VA Aid and Attendance Benefit and The Vial of Life Marketing

Slide 4: The Veterans Administration has established a pension program whereby the purchase of personal care and attendant home services may be paid for through a Veteran’s acquired pension. If they are a Veteran or the surviving spouse of a Veteran who has served at least 90 days or more on active duty with one day beginning or ending during a period of war, and they are in need of assistance at HOME due to their disabilities, they may be eligible for VA's non-service connected disability pension.

Slide 5:  This Special Pension allows for Veterans and surviving spouses who require the regular attendance of a caregiver to assist with:  eating,  bathing,  dressing,  undressing  or taking care of the needs of nature

Slide 6:  This also includes individuals who are blind-  or a patient in a nursing home because of mental or physical incapacity.  Assisted care in an assisted living facility also qualifies.  It is not a benefit for a person needing housekeeping or respite or part time care. This most important benefit is overlooked by many families with Veterans or surviving spouses who need additional cash flow to help care for ailing parents or loved ones.

Slide 7: • Veterans must have served 1 day during an active war and had no less than a 90 day service. • Surviving spouses must still have been married to the veteran when they passed. • They must have a doctor’s order insisting they need the aid and attendance of a caregiver every day. • They must have less then 80K in checking and savings- even less if they are applying as a single person (not including their home or vehicles). If they have IRAs and CDs they are included as income. • They must have received an honorable discharge or general discharge. • They can choose where they want to live as long as it is a credible facility or community or home care company. • They may not qualify if they are on state assistance. (Medicaid or another subsidized program due to their low income).

Slide 9:  It’s hard to speculate on what a family will experience while filing for the Aid & Attendance Special Pension.  Each case is unique and carries its own set of challenges.  One thing you can expect (and families should expect) is that it will take 4-6 months for the application to be processed.  Fortunately, all benefits are retro-dated back to the original filing date.  However, if the loved one is ill, it can be a challenge to get everything done quickly.  Pre-Qualification Form: http://www.veterans-express.com/PreQualificationForm.asp

Slide 10:  Up to $1,554 per month for a wartime veteran; OR  Up to $998 per month for a surviving spouse; OR  Up to $1,842 per month for a qualifying couple.  Note: These amounts apply only to 2008; benefits are adjusted each year based on increases in the cost of living.  Because of the A&A Special Pension, many veterans will not have to live out their lives in Medicaid or VA nursing homes.  Instead, assisted living (or home care) will be an affordable option.  *Benefits start when the VA receives a packet, not when a senior begins home care or assisted living services. Getting your packet done and handed in quickly is crucial. Your loved one must be currently or close to receiving home care or living in an assisted living at the time they apply. They must have the debt of the costs to be in need of the benefit.

Slide 11:  Pre-qualifying is a way to see if the applicant "could" get the benefit, but what the VA does not tell them is that qualifiers can change with different scenarios such as: * Older age * Too much savings  *Example: A 76 year old senior with 40K in savings (IRA's, CD's, Savings, and Annuity) may be a good candidate, but a 92 year old man may be considered to have enough money (due to the fact he is over life expectancy in the eyes of the VA.) Same goes for the married couples. 80K may be fine for 76 and 74 year old married couple, but in their upper 80's-90, you may want to consider the possibility of denial due to high savings.

Slide 12: www.Veterans-Express.com does NOT recommend moving assets into annuities, or making financial transfers in order to qualify. However, the VA does not look back on what the Veteran had before they applied. (BUT MEDICAID DOES!) The problems occur when an untrained financial advisor makes inappropriate annuity suggestions, or inadvertently ends up disqualifying a Veteran for Medicaid down the road- because of poor decision making on asset transfers. BE CAREFUL.

Slide 13:  If a Veteran decides to apply, www.veterans-express.com will provide all of the forms needed. The Veteran must locate the following documents:  Discharge papers  Marriage license (for marriage of surviving spouses)  Death certificates (for surviving spouses) *** Cannot stress enough how important it is to obtain the claimants medical records from their doctors office. This will make it much easier for the VA adjudicator to make a decision when they receive the application. If the records are not included they will send away for these records and that takes TIME! Also, Include proof of income like bank statements or social security statements.

Slide 14:  Only the claimant/senior signs the paperwork.  VA does not recognize a power of attorney to sign for the claimant. If that is not possible, have them sign an "X" and follow the witness instructions.  Make sure everything is correct when you mail it off to the REGIONAL OFFICE in your state.  Example: Income $2000 /month Medical expenses (includes PVT health care, and other medical costs paid out of pocket, RX, DR co pays, insurances, nursing home costs, eye glasses, dentist, and so on) $2000 total medical expenses Income here is zero, full benefit should be awarded. Always list all of your medical expenses creating as much a deficit as possible to show the VA you are in financial hardship due to your medical expense vs. your income. Better to play it safe! The VA does make the final decision. Savings reported are what was recommended and at or under the amount in the "safe zone"

Slide 15:  Claimant signed ( or made an "X" and had witnesses)  All copies of discharge papers, marriage, death cert., and medical history provided by MD office, proof of income (bank statements, block out account numbers) is all there.  Big envelope and an address to the REGIONAL OFFICE IN THE STATE WHERE THE CLAIMANT LIVES only.  Do not send these documents to any other location. Send delivery certified so they can track the package.  Remember, if the VA loses it, they will have to submit a new application but now the senior can prove they sent one and the VA will have to retro-date it back.  Make a copy of the file to keep for that purpose.

