Many individuals who apply for the VA Aid and Attendance disability pension benefit don’t fully understand how to adjust their qualifying income by VA qualified medical expenses.
Qualified medical expenses are those medical and care expenses that are normal and recurring that will be paid out of pocket over the next 12 months, and are not reimbursed.
This means that you will pay for the medical and care expenses and they will not be paid by insurance or anyone else. They have costs you pay 100% by yourself.
The VA will consider these qualified medical expenses and annualized them over the 12 months from the claim application date. These medical expenses include:
- Health & Long-term-care Insurance premiums
- The cost of home care (unless provided by Medicaid)
- The cost of paying a private person (including a non-spouse family member) to provide care
- The cost of adult day care not covered by Medicaid
- The cost of assisted living not covered by Medicaid
- The cost of a nursing home facility not covered by Medicaid
Large one time medical expenses can also be used as qualified medical expenses for a 12 month period. To continue your benefit at the same dollar amount the following 12 month time frame however, you’ll need other qualified medical expenses to replace this large one-time expense.
Other qualified medical expenses include:
- Doctor and Dentist costs and co-pays
- Hospital charges not covered by insurance, Medicare or Medicaid
- Prescription cost and co-payments
However, the VA will not allow these as normal and recurring expenses. Therefore, they will not allow them to determine the monthly benefit payment. You will instead have to wait until the 12 month period is over and then request they be considered as qualified medical expenses. You would only do this if you had not received the maximum allowable benefit amount.
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