals is to pay for care out of their own personal income and savings. Unfortunately, this can ruin you financially by depleting funds intended for retirement, such as your IRA, 401(k) investment accounts, and even from your savings account. Many less-wealthy families falsely believe they must use up all their own funds to pay for long term care. Fortunately, this isn’t the case, as many individuals with limited finances have alternative options, like NJ Medicaid.  Later on this page I’ll explain how we can help you, so read on.
  • New Jersey Medicaid – This government program is jointly funded by the State of New Jersey and the federal government. Medicaid is administered by the NJ Department of Health & Senior Services through the Country Board of Social Services. It was created, along with Medicare, to help seniors and disabled persons pay for long-term care. Often the best payment option for individuals with Alzheimer’s, Dementia and other serious and chronic conditions not covered by Medicare or Private health insurance is Medicaid. Medicaid can cover the cost of medical care, nursing home care, home based care and assistance, therapy and community services. The downside to Medicaid is its strict financial and medical eligibility requirements. However, if you pass these restrictions, you will see the many positives to this beneficial program.  Here at Hanlon Niemann & Wright it’s our mission to help you qualify for NJ Medicaid. That’s why I’ve written this site to help you know the ins and outs of Medicaid eligibility.  You do not have to go broke or go it alone!

What is the Difference Between Medicare vs. Medicaid?

Due to their similar sounding names and the fact that they are both government programs typically benefiting seniors and the disabled under the age of 65, Medicaid and Medicare are often confused. It is important to understand that each is its own distinct program and each has different qualification requirements.

Medicare is essentially public health insurance for individuals that are 65 or older, or younger than 65 but have a qualifying disability. Medicare becomes the primary health insurance coverage for these individuals. Medicare does NOT pay for long-term care. Many individuals often confuse Medicare and Medicaid for this reason. Confusion typically arises because Medicare pays for rehabilitation after an individual is hospitalized. This includes placement in a skilled nursing facility. However, Medicare places a 100 day limit on the period of time one can receive payment for rehabilitation. Most people are unaware that Medicare seldom approves 100 days of rehabilitation.  It is generally approved for a much shorter time period.  This cap may be further reduced depending on how successful your rehabilitation goes. For example, if you fail to make progress to a specified level of health for your condition, Medicare may cut funding, deeming your condition custodial and thus, not covered. With Medicare, there is also a deductible of around $120 a day after the first 20 days. Since Alzheimer’s and many other cognitive illnesses have no known cure, it is impossible to rehabilitate. Therefore, Medicare will NOT pay for the care of an individual with Alzheimer’s and other degenerative conditions and disease.

Medicaid, on the other hand, is designed to help individuals pay for long term care in a nursing facility, assisted living residence, and sometimes at-home. If you have no knowledge or experience with Medicaid, don’t worry. Most people are in the same boat. While Medicaid is funded by both the federal government and the state of New Jersey, it is administered solely at the state level through the County Board of Social Services. This means that rules will vary depending on what county you are in. Compliance with Medicaid qualifications is a necessity.  New Jersey has extremely strict requirements that must be followed if you wish to receive assistance. Since Medicare doesn’t provide coverage for Alzheimer’s and many other diseases affecting seniors, it is important that you consult an experienced NJ Elder Care attorney to make sure you follow these requirements. Otherwise, should you lack long term care insurance, you will be forced to pay for the care of your loved one out of his or her own pocket if they fail to qualify for NJ Medicaid.

Here is a brief breakdown of the two government-funded programs:

MEDICARE MEDICAID
Eligibility based on being age 65 or older or having a qualifying disability if younger than age 65 Eligibility based on strict income and resource limits
Federally administered uniform rules and regulations applicable in all 50 states Both Federal and Individual state laws, rules and regulations apply
Pays for up to 100 days of nursing home care for approved rehabilitation programs only Pays for long-term care at nursing homes, assisted living, and at-home services without regard to time limits
Pays for primary hospital care and related medically necessary treatment only Pays for medications, therapy, medical equipment, limited home care and much more

There Are Some Common Misconceptions About NJ Medicaid Paying for Alzheimer’s, Dementia and Other Chronic Diseases

Myth 1)  “I’ve been told I’m allowed to make gifts to my children, church, and/or favorite charity without a penalty as long as it’s ‘reasonable and less than $15,000 per year’.”

