A medical expense figure is only as good as the months it sits in. The VA works from what was paid, when it was paid, and who covered it, so sizing the total starts with a sort, not a sum.

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Sort by the month the money left

Pull every bill, receipt, and bank line for the period the form covers. Place each one in a month column based on the date it was paid, not the date printed on the invoice. Where a bill was paid in one month for care given in another, write down both dates. Before you finalize, confirm with the VA which date the current expense form asks for, because the form's wording controls how the columns should be set up.1

Subtract what someone else paid back

Insurance reimbursements, a payment from another program, or a refund reduces the out-of-pocket amount. List only the portion the family actually paid. If a bill was partly covered, the uncovered part is the figure to record. The mistake to avoid is adding the gross invoice and forgetting the offset that came back later.

Keep the care line apart from the supply line

Aide wages, agency invoices, and supplies sit on different documents. Keep them in separate columns so each total can be checked against its own paper. If a family member is paid for hands-on help, ask the VA office what proof it accepts for those payments, such as a dated payment record or a bank entry, and gather it as you go. Asking before filing is far easier than answering a request for more paper after the form is already in.

Check the total against the paper

Add each month's column, then add the months together. Compare the sum to the paper pile. Any month with no entry needs a short note explaining why, such as a month with no billed visits or no supply purchases. A blank month invites questions, while a month with a written reason is easy to explain.

Keep the sheet current

The sheet is the working file, not a one-time form. Add each new bill the week it arrives, and keep a copy of whatever was filed. When hours change, the monthly figure changes with them, so the sheet should show what was actually paid each month rather than a number carried forward from an old quote. Keep the original receipts in one folder with the sheet on top.

What to ask before you file

  • Does the current medical expense form ask for the date paid or the date of service?
  • Does the office accept payments made to a family member as expenses, and what proof does it want?
  • Does it count expenses from a period before the claim was received?
  • What happens to a bill that is reimbursed after it was already listed?

Where to check the rules

Read the VA's own rules before relying on any sheet, including the current expense form and the pension eligibility requirements.23 For office help in the St. Louis area, see Local Help: St. Louis Offices. For the source list behind this briefing, see Sources.

Notes

  1. VA.gov, Aid and Attendance and Housebound benefits.
  2. VA.gov, Medical Expense Report, VA Form 21-8416.
  3. VA.gov, pension eligibility requirements.