Complete Guide to Medicaid and Long-Term Care Planning in Etowah
Planning for long-term care and Medicaid can feel overwhelming, especially when health concerns and financial pressures come together. Our goal at Jay Johnson Law Firm is to provide clear, compassionate guidance tailored to the needs of Etowah families. This page explains the options available under Tennessee law, practical steps you can take now to protect assets and secure benefits, and how to coordinate care planning with medical providers, family members, and care facilities. You will find straightforward information to help you make informed choices that fit your family’s situation and long-term goals.
Medicaid rules and long-term care planning require attention to both legal and financial details, and timing matters. Early planning can reduce stress and improve the likelihood of qualifying for benefits while preserving as much of your loved one’s resources as possible. Our approach focuses on realistic, legal strategies that reflect Tennessee’s Medicaid eligibility rules, spousal protections, and available long-term care services. We aim to equip you with the knowledge to avoid common mistakes and to take practical steps so you can concentrate on care and wellbeing rather than paperwork and uncertainty.
Why Medicaid and Long-Term Care Planning Matters for Etowah Families
Effective planning for Medicaid and long-term care helps families manage the high costs of nursing homes, in-home care, and assisted living while preserving dignity and family resources. Proper legal planning can protect a spouse’s income and living arrangements, clarify decision-making authority for health and finances, and reduce the risk of delays or denials in benefits. For many families, having a clear plan lessens emotional burdens and improves access to needed services. Thoughtful planning also supports transitions between levels of care and can help maintain eligibility for government programs when it matters most.
About Jay Johnson Law Firm and Our Approach to Long-Term Care Planning
Jay Johnson Law Firm serves families across Hendersonville and surrounding Tennessee communities with focused attention on elder law and long-term care planning. Our lawyers take a practical, client-focused approach that considers medical realities, financial constraints, and family dynamics. We work to create plans that are clear, legally sound, and tailored to individual circumstances. Whether reviewing benefits eligibility, preparing planning documents, or coordinating with care providers, we help families navigate the process with sensitivity and steady guidance so they can focus on the needs of their loved ones.
Understanding Medicaid and Long-Term Care Planning in Tennessee
Medicaid and long-term care planning includes understanding eligibility rules, the types of assets counted for benefits, and methods to protect family resources while qualifying for services. In Tennessee, rules govern income limits, asset transfers, and look-back periods that affect eligibility timelines. Planning can involve creating trusts, structuring asset ownership, establishing power of attorney documents, and coordinating veterans’ benefits when applicable. The goal is to secure access to necessary care while respecting the legal framework, and to develop a step-by-step plan that fits each family’s values and financial realities.
A well-rounded understanding of the process also includes recognizing the roles of caregivers, the importance of timely documentation, and how to handle facility admissions and billing. Communication with medical providers, social workers, and facility staff helps ensure all paperwork is complete and accurate. Families should also be aware of Medicaid’s rules about transfers, income spend-down strategies, and trust options, as these can have significant long-term effects. Clear planning helps reduce surprises and makes it more likely that benefits will begin when they are needed most.
What Medicaid and Long-Term Care Planning Means
Medicaid and long-term care planning refers to legal strategies that help individuals qualify for Medicaid coverage for nursing home care, in-home care, and related services while limiting the financial impact on the family. This planning addresses eligibility rules, asset management, and legal documents such as powers of attorney and advance directives. It also encompasses coordination with care providers and assessment of community resources. The objective is to balance the need for care with the desire to protect family assets, to ensure timely access to services, and to document decision-making authority for health and financial matters.
Key Elements and Typical Processes in Planning
Core elements of a planning process include evaluating current assets and income, reviewing medical needs and anticipated care costs, preparing or updating legal documents, and developing a path to benefits that complies with Tennessee’s Medicaid regulations. The process often begins with an assessment, continues with document preparation and possible asset restructuring, and concludes with application assistance and follow-up. Communication among family members and care providers is vital. A thorough plan addresses immediate needs while creating contingencies for future changes in health or finances.
Key Terms and Glossary for Medicaid and Long-Term Care
Understanding common terms helps families make informed decisions. This glossary covers phrases you will frequently encounter while planning for long-term care in Tennessee, such as Medicaid eligibility, countable assets, look-back period, and powers of attorney. Knowing the definitions and practical implications of these terms reduces confusion and enables better coordination with care providers and benefit administrators. The goal is to translate technical language into clear actions families can take to protect their interests and secure needed services.
