New A&A Eligibility Regulations Changing October 18, 2018
The following are the most significant rule changes that will impact veteran eligibility.
A Three-Year “Look-Back” Period Will Apply
- Doesn’t apply to asset transfers prior to implementation date.
- Does apply to asset transfers to family, trusts and annuities in the three years immediately prior to application date effective October 15, 2018.
- Improper transfers during the three year period prior to application are subject to up to a five year penalty, based on amount of funds transferred.
Asset Cap Established
- An asset cap equal to the Medicaid Community Spouse Resource Allowance of $123,600 will apply under the new regulations. Both spouses’ assets and first-year annual incomes are counted toward the asset cap.
Expansion of Eligible Medical and Care Expenses
- Qualifying payments to caregivers will include services which previously did not count as UME,
such as shopping, preparing meals, laundry and housekeeping, managing the applicant’s
medications, and helping with the applicant’s finances.
- Prescriptions, special dietary items, vitamins and supplements prescribed by the applicant’s physician count toward UME deductions.
- Costs related to service animals and transportation for healthcare purposes will also become countable as UME.
- Ambulating within the living area and medication administration have been added to the services an applicant needs to qualify for the A&A benefit.
What remains unchanged?
- A veteran must have served during a period of conflict as defined by Congress, serving for at least 90 days with at least one day during the period of conflict. The dates of service determine eligibility, front line service is not a requirement.
- The veteran’s cost of medical care most exceed their income
- The applicant must have a doctors order that they require regular assistance with two of the following services:
- Bathing and/or showering
- Ambulating within the living area
- Dressing Personal hygiene
- Eating and/or drinking (toothbrushing, toileting, diapers) (not including meal preparation)
- Medication administration
- Mobility (not medication reminders) (walking, getting in and out of bed or chair)
- Or, the applicant requires regular supervision due to cognitive or physical limitations
For more information, contact War Veterans Association of Colorado at 303-829-0205