During the application process for the VA’s Aid and Attendance pension benefit, one of the many things you are required to disclose is all sources of income. Chief among them is Social Security. A lesser-known application factor is whether you are receiving Medicaid benefits.
Social Security income is used to calculate your income against your unreimbursed medical expenses (UMEs) to determine your financial need for the benefit. Medicaid benefits can directly impact how much of the Aid and Attendance benefit lands in your bank account. Let’s briefly examine each.

Social Security

The application for pension benefits requires the veteran, or surviving spouse, to reveal the gross income for the veteran, spouse, and all dependents in the household. “Gross” is the keyword to pay attention to. Most people know exactly, to the penny, how much the Social Security direct deposit is when it hits the bank account at the beginning of the month. This is the net. Most people have Medicare Part A, and sometimes Part D (prescription drug plan), premiums are taken out of the Social Security amount. In 2020, the typical amount taken out for the Part A premium is $144.60. The VA uses the gross amount in its benefit calculations. This amount is reflected each December in the Social Security income verification letter sent out to show the new amount for the upcoming year.
So why is this gross amount important? The VA requests income verification from the IRS when it has your application, so it knows exactly what you receive from Social Security. It takes all your income sources, totals them up, then measures that total against what you pay in unreimbursed medical expenses (i.e., assisted living facility or caregiver bills, supplemental healthcare premiums, etc.). If your UMEs are greater than your income, it shows that you need financial assistance and you are more likely to receive the full VA A&A pension amount.
But if you disclose your net Social Security income, the VA will catch it and use the information from the IRS. Now, if your income ends up greater than your UMEs, the VA will reduce your benefit amount down from the full benefit.


There is an important distinction when talking about Medicaid. There is nursing home care, also known as skilled nursing, and there is home-based care, which includes assisted living facilities. If you are on home-based Medicaid, you could still receive the full VA A&A pension amount. But if you are in a skilled nursing facility and Medicaid is picking up the bulk of that tab, then your VA A&A benefit amount is capped at $90 a month.

Figuring it all out

A Florida elder law attorney can help you examine your Social Security and Medicaid numbers, and show you how they fit into a plan to qualify for the VA Aid & Attendance benefit.  Call the Law Office of Michelangelo Mortellaro, P.A. for a free consultation at 813-367-1500.