1. A Public Service Presentation provided by the Society of Certified Senior Advisors® (SCSA)

3. Benefits for Those Who Served Medical Care Home and Vehicle Modification Grants Education and Training – H.S. Diploma Property Tax Abatement – 10% disabled Dependent & Survivors benefits Home loans Life Insurance Dependents & Survivors Compensation Burial Allowance $600-2,000

4. Who is Eligible? Honorable discharge Retired Service connected disability Some no service connected disability Some require serving during wartime Must enroll in VA medical system Some based on income and/or assets

5. Medical Benefits Preventative care Physician care Surgical care Hospital care Pharmacy Prosthetic services

6. Medical Benefits Dementia in-patient unit Respite (30 days per year) Adult Day Services Domiciliary care Hospice/Pallative care

7. Healthcare Priority Levels Group 1 – 50% or more military connected disability Group 2 – 30-40% Group 3 – 10-20%, former POA, Purple Heart, Voke Rehab, disabilities incurred from treatment Group 4 – Aid and Attendance, housebound or catastrophic disabled

8. Healthcare Priority Levels Group 5 – Pensions, eligible for Medicaid, non- service connected disabilities and gross income and net worth below thresholds Group 6 – WWI, exposed to radiation, combat after 1998, 2003-2011 Group 7 – Below threshold and agree to pay co- pays Group 8 – Above threshold and agree to pay co- pays

9. Enrollment Enrollment coordination car verify benefits Registration is sometimes suspended for Groups 7 & 8 that fall above the income threshold Procedures/care must be in VA hospital or have prior authorization Must apply separately for long term care Not health insurance Must enroll in each hospital

10. Limited Benefits In-home healthcare Homemaker and home health aide Ambulance service Durable medical equipment Eyeglasses Hearing aids Dental care

11. Long Term Care In-home custodial care (primary for service connected disabled veterans) Residential care Veteran’s home Nursing Home (70% + disabled priority) Aid and Attendance Pension

12. Service Connected Disabilities Lou Gehrig’s (presumed) TB Hearing Loss Arthritis due to prior injury or wound Gulf war syndrome Radiation – cancers Asbestos Vaccinations & Medications

13. Agent Orange Presumed Conditions Diabetes Type 2 Ischemic heart disease Chronic B-cell Leukemias Chloracne Hodgkin’s disease Myeloma Non-Hodgkin’s Lymphoma

14. Agent Orange Presumed Conditions Parkinson Neuropathy Prostate cancer Respiratory cancers Soft tissue sarcomas Service Connection Compensation up to $2800

15. Aid and Attendance Pension For Veterans and their spouses or surviving spouses Must have served 90 days with one day during active war Honorable or General Discharge Disability over age 65 – does not have to be service connected Under 65 must be 100% disabled

16. Eligibility Tests 1.Service Test 2.Medical Test 3.Income/Expense Test 4.Resource Test

17. Periods of War World War II: December 7, 1941 – December 31 – 1946, extended to July 26, 1947 Korean Conflict: June 27, 1950 – January 31, 1955 Vietnam Era: August 5, 1964 – May 7, 1975 or February 28, 1961 – May 7, 1975

18. Medical Qualifications Need the assistance of another person to perform at least two activities of daily living (ADL) – Bathing – Dressing – Toileting or personal care – Transferring – Require a protective environment and ADL assistant Residing in a nursing home

19. Income/Expense Qualifications Income reduced by monthly unreimbursed medical expenses (including the cost of care) If equals 0 you receive the full benefit Allowable medical expenses – Medicare B & D premiums Medicare supplemental premium Medical supplies (testing & Dependents) Assisted living rent, independent living with care, homecare, family paid care, nursing home care

20. Asset Qualifications Not just stated number of $80,000 or less Based on age and expenses Excludes primary home* and vehicle * If later sold, could cause repayment demand.

21. Too Many Assets Currently no penalty for repositioning assets in a special irrevocable trust to qualify – 3 year look back proposed Medicaid has five year look-back Need Long Term Plan to get eligible and preserve assets for nursing home care if needed Utilize an elder law attorney and VA Accredited Attorney to make sure you can qualify for both

22. Proper Planning Iatrical part of a good Long Term Care Plan to get quality care for least financial impact Plan as if you will need nursing home care Protect your money from risk, professionals helping you plan have a duty to protect your money Requires flexibility without penalty

23. Why Plan? Begin Look Back Period – if nursing home care is not needed in the next 5 years, assets inside irrevocable trust are preserved If needed sooner, maximum liability is 50% of estate VA pension helps reduce liability Annual benefit usually outweighs any surrender penalties

24. Benefits Calculator Tax free and for life Helps reduce nursing home liability Veteran$1,733 per month=$20,796 per year Veteran & Spouse$2,054 per month=$24,648 per year Surviving Spouse$1,113 per month=$13,356 per year

25. Applying Numerous forms to complete Must have complete information Must have expense when you apply Approval can take from 4-6 months If approved, the benefit will be awarded retroactively to the month following application Get assistance from Accredited Agent or Attorney to make sure you get approved

26. Hurdles If missing information or incorrect forms are used – you are sent to back of the line again VSO’s and social workers have limited knowledge on how to qualify and cannot tell you how New Claims Agents – apply rules as they see fit Memory Loss requires a Fiduciary to handle their money = delay