Georgia Case Addresses The Impact Of VA Aid and Attendance Benefits On Medicaid Eligibility

A May 27, 2009 Administrative Law decision in Georgia addresses the impact of Veteran’s Administration (“VA”) Improved Pension with Aid and Attendance benefits on Medicaid eligibility. M.W. v. Georgia Department of Human Resources, reprinted here, concerns a nursing home resident who was the surviving spouse of a veteran and who was receiving Improved Pension with Aid and Attendance from the VA. The VA benefit was comprised of an “aid and attendance” benefit and a “widow’s pension.”

M.W. applied for nursing home Medicaid but was denied due to excess income resulting from her VA benefits. If the VA benefits were not considered as countable income, M.W. would have been approved for Medicaid benefits. However, although Medicaid excluded the aid and attendance portion of the VA benefit from the applicant’s countable income, it included the widow’s pension as countable income.

Medicaid’s denial was reversed by the Administrative Law Judge (“ALJ”). The ALJ reasoned that, with regard to M.W.’s VA benefits, her income exceeded the maximum annual pension rate, and she would have been ineligible for VA benefits, if the VA had not deducted Unusual Medical Expenses (“UME”) and Continuing Medical Expenses (“CME”) from her income. Therefore, the ALJ concluded that M.W. received VA Improved Death Pension with Aid and Attendance “to reimburse her for her out-of-pocket UME and CME.”

The ALJ noted that, according to Georgia’s state Medicaid Manual, “UME/CME reimbursements and A&A … are never considered as income for determining Medicaid eligibility.” Consequently, the ALJ concluded that the entire amount of M.W.’s VA benefits must be excluded as income, for purposes of Medicaid eligibility, because M.W. “only received the VA Pension with Aid and Attendance to reimburse her for her out-of-pocket UME and CME.”