Military long-term care presents a significant challenge for the families of affected service members. In this post, I answer common questions military families struggling with this important issue may have. At the end, I include a few military caregiver resources.
Among Ken Kattner’s other injuries, suffered while deployed in Iraq, he sustained a traumatic brain injury. His combined and irreversible injuries are significant enough to require long-term care for the rest of his life. For the next 50+ years of their married life, Patty, his wife, will likely be that caregiver. She worries about a future where she may not be there for Ken, or his care needs become too great. What then?
Their story is a reminder that long-term care insurance (LTCI) can be a financial lifesaver for people of any age. Particularly, for the special circumstances of military families.
The Kattner couple struggles with a situation that has become increasingly common. Military personnel are returning home from combat operations with health issues that often require extended care. According to a RAND Corporation study, there has been a 25% increase in the need for military long-term care since 2001. Family members, spouses in particular, are the most likely to provide the needed care.
A major concern for military families is the financial impact of providing long-term care for their service member or veteran. When planning for long-term care in the military, you can purchase private long-term care insurance before you need it, or apply for Aid & Attendance after the fact. One is planning, the other is hoping for the best.
Getting a few of your questions answered concerning military health care and military long-term care may help you prepare better. So, here we go.
Doesn’t TRICARE Cover Me?
Most people assume that military long-term care is covered under the military’s healthcare program, TRICARE. This is not the case. The government does have a Federal Long Term Care Insurance Program, but not everyone is eligible. In addition, the TRICARE website notes that the enrollment process for FLTCIP is unnecessarily complex.
What about Medicaid or Medicare?
Medicaid does provide benefits for long-term care services. However, only people with limited income and resources qualify, and eligibility for services varies from state to state. Neither Medicare nor Medicare Supplement Insurance (Medigap) policies are meant to pay for long-term care. Medicare is a form of health insurance, and Medigap is an optional policy that helps cover some of the costs Medicare doesn’t cover.
Isn’t Aid & Attendance a Military Long-term Care Benefit?
Aid & Attendance can help pay for the costs of long-term care not generally covered by health insurance or other government programs. It is a military long-term care insurance benefit that you can apply for when you need it. That makes it different from both private long-term care insurance and Federal Long-Term Care Insurance policies. With long-term care insurance, you have to purchase it before you need it.
It can be tricky and confusing to qualify for Aid & Attendance, but it’s worth trying if there’s no LTCI. The application process is unduly complicated, so veterans are advised to get free help from a recognized Veterans Service Organization. An alternative is to hire a private lawyer to navigate the process.
To qualify for receiving Aid & Attendance, you need to have served a minimum of 90 days in any branch of the military with at least one of those days served during an Eligible Wartime Period. The number of wartime days to qualify may be more if you served after September, 1980.
Like Medicaid, Aid & Attendance is based on financial need. Generally, you must qualify for Veterans Pension to qualify for Aid & Attendance. Aid & Attendance benefits are added on top of Veterans Pension benefits. So, it increases the upper income level cutoff for receiving benefits. Therefore, it’s possible for some to qualify for Aid & Attendance who have too much income for basic Veterans Pension.
Unlike Medicaid, Aid & Attendance is a military long-term care benefit that doesn’t require repayment. When a civilian receiving Medicaid benefits for nursing care dies, Medicaid must seek compensation from the estate. If that fails, they seek repayment from the family. That’s not the case for Aid & Attendance that provides military long-term care without the expectation of repayment.
What Are the Requirements for Military Aid & Attendance?
Aid & Attendance is usually reserved for veterans already qualified for and receiving Veterans Pension benefits. To qualify for Veterans Pension Benefits, you must have 90 days active service in any military branch. This must include one or more days during an Eligible Wartime Period. Additional qualifications include at least one of the following:
- Age 65 or older
- Permanently and totally disabled
- Receiving either Social Security Disability or Supplemental Security Income
- Currently living and receiving skilled nursing care in a nursing facility
On top of those qualifications, you must meet one of these conditions:
- You require help with at least one ADL (Activities of Daily Living), which are – eating, bathing, dressing, toileting, transferring, and continence
- You’re currently in a nursing home for physical or mental limitations
- You are bedridden
- Your corrected eyesight is 5/200, or worse, in both eyes
As I mentioned earlier, qualifying for Aid & Attendance is complicated. There are layers and caveats associated with the above qualifications that require professional guidance. However, it’s an option if you served in the military, don’t have LTCI, and have a low income.
What If I Don’t Qualify for Military Long-Term Care Benefits?
It’s easy to be disqualified for Aid & Attendance benefits if you have a modicum of income and assets. It’s similar to, but not the same as, qualifying for Medicaid. Often, veterans won’t qualify for Aid & Attendance with retirement savings, a 401K, or other assets totaling over $30,000. If your assets qualify, ask about income limitations that are based on a complex income to medical/long-term care expense formula.
Rather than risk having to rely on Aid & Attendance, another option is to plan for your own future. Grow you retirement savings to ensure a livable retirement, and secure those savings with long-term care insurance.
Young people are hesitant to purchase insurance they think they won’t need. Additional monthly costs, especially for young military families, may be tough to bear. But odds are that you will need long-term care at some point in your life. Statistically, 70% of Americans over the age of sixty-five will need long-term care during their lifetimes. And, that’s without military service.
Pinning your financial future to whether you’ll return from combat needing long-term care, or not, is risky business. Whether you need military long-term care when you’re young, or later in life, an LTCI policy provides for it.
It’s important to understand, however, that not all private long-term care insurance policies offer the same benefits. For example, many don’t offer cash benefit options with immediate payments for friends or family who serve as informal caregivers. They also may not cover things like respite care that can provide temporary relief for long-term caregivers.
All Long-Term Care Policies Are Not the Same
Capital Retention Long-Term Care Insurance policies cover all these needs and more. You have a choice of cash or reimbursement benefits. Respite care is available when your primary caregiver needs a break, or is unable to provide care temporarily.
In addition, a Care Coordination service, staffed with licensed health care professionals, is at your disposal. These professionals help you understand how to get the most out of your long-term care insurance benefits. They can recommend good care facilities, easily navigate the claims process, and work with the care facility on your behalf.
When Should I Purchase Long-term Care Insurance?
LTCI companies advise getting long-term care insurance when you are young and healthy to get the lowest rates. Once an injury or illness that requires long-term care occurs, it’s too late to purchase private long-term care insurance. If you’re in the military, it’s wise to have long-term care insurance in place prior to combat deployment.
With Aid & Attendance, you can receive benefits post-injury, if you are income qualified. But you’ll be disqualified for private long-term care insurance if you are already experiencing qualifying care needs.
Planning ahead is a financial must to protect yourself, your family, and your assets. Waiting to apply for Aid & Attendance after the fact is riskier. You commit to poverty level income and assets the rest of your life to continue qualifying, if you do qualify.
Are There Resources for Military Caregivers?
If you are the caregiver for a military spouse or family member, there are support systems available to you. Get in touch with VA Caregiver Support, an extension of the U.S. Department of Veterans Affairs. Another great resource is the Elizabeth Dole Foundation dedicated to empowering military caregivers. Lastly, the Rosalynn Carter Institute for Caregiving supports both military and non-military caregivers.
If you’re ready to protect yourself, your family, and your financial future from devastating long-term care costs, call me. 844 805 3557. Or you can schedule a callback, and I’ll call you. Take advantage of a free consultation where we discuss your specific needs and pre-qualify you.
(Sources: The American Homefront Project and LongTermCare.gov)
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