Slide 16:  The Veteran should receive a courtesy letter in about 4-6 weeks from the VA stating they have received their application and are working on it.  If they do not get the letter call 800-827-1000.  Also, if someone else is calling for the claimant, make sure they filed a 21-22a.  Have the veterans social security number available.  The VA still may not speak with a representative but be persistent or have the claimant present.  Just make sure the 21-22A is filed!

Slide 17:  The Veteran will receive a few correspondences from the VA. Some will make no sense.  These letters can be erroneous and sometimes ask them for things they already submitted.  They still need to address it because it’s worth it!  Be persistent and vigilant for your senior.

Slide 18:  If all goes well, they will receive a letter saying "Benefits have been awarded" in the average time of 6 months with a date when the benefits will begin!  Success!  However, if they have found the claimant to be " Incompetent" due to extreme dementia or Alzheimer's, they may withhold the benefit until a fiduciary is set in place. (usually DPOA)

Slide 19: Consider the use of Reverse Mortgage proceeds (takes about 30 days or less) to fill in the blanks on the private pay cash flow until the VA benefit kicks in. Or use in combination with the VA Benefit!

Slide 20: WWW.Veterans-Express.com http://www.veterans-express.com/PreQualificationForm.asp Senior Advocate/ VA Benefits "There are no problems only solutions“ info@veterans-express.com Melissa Delieto 951.695.5188 ext 304 877-408-8340 toll free fax

Slide 21: Vial of Life Marketing Webinar 2008

Slide 22:  An Added Value Service and Community Service  The Vial of Life Project has been around for many years. In fact, you can find a couple of versions of it on the internet by doing an internet search for “vial of life”. However, there is a way to brand this as your own, and add it to your suite of services as a give away, added value service, and as a “senior safety” community service. 

Slide 23:  After all, if we are in the business of keeping seniors in their own homes longer, doesn’t it make sense to offer them away to stay safe as well!?  The Vial of Life is simply this: A brief information sheet including current medications, allergies, doctor’s names, next of kin, is placed in a vial (which can be a blank prescription drug container, or any small bottle or container of any kind). The vial is then placed inside the refrigerator on the door, or in the freezer. A magnet or sticker is placed on the front door (on the inside) alerting emergency medical personnel that vital information is located in the refrigerator.

Slide 24:  Today most EMS personnel are trained to look for the vial of life or some indication that vital information is easily accessible in the house.  Here is your marketing opportunity.  Have simple magnets or stickers designed that say VIAL of LIFE in Refrigerator. The stickers can be shaped like a house or whatever form you prefer.  Be sure to have something like this printed on the sticker/magnet as well: Compliments of XYZ Home Care/ Adult Day Care Services 555-555-5555 Or- In-Home Care (Adult Day Care, Financial Planners) Help(s) Seniors, and So Does The Vial of Life, Compliments of XYZ _________ Service. (You do the formatting etc)

Slide 25:  Now you have to obtain the “vial” or container.  One way to get containers for the “vial” is to order them online. Here is a sample website. http://www.containerandpackaging.com/index.html  You only need a small bottle to make this work.  Or, you can call on your local small (not big chain) family owned and operated pharmacy, explain what you are doing and ask if you can buy some containers at a discounted rate from them. Why would they be interested?  If you offer to put their name on the vial of life FORM as a sponsor, they get essentially free advertising. A no brainer!  You may also want to order some cheap stickers so that you can label your containers “Vial of Life”. You can also print those on your own computer using basic address labels.

Slide 26:  Next you need to print out your vial of life forms. (coming up) www.vialoflife.com  Finally, everything including your form, magnet/sticker for the door, and labeled container go into a plastic sandwich bag, with a short set of instructions.  Hand out the baggies with the Vial of Life at every opportunity- seminars, senior fairs, to referrals, as a FOLLOW UP with people who have inquired about a senior service.  What else can you place in that baggy? A short FAQ on your services? A coupon for a free consultation? The options are limitless.

Slide 29: Sample Magnets Sample Stickers

Slide 30: Another marketing tip: Create a sign that says: FREE VIAL OF LIFE IMPORTANT FOR ANYONE WHO TAKES PRESCRIPTION DRUGS!