Using Aid & Attendance for Professional Home Care Services

Annualization of Home Care Costs
Medical expenses for home care aides are allowed prospectively for annualization if those expenses are reasonably predictable. The evidence would also have to show that the need for care is ongoing and regular. Expenses may be allowed whether the care recipient has a rating for aid and attendance or housebound or is not rated. However, deductible payments to a non-rated beneficiary are more restrictive.

 

Evidence must be submitted indicating an ongoing need for the care and the level of care in order for the Veterans Service Representative to consider the medical expense as recurring and eligible to be annualized. A form such as the one we provide in our block entitled "Form 2 -- Care Provider Report (used to provide evidence of recurring medical expenses)" should be used for this purpose. Also a copy of a contract between the provider and the recipient, covering at least a year, and outlining the provisions and the cost should be submitted to prove the intent of the care recipient and the provider.

 

For an explanation of the special annualized treatment of unreimbursed long term care costs and insurance premiums please go to the article entitled "Understanding the special case of long term care medical costs."

 

The non-veteran spouse of a living veteran may also be eligible for annualization of home health aide costs. If the home care is being furnished by a licensed health professional, then not much further proof is necessary other than the documentation proving the care is being provided. If the provider is not licensed, we are not sure much could be done to allow deduction for anything other than direct medical services. As outlined below, payments to nonlicensed providers are only allowed if the care recipient has a rating for "aid and attendance" or "housebound." Unfortunately, a non-veteran spouse of a living veteran cannot receive a rating and therefore would not be eligible for annualization of costs.

 

Our readers could try the suggested approach outlined for assisted living and other similar facilities in order to request annualization and deduction for non-rated beneficiaries, but there is no assurance VA would allow the deductions. The idea is to try to convince the service representative the spouse should have a rating even though officially none is allowed.

 

VA will not rate a non-veteran spouse of a living veteran for "aid and attendance" or "housebound" and even though the spouse’s home care medical expenses may be annualized to produce a benefit, the Pension award will be much smaller without the allowance for a rating. Of course, a death claim is different because the surviving spouse can receive a rating in that case.

 

For information on ratings please go to the article entitled "Who is eligible for the aid and attendance Pension benefit?"

 

Home Care Recipient Is Not Rated
Payments for care at home for a recipient who is not rated for housebound, or aid and attendance are only allowed for annualization if made to a licensed health professional. The term "licensed health professional" refers to an individual licensed to furnish health services by the state in which the services are provided. The term includes registered nurses, licensed vocational nurses and licensed practical nurses. Some states also license non-medical home care providers to provide services as well. Since this is a fairly new practice, we don't know if these people would qualify under the definition above but we suspect they will.

Read More When should a Veteran or their Family use a Consultant?