Myth 2) “I’ll put my children’s names on all my bank accounts and say the money is theirs. If that doesn’t work, I’ll just hide my assets.”

REALITY CHECK:

Both myths are wrong because the individual is seeking to give away or hide assets to qualify for Medicaid eligibility. First, the $15,000 that one is entitled to give away without penalty is an IRS rule that pertains to taxes only. It is completely irrelevant to Medicaid eligibility.  Medicaid does not recognize the tax code.  It is not subject to the IRS or the tax code.

Putting your kids’ names on your bank accounts has no effect on Medicaid eligibility. New Jersey follows what is called the “source of funds” rule. This rule states that ownership of the funds in your accounts is determined by who funds the account. Therefore, unless your kids earned the money in the account (provided the source of the funds), this money is not protected.

On a further note, as regards to gifting your assets outright to your children, this is not recommended. One of my golden rules for Medicaid has been (there are exceptions of course) “do not give to your son or daughter directly.” In addition to not always protecting the assets for Medicaid purposes, gifting outright to a child can have significant and adverse income and estate tax implications. For example, if a mother transfers her house to her daughter, this changes her property tax classification from owner-occupied to non-owner occupied. This may result in an increase in property taxes and could even eliminate certain exemptions (i.e., Freeze Act and Homestead Rebate). In addition, gifted assets do not receive a favorable step-up in cost basis (what you paid for the asset). This results in an unfavorable income and death tax consequence which otherwise could have been avoided.

The better solution is oftentimes creating and funding an Irrevocable Trust which I discuss at length later in this site.

Protecting Exempt Assets When Qualifying for Medicaid?

Protecting Assets and Income from Nursing Home and Long Term Care Expenses

Qualifying for Medicaid sometimes requires you to spend down your assets. Fortunately, NJ Medicaid laws allows certain assets to be exempt for qualification purposes, but many tricky rules apply.  The following items of property are NOT counted in the state’s eligibility determination, if structured correctly:

  • Your home, under limited and defined conditions, with a maximum equity of up to $750,000 (indexed annually for inflation), if you can show an “intent to return” to the home after your placement in the nursing home. Single applicants are at a severe disadvantage if they own a house.  Call me to learn the rules.  NJ has a tough standard for single individuals.
  • Personal belongings, such as household furniture and personal property.
  • One car or truck, (assuming you meet certain condition(s)).
  • Burial plot and some related items. This applies to the applicant, spouse, and immediate family members.
  • Pre-paid Funeral Contract, if it is irrevocable.
  • Up to $1500 in face value of life insurance. If face value is greater than $1,500, the cash value is countable as a resource for payment.
  • Rental Income Property (subject to limiting conditions).
  • Qualifying Medicaid Annuities (a/k/a SPIA).  This type of annuity is highly specialized and not available through most insurance companies but it is a critical measure to protect a lot of your hard earned $$$.
  • Certain tools and equipment used for profit a businesses (assuming the business generates incomes).

All Non-Exempt Assets Are Labeled as Countable Resources

If an asset is not exempt, it will be counted as a resource for Medicaid purposes and therefore must be spent down. This means New Jersey assumes the asset can be used to pay for long-term care costs. Countable resources are basically anything of value that is not exempt. This includes, but is not limited to:

  • Cash
  • Bank accounts
  • US savings Bonds
  • Credit Union accounts (CD’s)
  • 401(k)s, IRAs, and all other defined compensation plans
  • Pre-paid funeral contracts that can be revoked
  • Revocable Trusts (depending on terms/conditions) and sometimes Irrevocable Trusts
  • Real estate, (other than your primary residence) if married.  If not married, real estate is not exempt. 
  • Vacation homes and second homes
  • Any car or truck beyond your first vehicle
  • Stocks, Bonds, Mutual funds, and other investments
  • Land contracts or mortgages held on sold real estate
  • Commercial annuities
  • Boats

Single vs. Married: Different Situations When Applying for Medicaid

Single Individuals

Medicaid applicants who are single (widowed, divorced, never married) face a much harder road to becoming Medicaid eligible in New Jersey. The State has strict requirements for eligibility that forces many to spend down a significant portion of their assets to become eligible unless you know the secrets to protecting those assets.

