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Lavine Long Term Care Insurance

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Lavine Long Term Care Encyclopedia

Veterans Administration Benefits

I’m a veteran, so my care should be covered by Veterans Administration, shouldn’t it?

As a veteran of the United States armed services, you qualify for certain medical care by the Veterans Administration (VA), which provides benefits for a variety of long term care needs. These include nursing home care, respite care, and adult day care. Long-term care benefits are based on clinical and financial needs.

To qualify for VA nursing home benefits, a veteran must have either:

  1. A service-connected disability rated at 70% or more;
  2. A service-connected disability that is clinically determined to require nursing home care. The VA may provide nursing home care benefits to other veterans not falling into one of the above categories, depending on the space and resources available. In those cases, the veteran would need to fill out an asset and income assessment to determine how much the VA would contribute (if anything) to the nursing home bill.

Those who qualify for VA benefits have no choice regarding the location of their care. The VA pays for nursing home care only in a VA facility or in a nursing home with which the VA has a contract.

Should a veteran have a service-connected disability as defined by the VA, the VA will cover 100% of the cost of the veteran’s nursing home care. For those veterans with non-service connected disabilities, there may be a co-pay depending on the veteran’s family’s financial situation. The maximum co-pay for nursing home care services is $97 per day.

Adult Day Care Benefit: The VA’s adult day care program is considered part of a basic benefits package. The program provides medical and rehabilitation services to disabled veterans in a group setting. If a veteran is enrolled in the VA for health care and they meet the clinical admission criteria for adult day care benefits, they will qualify for the program.

Similar to nursing home care benefits, if a veteran has a service-connected disability, they will not be charged for the cost of adult day care. Other veterans with a non-service connected disability may be charged up to $15 per day.

Respite Care: The VA now provides respite care in the home or other non-institutional settings in addition to VA nursing home and hospital beds. The services provided will vary depending on the veteran’s needs. As with other long term care benefits, veterans with a service-connected disability pay no fee but veterans with a non-service-connected disability will be charged up to $97 per day for inpatient respite care and $15 per day for outpatient respite care.

Respite care is defined as temporary care of a few hours or weeks of a sick or disabled person to provide relief to the regular caregiver, usually a family member.