We hear it all the time, “My client is currently getting in-home care from Medicaid or VA Choremakers and wouldn’t qualify.” But did you know that Homemaker Services and Medicaid can be layered with the VA benefit Pension with Aid and Attendance? It is another resource the Veteran or surviving spouse can apply for to help pay for home care services. This doesn’t mean a mountain of paperwork for your agency either. At Veterans Care Coordination, our Client Care Department has expertise in navigating other local programs to meet the care needs to stay at home. We will help identify VA Medical Centers, local Medicaid offices, Department of Aging, Senior Centers, and more to maximize the allowable home care programs.

Using Additional Programs with Pension with Aid and Attendance

Veterans Care Coordination (VCC) helps Veterans and surviving spouses meet their desire to age in place, in the comfort of their home through the use of Pension with Aid and Attendance for home care services. However, in some cases, the number of home care hours provided through the Pension with Aid and Attendance alone may no longer be enough coverage to offer the necessary support to stay independent in their home. Did you know that other Federal, State, and local programs are available to use alongside Pension with Aid and Attendance for extra support? 

Homemaker Home Health Aide Program

The Homemaker Home Health Aide Program is a program for Veterans through the local VA Medical Center (VAMC). Eligibility for this program is for Veterans of any age enrolled in the VHA Standard Benefits Package with the need for service. Personal Care services can be provided in the home through a third-party agency contracted with the Department of Veterans Affairs. A Registered Nurse (RN) comes into the home to complete an initial assessment. The RN will complete a care plan to include Activities of Daily Living such as dressing, feeding, and bathing. Along with instrumental activities of daily living; shopping, light housekeeping, and laundry. Homemaker and Home Health Aide services can be used in combination with other Home and Community Services, which can be found on the VA’s website. 

Veteran Directed Care Program (VDC) 

VDC began in 2009, previously known as Veterans Directed Home and Community Based Services (VDHCBS), but is referred to by multiple names depending on the region; Cash for Veterans, Veterans Community Living, Veterans Independence Plus, and Veteran Directed Home Services. This program sets Veterans with a budget to choose their provider for home care services. Veterans may also hire a family member that can be paid for the care provided. Similar to the Homemaker Home Health Aide Program above, this is applied for through the VA Medical Center. Eligibility for this program is for Veterans needing a nursing home level of care and currently reside at home, with a loved one, or in an independent living facility. Unlike Pension with Aid and Attendance, there are no income or asset limits. 

Home and Community-Based Services (HBCS)

Home and Community-Based Services were directed through Medicaid starting in 1983. This program continues to grow and is available through multiple options, including Home and Community Based Waivers or Medicaid State plan options. Federal guidelines govern HCBS, but individual states develop and operate within their own additional state guidelines. Eligibility for this program includes certain income and asset levels set by particular state requirements and the level of care need or support in their home. Most states view the Pension with Aid and Attendance as an income exclusion, meaning there is no conflict of interest in having multiple programs. As of 2020, over 2.5 million individuals are enrolled to receive Home and Community Based home care services. Services provided through HCBS can include personal care, homemaking services, respite care, and adult day health services. In addition, some states offer a Self Directed Services option, allowing both Veterans and Surviving Spouses to hire a friend, family, or neighbor as their caregiver to be paid for the care provided. 

For example, Missouri Medicaid (MoHealthNet), through the Department of Health and Senior Services, under the Division of Senior and Disability Services Administration, offers multiple programs, including HCBS, Consumer Directed Services, Money Follows the Person, or Aged and Disabled Waiver. To obtain more information on a state’s HCBS options, visit or contact the local Medicaid Office.  

As your partner, Veterans Care Coordination strives to be a reliable and knowledgable resource. We are here to help navigate the process and direct your clients towards the best potential outcome to help them age independently at home.