Some single individuals seek to gift assets to trusted friends outside the family in an attempt to qualify for Medicaid. This typically occurs when the individual is diagnosed with Alzheimer’s, Parkinson’s, a stroke or another major illness and knows they will need long term care very soon. Unfortunately, federal law imposes a “look-back period” of five years from when a gift was made, extended from what used to be only three years. This means that when applying for Medicaid, New Jersey can look back at your finances up to five years prior to the date you apply. If you have gifted assets within this 5 year period, these gifts count against you for Medicaid eligibility purposes.

Some may think that no way will NJ look back at an asset given away three or four years ago but let me be clear: I guarantee they will. It is important to plan for your long term care and qualifying for Medicaid today. Nobody has a crystal ball that can see into the future. We don’t know what the future has in store for us. Who knows how long it will be before you or your loved one needs some sort of long term care? Planning today is the safest way to ensure eligibility for many individuals. We need to start the five year clock; the sooner the better, especially when diagnosed with an early on-set condition or he or she has lived to a significant age.

For those of you who are single, focusing on your income should be your priority. You must keep in mind income from all sources is to be considered by Medicaid. This includes social security, pensions, annuities, VA benefits, etc.

Single?  You Must Read This!

If your spouse or a parent(s) is single and in crisis, I can still save a significant amount of your assets ($$$) if you act immediately.  Yes, you read me correctly.  I can save your divorced or widowed parent, sibling, friend or the neighbor(s) down the street a significant amount of $$$ under many, not all but many circumstances.  Isn’t it worth a call or email to meet with me to see what can be done?

Here’s a Hypothetical Example of How We Can Protect Income and Savings

Suppose Jim is a widowed veteran, aged 76, receiving Social Security income of $1,300 and income from a pension of $1,100. While he has always been physically healthy, his Parkinson’s has become a big concern for the rest of his family. They decide collectively that it would be in his best interest to enter a long-term care facility so he can receive the 24 hour care he needs. The family finds a facility that seems ideal based on his needs and its location. The cost is $9,200 per month. He also has a pharmacy bill of around $300 per month. Jim has $400,000 in savings and investments. So how should he pay for his long-term care?

Jim’s total income is $2,400, taking into account the $1,300 from social security and $1,100 from his pension. He also receives benefits in the amount of $1,644 tax free dollars from his Veteran’s Aid and Attendance Benefit, a wartime veteran’s pension which we will discuss in detail. Adding this benefit to his income, the total is $4,044. Since his care and pharmaceutical costs are $9,500 together, he winds up $3,456 short. If we add this up every month, Jim is looking at $207,360 over five (5) years that he must pay out of his own savings. This figure does not include inflation or transition to a $13,000 per month nursing home. Now is a good time to start financial planning. The family understands where they stand. When the family consults with me, we can determine what assets are appropriate to gift to family members, what amount should be left “at risk”, and what other financial determinations that can be made.  Remember asset protection is possible even for single persons in crisis.

What About Married Couples?

Although single individuals typically face a tougher road when it comes to Medicaid eligibility, married couples also face eligibility problems and challenges. The problems are usually caused by a lack of knowledge about the Medicaid system and their right to avoid impoverishment. Unfortunately, when many individuals finally realize their error, it’s often too late.

Arguably the most common example is a misconception about what counts toward Medicaid’s eligibility.  Many people say something along the lines of, “My wife’s name isn’t on any of the bank accounts and most of the stocks and investments we have are in my name, so these assets are safe from Medicaid.” Or, since this is a second marriage, the assets I brought into the marriage are exempt from spend down. This is incorrect. New Jersey views all assets as jointly owned by married couples for purposes of eligibility. Therefore, it is irrelevant whose name is on what account or whether this is your second, thirds, or fifth marriage. All assets of both spouses are considered when determining the financial eligibility of either spouse and calculating his/her required spend down.

