A home aide arrangement and an assisted living placement are priced differently, and the paperwork differs too. In a facility, the family receives one monthly invoice that often mixes housing, meals, personal care, and health services. Before the family can judge what the pension might offset, that invoice has to be pulled apart.1

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Ask for the bill in parts

Request an itemized monthly statement from the facility and ask it to separate the charges into groups such as housing and meals, personal care or service level, health services, and extras like supplies or transportation. Ask what triggers a change in the service level and whether a change re-prices the monthly bill. A single flat rate tells you little about which lines matter.

Check each line against VA's rules

VA decides which expenses count toward the pension calculation, and the rules treat categories differently. Do not assume that every line on the facility bill counts, and do not assume that none of it does. The expense section of the pension information on VA.gov sets out what VA accepts, and the facility's split is what lets you test each line against that section.2

VA also applies a threshold before expenses reduce countable income, so a small line may have no effect at all. Work out the total for the lines that might count, then see whether it clears that threshold on the VA page before deciding how much weight to give it.

Fit the setting to the household

  • If the veteran is single, confirm that the quoted rate is for one person and that no second-person charge will apply later.
  • If a spouse lives in the same facility or in a separate one, the two bills and the two benefit calculations must be kept apart, and the family should confirm how VA will see each.
  • If a spouse still lives at home, confirm which costs stay with the home and which move with the veteran, so that the same expense is not counted twice on two different forms.
  • Ask whether the facility will provide written documentation for VA and whether it will bill the family directly or through an agent.
  • Ask about the move-in deposit, the notice period for leaving, and whether any refund depends on the timing of the move.

Compare facilities on the same terms

Put each facility's answers into the same table: the level-of-care tiers, the price for each tier, the documents provided for benefit claims, the deposit and notice terms, and the billing contact. A facility that cannot split its bill, or that will not put its service-level terms in writing, has made the calculation harder for the family, not easier.

The Aid and Attendance Briefing home page connects this piece to the rest of the desk's guides on the pension itself.

This desk is not affiliated with the U.S. Department of Veterans Affairs.

1 VA.gov, Veterans pension benefits overview.
2 VA.gov, pension expense rules, including the treatment of unreimbursed medical expenses.