Medicaid Eligibility
Medicaid eligibility refers to the criteria that determine whether an individual qualifies for Medicaid-funded long-term care services. Eligibility is based on income, countable assets, medical need, and residency rules. Tennessee imposes specific limits and rules designed to ensure applicants meet both financial and care-need standards. Understanding these criteria is essential for developing a plan that positions an applicant to receive benefits without unnecessary delay. Eligibility assessments often require documentation of finances, medical records, and other supporting materials.
Look-Back Period
The look-back period is the timeframe before a Medicaid application during which certain asset transfers are reviewed to determine whether a penalty period should apply. Transfers made during this period can affect eligibility, potentially delaying access to benefits. The look-back aims to prevent applicants from giving away assets solely to qualify for Medicaid. Planning strategies must account for the length of the look-back and the nature of transfers to avoid unintended penalties, while still considering legitimate personal and family planning goals.
Countable Assets
Countable assets are financial resources and property considered when determining Medicaid eligibility. Typical items include bank accounts, investments, and ownership interests in property, whereas certain assets may be exempt or treated differently under state rules. Properly identifying which assets are countable and which are exempt is a critical part of planning, since it affects eligibility timelines and the feasibility of different strategies. Reviewing asset ownership and titling can reveal options to protect resources while remaining within legal limits.
Power of Attorney and Advance Directives
Powers of attorney and advance directives are legal documents that designate who can make financial and medical decisions if someone becomes unable to act on their own behalf. These documents facilitate timely decision-making, help coordinate care, and ensure financial affairs are managed appropriately. Including these documents as part of a long-term care plan helps families avoid guardianship proceedings and provides clear instructions to providers and institutions. Updating these documents to reflect current wishes is an important step in preparing for future care needs.
Comparing Approaches: Limited Versus Comprehensive Planning
When planning for Medicaid and long-term care, families often face a choice between limited, immediate steps and a more comprehensive, long-term plan. Limited approaches may address a single concern, such as preparing an application or executing immediate documents, while comprehensive planning evaluates long-term goals, asset protection strategies, and contingency plans. Each approach has trade-offs: a limited plan can be faster and less costly up front, but a comprehensive plan can provide broader protection and smoother transitions over time. Choosing the right path depends on timing, resources, and family priorities.
When a Focused, Limited Approach May Be Appropriate:
Immediate Need for Benefits
A limited planning approach can be appropriate when an individual requires immediate assistance to secure Medicaid benefits or to address a sudden need for long-term care. In such circumstances, taking targeted actions such as preparing a Medicaid application, gathering necessary medical documentation, and ensuring key legal forms are signed can speed access to services. This approach aims to respond to an urgent situation by clearing administrative and documentation hurdles so care can begin promptly, while still considering follow-up steps for longer-term protections.
Simplicity of Financial Situation
When a person’s financial affairs are straightforward, a limited planning route may meet immediate needs without complex restructuring. Situations with clear asset ownership, limited investments, and straightforward income sources often allow for efficient assessment and application. A focused plan in these cases can handle necessary legal documentation, coordinate benefits, and provide a quick pathway to care. Families with uncomplicated circumstances may find this approach cost-effective while still achieving timely enrollment in relevant programs.
Why a Comprehensive Planning Strategy Can Be More Effective:
Protecting Family Resources Over Time
A comprehensive planning strategy helps preserve assets and plan for multiple contingencies over a longer horizon. When family resources, property ownership, or complex financial arrangements are involved, a broad plan examines how various legal tools, titling options, and timing considerations interact. This approach anticipates future needs and creates a framework that reduces the risk of unintended disqualification from benefits, helps protect a spouse’s income and housing, and supports a smoother transition between care settings when health conditions change.
Coordination with Family and Care Providers
Comprehensive planning emphasizes coordination among family members, medical providers, and financial professionals to create a cohesive plan. This can include developing durable powers of attorney, healthcare directives, and tailored strategies for asset management and benefits qualification. Bringing all stakeholders together reduces the chance of misunderstandings and helps ensure that care plans align with the person’s wishes and financial realities. Such coordination can also simplify communications with facilities and case workers during transitions and ongoing care.
Benefits of Taking a Comprehensive Approach
A comprehensive approach to Medicaid and long-term care planning offers greater peace of mind by addressing multiple issues before they become emergencies. It typically reduces the risk of sudden financial loss, provides clearer instructions for medical decision-making, and can minimize delays in accessing benefits. By planning ahead, families can better preserve the financial wellbeing of a spouse and dependents, arrange for continuity of care, and structure assets in a manner consistent with legal requirements. This holistic method supports long-term stability and thoughtful decision-making.