The Medicaid regulations treat a married couple as a single financial unit for the purpose of determining Medicaid eligibility. When a married Medicaid applicant requires long-term care, the Department of Human Services imposes a resource limit on both the assets of the applicant (spouse who needs long-term care in a facility) and the non-institutionalized spouse (the community spouse).

Definitions of Resources and Countable Resources

N.J.A.C. 10:71-4.8(a) states that: “The total countable resources of a couple shall include all resources owned by either member of the couple individually or jointly together.” Resources are defined as:

[A]ny real or personal property which is owned by the applicant (or by those persons whose resources are deemed available to him or her, as described in N.J.A.C. 10:71-4.6) and which could be converted to cash to be used for his or her support and maintenance. Both liquid and non-liquid resources shall be considered in the determination of eligibility, unless such resources are specifically excluded under the provisions of N.J.A.C. 16:71-4.4(b).

What Resources Owned by a Married Couple Are Exempt from Mandatory Spenddown

“A resource which is excludable is not considered in the determination of eligibility for participation in the Medicaid Program.” For example, a home owned by the applicant as his/her principal residence and continues to be used by the community spouse is excludable.

The following resources shall be classified as excludable:

  1. A house occupied by the individual as his or her place of principal residence, and the land appertaining thereto, shall be excluded:

….

    1. An absence of more than six months is assumed to indicate that the home no longer serves as a principal residence. However, if the home is used by a spouse or there is evidence that the absence from the house is temporary, the home may continue to be excluded. With that exception, the [county welfare agency] shall extend the period only with approval from the Division of Medical Assistance and Health Services.

Penalizing Spouses Who Make Gifts Within Five (5) Years of Applying for Medicaid

Applicants are subject to a transfer penalty when they transfer or dispose of resources for less than fair market value during or after the start of the sixty-month look-back period before the individual becomes institutionalized or applies for Medicaid as an institutionalized individual. As to transfers of assets, an “individual” means “[t]he individual him or herself who is applying for benefits and “[t]he individual’s spouse.” N.J.A.C. 10:71-4.10(b)(1). Assets “include all income and resources of the individual and of the individual’s spouse.” N.J.A.C. 10: 71-4.10(b)(3).

Medicaid regulations permit either spouse to liquidate their individual or collective assets to support an institutionalized or future institutionalized spouse. Moreover, a transfer penalty does not apply when “assets are transferred to the individual’s spouse.

Another common misconception is that couples can gift their assets to children to avoid adverse Medicaid consequences when the time comes. As previously mentioned, this tactic will not work. In fact, this is a major Medicaid rule violation, known as an “improper uncompensated transfer.” The State’s rules pertaining to Medicaid and gifting are extremely strict and must be followed. Always be careful when gifting your assets, as it can have significant Medicaid and income/estate tax implications and elder exploitation consequences.

The Spousal Impoverishment Act (Commonly Referred to as “Protecting the Community Spouse”)

While long-term care costs for a declining spouse must be considered, one must also think about the costs of living and support for his/her spouse to live a comfortable lifestyle. Contained within Medicaid laws is the “Spousal Impoverishment Act”, which dictates how much in resources, assets and income the community spouse can keep and live on should their spouse become sick and require long term care.

New Jersey refers to the spouse receiving care as the “institutionalized spouse’ and the spouse remaining home as the “community spouse”. The law states that the community spouse may keep up to a maximum of $133,640+/- (this amount increases annually). This is referred to as the Community Spousal Resource Allowance (CSRA). The institutionalized spouse may keep $2,000 under NJ Law.

PROTECTING THE RESOURCES AND SAVINGS OF THE “AT HOME” SPOUSE

The Community Spouse Resource Allowance (CSRA)

In New Jersey, a community spouse is given a monthly spending allowance which is an amount of $$$ (i.e., assets, investment, CD’s, annuities, etc.) which he/she can keep without disqualifying the sick and/or institutionalized spouse’s eligibility for Medicaid.  This allowance often is referred to by its acronym, CSRA.

The purpose of this resource allowance (CSRA) is to prevent the community spouse from becoming impoverished after his/her spouse qualifies for Medicaid benefits.

Because Medicaid includes the assets of both spouses when dividing the eligibility of the sick spouse regardless of whose name it is owned under, it is critically important that the family maximize the CSRA available to the healthy spouse remaining at home, otherwise everything the family worked for and saved during the marriage will have to be spent down and lost before Medicaid comes to the rescue.

