Can veterans get Medicaid while they are drawing Department of Veterans Affairs benefits, and should they?
While it is theoretically possible to be eligible for both Medicaid and VA benefits, such as Aid and Attendance (A&A) or Housebound benefits, very few individuals get assistance from both programs at the same time. If they are eligible for both programs, usually they receive the one that provides the greater benefit.
According to the Kaiser Family Foundation, nearly one in 10 working-age veterans receive Medicaid, with 40% of them having Medicaid as their only health coverage.
The programs have different eligibility rules and payment amounts, so depending on your situation, one program may be better than the other.
While all Americans are eligible for Medicaid if they meet the eligibility requirements, veterans and their survivors are eligible for special benefits from the VA, usually only if the veteran has a service-connected disability.
Medicaid
To clear up any confusion: Medicaid is not the same thing as Medicare. While both programs provide basic health insurance to eligible beneficiaries, Medicaid is a joint federal/state program that provides health coverage for people with lower incomes, and Medicare is a federal health insurance program that is generally only available to those over 65 or those with severe disabilities.
Medicare does not usually provide long-term-care coverage, while Medicaid provides both nursing home and community or in-home care, depending on the situation and state rules.
Since Medicaid is a federal program administered by state governments, the eligibility rules and payment rates vary by state; however, there are some basic rules regarding Medicaid that apply to all.
Medicaid eligibility is very complicated, and best determined by a social worker or state assistance office. In general, a person's Medicaid eligibility is linked to their eligibility for other federal assistance programs such as the Supplemental Security Income (SSI) program, or the Temporary Assistance for Needy Families (TANF) program.
- The SSI program provides cash payments to disabled adults and children as well as those 65 years or older. It is administered by the Social Security Administration,
- TANF is commonly referred to as "welfare" and is available only to families with children. Many states have rules requiring many TANF recipients to work a limited number of hours each week to maintain eligibility. Monthly TANF payments can also vary, depending on state.
Since Medicaid is a safety-net social program, available only to the most in need, it has limits on how much recipients can earn and how much property they may own. These amounts also vary by state. In most states only those who earn less than about 100%-138% of the federal poverty level are eligible for Medicaid. Most states limit a Medicaid recipient's assets to about $2,000; their home and vehicle usually are not counted as assets.
Determine if you are eligible and apply for Medicaid.
VA Benefits
The VA provides several different types of benefits to low-income veterans and their surviving family members:
- Veterans Pension: For low-income honorably discharged wartime or permanently and totally disabled veterans, and those over 65. It is also available for those in a nursing home or receiving SSI or Social Security Disability Insurance (SSDI) from the Social Security Administration.
- Housebound benefits: For those eligible for the veterans pension who are mainly confined to their home due to a disability. The disability does not need to be service-connected.
- Aid and Attendance benefits: For those eligible for the veterans pension who have a serious disability that requires regular in-home care.
- Survivors pension: For low-income dependents of veterans who would be eligible for the veterans pension if alive.
As is the case with Medicaid, only those with income and assets below a certain level are eligible for VA pensions.
Differences Between Medicaid and Veterans Benefits
The best program for you can depend on many things. Are you a disabled veteran? What state do you live in? How much is your income? What assets do you have? What type of care do you need? The answers to these questions can make a big difference.
Income
To qualify for Medicaid, a single person's average monthly income limit is around $1,500; this varies for those with dependents.The income limits can be greatly different, depending on the state and type of care one is seeking.
For example, some states will only provide Medicaid for those seeking nursing home care if the person has no income. Others allow a small monthly income.
In most cases, you can deduct medical expenses from your monthly income when determining eligibility.
See the American Council on Aging website for state specific Medicaid income limits.
To qualify for a VA pension, the 2022 monthly income limit is $1,229, those eligible for housebound benefits have an income limit of $1,502 and those qualified for Aid and Attendance benefits have a monthly income limit of $2,051. Medical expenses can also be deducted from income to qualify.
Assets
To be eligible for Medicaid, you normally cannot have assets over a certain limit; the national average asset limit is around $2,000. Your assets include everything except your home and vehicle, although in some states those are considered assets. Your spouse's assets are also considered.
To be eligible for VA pension benefits, you cannot have a net worth greater than $138,489; this does not include your car, house and furnishings. Your spouse's assets are also considered.
Medicaid or VA Benefits: Which is Better?
The type of care a person requires is usually the major deciding factor between choosing Medicaid or a VA pension.
Generally, for those needing home care or assisted living, VA benefits are better. For those who need nursing-home care, Medicaid is usually better. That is because Medicaid will usually cover the full cost of a nursing home, while VA benefits will only cover a portion. In 2020, the median monthly nursing home cost was $7,756.
Depending on the situation, the VA may also pay all or part of the cost of a private nursing home. However, in most cases, the VA will only pay a portion of the cost, with the veteran making up the difference through personal funds or insurance.
Medicaid payments are sent directly to the health-care provider, while VA benefits are usually paid directly to the eligible beneficiaries.
While Medicaid will cover the full cost of residential long-term care, in many states most long-term care facilities only accept a limited number of Medicaid patients. This means that even if someone is approved for Medicaid benefits, they may wait a very long time for an opening.
VA provides in-home health care if it is medically required, as well as services like adult day care and hospice care for all veterans eligible for VA medical benefits. Veterans with certain disabilities may also be eligible for nursing home care from the VA or state.
See: VA Long Term Care Payment Options
Depending on the situation, the VA may also pay all or part of the cost of a private nursing home. However, in most cases, the VA will only pay a portion of the cost, with the veteran making up the difference through personal funds or insurance.
If a veteran is eligible for both Medicaid and VA pension benefits, their VA benefit will be reduced to around $75 monthly, to provide basic living expenses, while the Medicaid benefit will cover the long-term care cost.
See: Nursing Home Care From the VA
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