Are You Positive that Veteran Benefits Have You Covered for Long-Term Care?

Life Insurance

Many Veterans will often avoid getting long-term care because they make the assumption that simply by being a Veteran that they will be taken care of. This simply is not so. Congress passed the Veterans’ Health Care Eligibility Reform Act in October of 1996. Congress attempted to create uniform rules on eligibility and benefits, codified as the Uniform Benefits Package.

This law classifies veterans [retired military continue to have health care benefits under TriCare (see below) or the US Family Health Plan] into priority groups, with the lower-numbered groups eligible for greater health care (medical) bene­fits. The priority is for services related to a disability.

As you will see, there is NO direct coverage for custodial care under these Groups.

Priority Group 1: Veterans with service-connected disabilities rated as 50% or more disabling, and/or veterans determined by the VA to be unemployable due to service-connected conditions.

Priority Group 2: Veterans with service-connected disabilities rated as 30% or 40% disabling.

Priority Group 3: Veterans with service-connected disabilities rated as 10% or 20% disabling; veterans who are former POWs; veterans awarded the Purple Heart, or whose discharge was for a disability that began in the line of duty; veterans who are disabled because of VA treatment and/or participation in a VA vocational rehabilitation program.

Priority Group 4: Veterans who are receiving Aid and Attendance or housebound benefits (on pension) from the VA; and/or veterans who have been determined by the VA to be “catastrophically disabled”.

Priority Group 5: Veterans who are receiving VA pension benefits; are eligible for Medicaid programs; and/or whose income and assets are below VA “means-tested thresholds”.

Priority Group 6: Those veterans seeking care for:

  • 0%-service-connected conditions, but also receiving VA compen­sation
  • Disorders relating to ionizing radiation and Project 112/ SHAD
  • Agent Orange exposure during service in Vietnam
  • Gulf War illness
  • Conditions related to exposure to environmental contami­nants during service in the Persian Gulf
  • Served in combat in a war after the Gulf War or during a period of hostility after November 11, 1998 for two years following discharge or release from the military.

Priority Group 7: Veterans who agree to pay a specified co-payment with income and/or net worth above the “VA Income Threshold” and income below the “Geographic Means Test Threshold”.

  • Subpriority A: Non-compensable 0%-service-connected veterans who were enrolled in the VA Health Care System on a specified date and who have remained enrolled since that date
  • Subpriority C: Non-service-connected veterans who were enrolled in the VA Health Care System on a specified date and who have remained enrolled since that date

Priority Group 8: Veterans who agree to pay a specified co-payment with income and/or net worth above the “VA Means Test Threshold” and the “Geographic Means Test Threshold”.

  • Subpriority A: Non-compensable 0%-service-connected veterans enrolled as of January 16, 2003 and who have re­mained enrolled since that date
  • Subpriority C: Non-service-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date
  • Subpriority E: Non-compensable 0%-service-connected veterans applying for enrollment after January 16, 2003
  • Subpriority G: Non-service-connected veterans who applied for enrollment after January 16, 2003. Effective January 17, 2003, the VA suspended new enrollment of veterans assigned to Priority Group 8 (the VA’s lowest priority group, consisting of higher-income veterans). If you are a veteran who enrolled for the first time on or after January 17, 2003, and your in­come exceeds the current year income threshold, you are not eligible for enrollment at this time. Veterans enrolled in Prior­ity Group 8 on or before January 16, 2003, will remain enrolled and continue to be eligible for the full range of VA health care benefits.

As you can see, there is quite a laundry list of levels of eligibility that are not automatically going to allow a Veteran to receive long-term care benefits. Benefit levels are based primarily on the level of disability/exposure, time or entry, and current income levels. If you realize that you do not qualify, or have a loved one you know that does not qualify, but who needs the protection, please call me.

About the author: Kyle McDonald holds FIC, FICF, FSCP® & CLTC designations. His viewpoint on life insurance is simple, “Anyone with a family must have life insurance. In the end, life insurance is for others you care about, not you.” He is ready to help you and your family get the best option available. Contact Kyle today at   1-800-651-1953 or KMcDonald@Pivot.com.