What this means
m21-1:XIII.i.3.D explains eligibility for medical services associated with aid and attendance (a&a) or housebound status. In plain terms, the official guidance says notify a Veteran of medical care eligibility and application information when A&A or housebound benefits are awarded. The information is provided on It also addresses if a pension award to a Veteran entitled to A&A (code 1 or 2) is terminated because of excess income, message code 652, A&A Term— [Year] Income Over Limit by $ _____, is issued for routing to the pension management center.
How this may help with a claim
Use m21-1:XIII.i.3.D to audit how VA handled eligibility for medical services associated with aid and attendance (a&a) or housebound status. Start with the decision date, the issue being reviewed, and the evidence VA was allowed to consider, then compare the record with this rule: Notify a Veteran of medical care eligibility and application information when A&A or housebound benefits are awarded. If a pension award to a Veteran entitled to A&A (code 1 or 2) is terminated because of excess income, message code 652, A&A Term— [Year] Income Over Limit by $ _____, is issued for routing to the pension management center. Cite the exact document and page when raising a factual or procedural error, and use the review rights in the actual notice for any deadline.
What to review in your file
- Check the file against this official condition: Notify a Veteran of medical care eligibility and application information when A&A or housebound benefits are awarded. The information is provided on
- Confirm that the record or notice addresses this source point: Follow the steps in the table below when an eligibility request is received for medical services under 38 U.S.C 1712(d).
- Document how this stated step or exception applies: Step — Action; 1 — Complete VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action, to show entitlement. Note:
Important limits
m21-1:XIII.i.3.D explains VA guidance for eligibility for medical services associated with aid and attendance (a&a) or housebound status; it does not guarantee an award or replace the statutes, regulations, binding decisions, and review instructions that control an individual claim. Conditions and exceptions still matter, including this source point: Notify a Veteran of medical care eligibility and application information when A&A or housebound benefits are awarded. Check the claims folder to determine if there is current data sufficient to permit furnishing income information for the next year.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Eligibility for Medical Services Associated With Aid and Attendance (A&A) or Housebound Status
- m21-1:XIII.i.3.D
- Eligibility Medical Services
- Associated Aid Attendance
- Requests Housebound Medical Benefits
- eligibility medical services under
- providing notification eligibility
- processing eligibility requests.
Original VA guidance
The official VA text of this section
Overview
In This Section
This section contains the following topics:
Scroll sideways to see the full table.
| Topic | Topic Name |
|---|---|
| 1 | Requests for Aid and Attendance (A&A) and Housebound Medical Benefits |
| 2 | Eligibility for Outpatient Medications for A&A Cases in Which Income Is Excessive |
1. Requests for A&A and Housebound Medical Benefits
Introduction
This topic contains information on requests for A&A and housebound medical benefits, including
- eligibility for medical services under 38 U.S.C. 1712(d)
- providing notification of eligibility to Veterans, and
- processing eligibility requests.
Change Date
April 12, 2007
XIII.i.3.D.1.a. Eligibility for Medical Services Under 38 U.S.C. 1712 (d)
Under 38 U.S.C. 1712(d), Veterans receiving additional compensation or increased pension for aid and attendance (A&A) or housebound benefits are entitled to medical services, including
- outpatient treatment
- drugs, and
- medicines.
XIII.i.3.D.1.b. Providing Notification of Eligibility to Veterans
Notify a Veteran of medical care eligibility and application information when A&A or housebound benefits are awarded. The information is provided on
- VA Form 21-8764, Disability Compensation Award Attachment, or
- VA Form 21P-8768, Disability Pension Award Attachment.
XIII.i.3.D.1.c. Processing Eligibility Requests
Follow the steps in the table below when an eligibility request is received for medical services under 38 U.S.C 1712(d).
Scroll sideways to see the full table.
| Step | Action |
|---|---|
| 1 | Complete VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action, to show entitlement. Note: A future examination diary control has no effect on entitlement. |
| 2 | Complete the Remarks section of Part II of VA Form 10-7131 to show the following, as appropriate: Veteran receiving [additional compensation/increased pension] by reason of being [in need of regular A&A/permanently housebound]. |
2. Eligibility for Outpatient Medications for A&A Cases in Which Income Is Excessive
Introduction
This topic contains information on eligibility for outpatient medications for A&A cases in which income is excessive, including
- income limitation for eligibility for medications
- cases involving the termination of pension awards
- processing message code 652
- establishing continued entitlement to medications
- requesting income information from the Veteran, and
- completing the Remarks section of VA Form 10-7131.
Change Date
April 13, 2020
XIII.i.3.D.2.a. Income Limitation for Eligibility for Medications
Per 38 U.S.C. 1712(d), the Department of Veterans Affairs (VA) continues to furnish outpatient medications to Veterans entitled to A&A, including those reduced under 38 CFR 3.552(b)(1), whose income exceeds the applicable limit by no more than $1,000.
XIII.i.3.D.2.b. Cases Involving the Termination of Pension Awards
If a pension award to a Veteran entitled to A&A (code 1 or 2) is terminated because of excess income, message code 652, A&A Term— [Year] Income Over Limit by $ _____, is issued for routing to the pension management center.
XIII.i.3.D.2.c. Processing Message Code 652
To process message code 652, follow the steps in the table below.
Scroll sideways to see the full table.
| Step | Action |
|---|---|
| 1 | Review the claims folder to verify that the Veteran is entitled to A&A, and determine the amount by which income exceeded the maximum annual limit. |
| 2 | Annotate VA Form 20-6560, Notice of Benefit Payment Transaction, with entry of the amount over the income limit in the message legend space “$ ______ ”. |
| 3 | Date and sign the form. |
| 4 | Send the form to the requesting medical facility. |
| 5 | Annotate the claims folder to show the income information furnished to the medical facility. |
XIII.i.3.D.2.d. Establishing Continued Entitlement to Medications
Establish continued entitlement to outpatient medications annually in those pension cases in which the current year income did not exceed the limit by more than $1,000.
Individual requests from the medical facility for income information for the next calendar year are received on VA Form 10-7131 during the last three months of the current year.
XIII.i.3.D.2.e. Requesting Income Information From the Veteran
Check the claims folder to determine if there is current data sufficient to permit furnishing income information for the next year.
If the claims folder does not already contain sufficient income data for the next year,
- request that the Veteran complete the appropriate Eligibility Verification Report form, and
- in the transmittal letter, indicate the reason for the request and state that the completed form should be returned within 30 days.
XIII.i.3.D.2.f. Completing the Remarks Section of VA Form 10-7131
Upon receipt of the desired information, or at the end of 30 days, enter the response in the Remarks, section, Part II, of VA Form 10-7131.
Use the table below to determine what to enter into Remarks when income information is received or not received from the Veteran.
Scroll sideways to see the full table.
| If … | Then … |
|---|---|
| income information is received, and the Veteran is entitled to A&A benefits, except as to income | indicate the amount by which income for the next year will exceed the applicable maximum income limit. |
| income information is received, and the Veteran is entitled to a resumption of pension, including the A&A allowance | process the case as a supplemental claim, and annotate VA Form 10-7131. |
| income information is not received | annotate VA Form 10-7131 to indicate that no reply was received from the Veteran, and do not take follow-up action. |