So, what can be done?  Fortunately, a lot.  First, advanced planning can and should be considered depending on the age and health of each spouse.  If a crisis is not at hand, meaning imminent placement or need for placement in a nursing facility, etc., then a five-year asset protection plan should/can be implemented. After five (5) years and if structured correctly, the assets are legally free from the spenddown requirements mandated by the state and beyond the reach of the nursing home and others.

But what happens if you don’t have five (5) years to wait?  What if you are in a crisis and mom or dad will need placement somewhere in a matter of months, weeks or even days?  Well, a lot can still be saved, and in many cases, almost everything.  It depends on several factors unique to each couple but the good news is that there is hope, even if dad/mom needs placement next week.

The solution to your crises is to call me immediately.  Alert my support staff that you are in crisis and need to get in to see me right away.  We’ll get you in.  If you are a child of aging parents, etc., and live far away, we can video conference or schedule a conference call at a set date and time.  Before we talk, I’ll send you an informational questionnaire that when completed will give me an immediate road map of exactly what we can do to protect your loved ones.

Please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com today to set up an office consultation.  

MOM/DAD ARE ALLOWED A MONTHLY SPENDING ALLOWANCE UNDER THE MEDICAID LAWS OF NJ

New Jersey allows a community spouse to keep $2,477 per month (as of 2023), an amount referred to as the Minimum Monthly Maintenance Needs Allowance (MMMNA). What exactly does this mean? Say a community spouse receives $500 in Social Security per month, while the institutionalized spouse receives $1,250. The $1,250 will automatically go to the community spouse since they have yet to the reach the MMMNA of $2,477, as opposed to the nursing home. However, if the community spouse were to earn $3,250, as opposed to $500, then the nursing home would take the $1,250 that the institutionalized spouse is receiving every month from social security, as opposed to the community spouse.

Is There Any Advantage to Your Loved One Being a Military Veteran?

Absolutely. The Veteran’s Aid and Attendance Benefit is commonly known as the “VA’s Best Kept Secret”. While Medicaid is the biggest form of government financial support offered for long-term care, there are other options for some individuals. For example, New Jersey offers a limited number of benefits for at-home services through a waiver program known as Medicaid Managed Long Term Services and Supports (MLTSS).  There are also the New Jersey Veterans homes located in Menlo Park, Paramus and Vineland.

The VA pension benefit is one financial option available to certain qualifying veterans. It helps these veterans, along with their spouses, with un-reimbursed medical expenses. While there are strict eligibility requirements, being broke is not one of them. There are some income and asset qualifications, but eligibility is mainly defined by being over 65 years old or homebound and in need of regular aid and attendance. This care can be necessary at your home, in an assisted living facility, or at a nursing home.

Let’s discuss this in greater detail now.

Veterans Benefits for NJ Veterans and Surviving Spouse

How VA Aid & Attendance Pension Benefit(s) Can Help Families Pay for Long Term Care Expenses

  • Married Veteran with a living spouse – Up to $2,266/ month, tax free
  • Single Wartime Veteran – Up to $1,911/ month, tax free
  • Widowed Spouse of a wartime veteran – Up to $1,228/ month, tax free

Eligibility can be tricky. The key lies in educating yourself on just how the benefit works. The most essential calculation is your income for VA purposes (IVAP). This is calculated by taking your gross income from all sources and then subtracting your un-reimbursed medical expenses (UME). Your UME’s typically include doctor and dentist fees, Medicare and health insurance premiums/co-payments, transportation costs to your doctor’s offices, and care costs for nursing home/assisted living facilities or in-home care, among others. The UME’s include any medical expense that you incur as it is an ongoing cost.  I know this is so confusing.  But hang in there and keep reading.  Absorb what you can.  Remember, when you’re done you can always call and meet with me to understand the topic better.

