senior issues
b y kerry park
Tapping into VA benefits Financing issues regarding nursing home care is one of the most difficult areas to navigate for those going through the process of accessing care for themselves, a friend or family member. Generally, the conversation revolves around one of four options: private funds, long-term care insurance, Medicare or Medicaid. There is another option available, however, which may be available to current and retired members of the military. Depending on a veteran’s particular situation and need, they may be eligible to receive fully-funded care in a VA contract nursing home in Rhode Island, paid for by VA Health Care. Most Rhode Islanders are familiar with the Veterans Home in Bristol – the state-operated facility that provides skilled nursing care to veterans and some family members. Fewer realize though, that the Providence Veterans Affairs Medical Center (PVAMC)
currently contracts with seven nursing homes throughout the state in its Community Nursing Home Program. Through the program, eligible veterans may receive nursing home care in communities that are near their friends or families. So, while the Veterans Home in Bristol is an option for many veterans, it is not the only choice. Unlike the requirements of Medicaid, which funds long-term care once the bulk of a patient’s assets have been depleted, those eligible for care in a VA contract nursing home in Rhode Island using VA benefits to fund their care do not lose their pension, Social Security or savings. Hospitalization is also not mandatory prior to nursing home placement, as is required for Medicare and Medicaid eligibility. “One of the greatest benefits of VA eligibility is that some people can avoid out-of-pocket costs for care and medications altogether,” said Sandy Matos,
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2012 chair of the Rhode Island Health Care Association Financial Management Group and director of financial services at Orchard View Manor in East Providence. “Be prepared though, the key to accessing VA benefits for nursing home care is pre-authorization,” Matos continued. “If you are admitted to a hospital that is not the VA Hospital, contact your VA social worker immediately. It’s extremely important that patients inform the VA of what’s going on from the outset in order to get the authorizations needed to be eligible for VA longterm care benefits.” Veterans who have a service-connected injury or disability of 70 percent or higher and who have a VA primary care physician could be eligible for nursing home care benefits. Service-connected disabilities are current chronic disabilities diagnosed by a medical professional and determined by the VA to have been
Medicare
caused or aggravated by military service. The actual percentage indicates the severity of the disability or disabilities. Planning ahead is important. Those whose conditions have been identified and treated by the VA before skilled care is needed will have an easier time and the best chance of success in the determination of nursing home benefit eligibility. If you would like information about nursing home care VA benefits through the Community Nursing Home Program and contracted facilities, contact your VA primary care provider at 457-3336.
Now through December 7.
It’s time to review your Medicare health and Medicare prescription drug (Part D) plans. Need help to make informed choices for 2013? Talk to a State Health Insurance Program (SHIP) counselor. To learn more about Medicare Open Enrollment events happening across the state, call the RI Division of Elderly Affairs at 401-462-3000 TTY 401-462-0740, or THE POINT at 401-462-4444 TTY 401-462-4445.
State of Rhode Island Department of Human Services
Division of Elderly Affairs This ad was produced, in whole or in part, through grants from the U.S. Administration on Aging and the Centers for Medicare and Medicaid Services.
November 2012