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Do I have to notify the VA about being on Medicaid?

Mother has been receiving VA Aid & Attendance since March 2014. On December 1 she was approved for Medicaid in NJ. I can't find anything in the VA's correspondence, Web site, etc., that says we have to notify the VA about the Medicaid approval, but I have heard that the A&A will eventually be reduced to $90. The state knows she's been receiving the A&A pension, which fortunately didn't disqualify her from being approved for Medicaid, so can I assume that the state somehow notifies the VA?
Status: Open    Feb 02, 2015 - 09:05 AM

Medicare/Medicaid, VA Benefits

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7 answers

Expert Answers

Aug 18, 2015 - 02:22 PM

No you need to notify the VA in writing as soon as you can. The VA will then reduce her pension to $90.00. It unfortunately sounds like your mother will be in overpayment situation and have to pay back the VA from the date Medicaid took over. If you have any additional questions or comments please direct them either to me or your local Veterans Service Officer.

Source: My Knowledge as a Veterans Service Officer, trained and accredidted in Veterans Benefits.

Aug 20, 2015 - 06:53 AM

Yes, you must notify the VA, BUT...
The $90 reduction is for Medicaid in Nursing Home ONLY.
If your mother is in assisted living, the VA will calculate her new VA benefit amount based on her income and new assisted living fee.
The VA will not ask for the funds back for the period between when you notify them and they reduce the award.
This can be very tricky, you need to make sure she doesn't receive too much in VA benefits, which could put her over income or asset. The treatment varies by state as to what is countable income/asset after the receipt of the VA benefit


Voted Best Answer

Aug 19, 2015 - 07:48 AM

I only caution you as to using them because if the VA makes a determination that she was in overpayment they will look for those funds to be returned. However, if you have notified the VA and due to their constant "process issues" and their inability to get anything done in a timely fashion then what you will need to do is request a waiver of the overpayment. But if the VA does not come looking for those funds later then it should be fine. I have had many cases where the VA said that the claimant failed to notify a change in income and/or expenses. Since you are able to show that you did in fact notify them you have a better case of them forgiving any debt that may be created from an overpayment. You can call the National number for the Pension Management Center at 1-877-294-6380, hopefully you will not be on hold as per usual when call the 800-827-1000 number. Additionally, this number you will speak to someone who has knowledge on the Pensions (hopefully) and can direct the best course of action.

Lastly, I would say that as long as the funds are used for medical purposes and not just given away for gifts, etc. There lies a better argument that the funds were used as they were intended for to assist with medical expenses, to combat the VA's argument that you were enriched unjustly.

Source: My Knowledge as a Veterans Service Officer, trained and accredidted in Veterans Benefits.


Feb 03, 2015 - 07:48 AM

I have the same situation and haven't heard a word from the VA. The state did include the full amount in my mothers cost of care so will be following this question.

Aug 18, 2015 - 03:54 PM

Thank you, mlfetrow. Once I knew for sure that Medicaid was picking up the tab for most of my mother’s assisted living expenses I informed the VA of my mother’s situation in writing via certified mail. That was in early April. In May I followed up with a second letter outlining her pre- and post-Medicaid expenses. In response I received a letter from the VA explaining that due to the “great number of claims” any action on my mother’s claim “may be delayed” and there was “no need to contact us in the meantime.” That letter was dated June 1. After a period of two months with no further word from the VA I called and set up a date and time for a return phone call from the VA’s Philadelphia Regional Office. On August 4 I received a return phone call and spoke with an individual there at length about my mother’s case and how the buildup of VA funds in my mother’s account was in excess of the $2,000 limit that Medicaid recipients were able to maintain in assets. I added that my (quite lucid) mother is under the assumption that the funds are hers to keep, spend, or even give away. The VA representative responded that, until the VA made a determination regarding my mother’s case, the funds could stay in my mother’s account and that she could use them to cover her expenses.

Right now my mother is contemplating using the funds to get hearing aids and new dentures. Based on the VA representative’s response, I’m under the impression that those expenditures might be okay for her to make. How does that sound to you? Once the money is gone (for those expenses), very little will be left for the VA to recover.

Aug 18, 2015 - 05:32 PM

I had the annual VA audit in February for my mom's A & A and was told it would be reduced but has not been changed. I have called the VA and was told it would take time ( it's now August) and that it would start effective the date we are notified, not retroactive. The Medicaid folks have heard nothing from the VA and although they were in error when computing her cost of care for the nursing home, axccording to the VA she would not be responsible to pay anything back. Just thought I'd throw that out there After the last response. Tx.

Aug 20, 2015 - 07:13 AM

P. Servaes, you are correct, my mother received the benefit while she was in the assisted living at full survivor spouse benefit. during the MaineCare application approval process her nursing home cost of care included this full amount As their determination. That was December of 2014. Her VA fiduciary audit was in February 2015 and we were advised that the amount should have been reduced. Paperwork was submitted by the fiduciary officer and I followed up with the VA in April after not hearing anything and her automatic deposit was the same amount. They told me it could take up to 90 days to complete the change and that we would be notified. It is now August and we are still receiving the same benefit amount. I contacted MaineCare DHHS ( Maine's medicaid program) and they have not received notification for a change either. We continue to send the full benefit amount to the nursing home as part of her cost of care. There seems to be no getting around this and we have done all we can do at this point.
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