Income (IVAP) = Gross Income – Un-reimbursed Medical Expenses (UME)

Let’s take New Jersey Veteran Harry Sharp for example. Harry is a 71-year old Korean War veteran receiving care at his home. He receives $1,700/month from Social Security and a pension. The cost of his in-home care is $3,000/month, in addition to the medication prescription costs of $200/month. Harry has $40,000 in savings but is concerned because he knows that his care and medication is $1,500 more than he receives every month. He knows that this will drain his savings account in less than two years because he knows he also has basic living expenses such as utilities and food. He also knows that care costs are constantly increasing, so he wouldn’t be surprised to see his costs jump in the future. It is important that Harry see a knowledgeable Elder Care attorney to advise him on his situation.

A knowledgeable advisor would calculate his IVAP by taking the $1,700 income he receives and subtracting the un-reimbursed medical expenses, which in this case is $3,200. This shows an IVAP of negative $1,500. Although Harry has $40,000 in assets, he will be eligible for the full VA benefit of $1,644 per month, tax-free. Remember, you don’t have to be completely impoverished to receive the VA benefit. Since his IVAP is a negative $1,500, he is eligible for the full benefit. Thanks to this calculation, Harry can rest easy knowing he is eligible to receive the VA benefit to pay for the care he needs and won’t have to drain his bank account.

How to Get a Pension Benefit From the VA

In filing a claim for a VA benefit, it is important to know that only three types of professionals are authorized to assist you. They are:

  1. A licensed New Jersey attorney that is also accredited with the VA.
  2. A Veterans Service Organization (VSO), such as your local American Legion or Veteran’s of Foreign Wars (VFW).
  3. A state of New Jersey County Department of Veteran’s Affairs official.

The new VA rules adopted in 2018 and strict eligibility requirements make it essential that you consult with an experienced advisor to assist you.

Fredrick P. Niemann, Esq. is a caring, sensitive NJ Attorney that can offer you qualified professional planning and assistance. Please call him toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com today to set up an office consultation.

Who Qualifies for the VA Pension Benefit?

If you belong to any of the following groups and received a favorable discharge, you meet the service requirements for the benefits (keep in mind you still must qualify financially):

  • Medal of Honor recipients;
  • Woman Air Force Service Pilots (WASPs);
  • WWI Engineer File Clerks;
  • WWI Signal Corps Female Telephone Operations Unit;
  • Female clerical employees of the Quartermaster Corps serving with the American Expeditionary Forces during WWI;
  • Women’s Army Auxiliary Corps (WAAC);
  • Reconstruction aides & dietitians of WWI;
  • Civilian Employees of Pacific naval air bases that actively participated in defense of Wake Island during WWII;
  • Male civilian ferry pilots;
  • Wake Island defenders from Guam;
  • Guam Combat Patrol;
  • Civilian personnel assigned to OSS secret intelligence;
  • U.S. civilians that participated in the defense of Bataan;
  • Quartermaster Corps members of the Keswick crew on Corregidor during WWII;
  • U.S. merchant seamen that served on block ships in support of Operation Mulberry in WWII invasion of Normandy;
  • American merchant marines in ongoing service during WWII;
  • U.S. civilian employees of American Field Service that served under the U.S. army and U.S. army groups during WWII;
  • Civilian Navy IFF radar technicians that served in combat areas of the Pacific during WWI;
  • U.S. civilian employees of American Airlines that served overseas in contract with the Air Transport Command between December 14, 1941 and August 14, 1945;
  • Civilian crewman of certain U.S. Coast and Geodetic survey vessels between December 7, 1941 and August 14, 1945;
  • Members of the American Volunteer Group (Flying Tigers) that served between December 7, 1941 and August 14, 1945;
  • U.S. civilian flight crew and aviation group support of TWA that served overseas between December 4, 1941 and August 14, 1945;
  • U.S. civilian flight crew and aviation ground support of Consolidated Vultee Aircraft Corp. that served overseas between December 14, 1941 and August 14, 1945;
  • Honorably discharged members of the American Volunteer Guard, Eritrea Service Command between June 21, 1942 and March 31, 1943;
  • U.S. civilian flight crew and aviation ground support of Northwest Airlines that served overseas between December 14, 1941 and August 14, 1945;
  • U.S. civilian flight crew and aviation ground support of Braniff Airways that served overseas in the North Atlantic between February 25, 1942 and August 14, 1945;
  • U.S. civilian female employees of the U.S. Army Nurse Corps that served in the defense of Bataan and Corregidor from January 2, 1942 to February 3, 1945;
  • The operational Analysis Group of the Office of Scientific Research & Development, Office of Emergency Management, which served overseas with the U.S. Army Air Corps from December 7, 1941 through August 15, 1945;
  • Chamorro and Carolina former native police that received military training in the Donnal area of Central Saipan and were placed under command of Lt. Casino of the 6th Provisional Military Police Battalion to accompany U.S. Marines on active, combat patrol from August 19, 1945 to September 2, 1945;
  • The Alaska Territorial Guard of WWII.

More Details About Eligibility for Non-Service Connected Pensions

So now that you know that the following requirements must be met initially:

  1. Must be an honorably discharged veteran, surviving spouse, or child of any military group. This includes special groups mentioned above;
  2. Must have served in active duty for 90 consecutive days, one of which was during a period of war;
  3. Must be at least 65 years old or have a qualifying “permanent or total disability”. Permanent or total disability means:
  • Receiving long-term nursing home care; or
  • Receiving Social Security disability benefits; or
  • Unemployable as a result of disability reasonably certain to continue throughout the life of the person.

Keep in mind the disability does NOT have to be one connected to the veteran’s service in the military.
Assuming you meet these eligibility requirements, it’s time to address the financial requirements. As you are aware, the Veteran’s program is a needs-based program that looks at your income and assets. There are two main tests to look at:

  • Gross income minus certain expenses
  • Certain expenses include un-reimbursed medical expenses for both the veteran and his household, as well as certain educational expenses.
  • Net Worth Limitation
  • Aside from certain items that are exempt, such as your house, car, etc., the maximum value of one’s assets they can generally allow is $148,240*. This includes savings accounts and assets, such as investments. Keep in mind this is just an estimate and various factors will be included in this determination.

*This number is as of 2023 and is adjusted annually.

Benefits Available

Special Monthly Pension Rates – Paid to the Veteran’s themselves

Based on 2020 Rates

SITUATION MAXIMUM ANNUAL PENSION RATE MAXIMUM MONTHLY AMOUNT RECEIVED
Permanently & Totally Disabled Veteran $13,752 $1,146
With one dependent $18,008 $1,500
Permanently & Totally Disabled AND Homebound $16,805 $1,400
With one dependent $21,063 $1,755
Permanently & Totally Disabled AND in Need of Regular Aid & Attendance $22,939 $1,911
With one dependent $27,195 $2,266
Increase for each dependent child $2,351 $196 additional

Death Pension Rates – Paid to the Veteran’s Surviving Spouse

Based on 2020 Rates

SITUATION MAXIMUM ANNUAL PENSION RATE MAXIMUM MONTHLY AMOUNT RECEIVED
Surviving Spouse $9,224 $768
With one dependent $12,072 $1,006
Surviving spouse that is Permanently Housebound $11,273 $939
With one dependent $14,116 $1,176
Surviving spouse that needs “Regular Aid and Attendance” $14,742 $1,228
With one dependent $17,586 $1,465
Increase for each dependent child $2,351 $196 additional

Call Today to Get Your Finances in Order and Start Planning for the Future

Fredrick P. Niemann Esq.

Much of the information I have given you seems complex and confusing. Don’t worry, it is. The best way to prepare yourself for significant long-term care charges is to plan early and make sure you apply for benefits as soon as allowed. In these difficult economic times, there is the possibility of funding cuts by the State, which means less financial aid available. The sooner you start moving forward and planning for the future, the safer you can feel that your finances will be safe and your loved one can receive the long-term care they deserve.

Contact Fredrick P. Niemann, Esq. today with any questions you may have concerning Alzheimer’s, Dementia, or long-term care planning in general. He can be reached toll-free at (855) 376-5291 or by email at fniemann@hnlawfirm.com.

We look forward to hearing from you.

Medicaid Eligibility Lawyers serving these New Jersey Counties:

Monmouth County, Ocean County, Essex County, Cape May County, Mercer County, Middlesex County,
Bergen County, Morris County, Burlington County, Union County, Somerset County, Hudson County, Passaic County