In addition to protecting assets, comprehensive planning often simplifies the administrative process by ensuring documentation is in place and eligibility criteria are proactively addressed. Having a plan helps when circumstances change, such as a shift in health needs or living arrangements, because contingencies and fallback options are already identified. It also eases communication with care facilities and public benefit offices, which can reduce stress on family caregivers and the person receiving care. Overall, a broad plan supports consistent, informed action over time.
Improved Access to Benefits and Services
Comprehensive planning increases the likelihood of timely access to Medicaid-funded services by addressing documentation, eligibility, and asset concerns in advance. By organizing financial records, preparing required forms, and anticipating potential eligibility issues, families can prevent avoidable delays. This proactive stance also allows for planning that respects the needs of a spouse or dependents, helping to maintain housing and necessary income. The result is smoother transitions into care settings and more reliable coverage for required services.
Greater Financial Security for Families
A thoughtfully designed, comprehensive plan can preserve family resources while meeting care needs, by identifying which assets can remain protected and how to manage income for spousal support. It reduces the chance of unnecessary depletion of life savings and can provide mechanisms to maintain financial stability for family members who rely on shared resources. Families that plan ahead often find they have clearer options for long-term care funding and more control over housing and legacy objectives.
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Practical Tips for Medicaid and Long-Term Care Planning
Start planning early and gather records
Beginning the planning process early can make a significant difference. Start by collecting financial statements, property deeds, insurance policies, and medical records. Having organized documentation speeds applications and helps identify planning options. Early planning also allows time to consider legal documents such as powers of attorney and advance directives, and to discuss wishes with family members. Organized records reduce stress during urgent transitions and make it easier to respond promptly to requests from Medicaid caseworkers or care facilities.
Communicate with family and care providers
Review and update documents regularly
Legal and financial plans should be reviewed periodically to reflect changes in health, finances, or family circumstances. Updating powers of attorney, advance directives, and beneficiary designations helps prevent complications during transitions in care. Regular reviews also allow you to adapt strategies for Medicaid qualification as rules and personal situations change. Keeping documents current and accessible ensures that decision-makers can act quickly when care needs arise, and that planning remains aligned with long-term goals.
Reasons to Consider Medicaid and Long-Term Care Planning
Families consider Medicaid and long-term care planning to protect loved ones, manage care costs, and avoid delays in receiving benefits. Planning supports a smoother transition into nursing homes or home-based care, clarifies who will handle financial and medical decisions, and can reduce the strain on caregivers. It also helps balance the needs of a spouse or dependents with the requirements for benefits, creating a path that minimizes financial hardship while meeting care obligations. Thoughtful planning addresses both immediate and future concerns with practical steps.
Another key reason to plan is to retain as much control as possible over personal affairs and legacy goals. Proper document preparation and asset review can limit the need for guardianship proceedings and ensure that financial resources are managed according to the person’s wishes. Planning also helps families make informed choices about housing, care options, and the timing of benefit applications. These considerations reduce uncertainty and support decisions that reflect the person’s values and the family’s long-term priorities.
Common Situations That Lead Families to Seek Planning
Typical circumstances prompting planning include a sudden decline in health, diagnosis of a chronic condition, anticipated need for nursing home care, or concerns about mounting medical bills. Families may also seek guidance when an elderly relative wishes to remain at home but needs help managing care costs. Other triggers include changes in marital status, the sale of significant assets, or the desire to protect a spouse’s standard of living. Each situation requires a tailored response that balances immediate needs and long-term goals.
Onset of Serious Health Conditions
When a serious health condition emerges, families often face immediate decisions about care settings and finances. Planning at this stage involves assessing care needs, understanding eligibility for Medicaid services, and ensuring legal documents designate decision-makers. Prompt action can reduce delays in benefits and help coordinate medical and long-term care arrangements. Addressing these issues early reduces administrative hurdles and provides clarity for family caregivers who must make decisions under stressful circumstances.
Admission to a Nursing Facility
An admission to a nursing facility can trigger the need for Medicaid planning to address payment and eligibility. Families may need assistance preparing applications, documenting medical necessity, and handling facility billing. Planning in this context also examines income and asset rules that affect ongoing eligibility. By organizing finances and legal documents, families can navigate the transition more smoothly, ensuring the resident receives appropriate care while addressing the financial implications for spouses and dependents.
Concerns About Asset Depletion
Worries about the rapid depletion of life savings due to long-term care costs lead many families to seek planning. Addressing asset protection, income management, and potential eligibility strategies can help preserve resources for surviving family members. This work involves careful review of ownership, titling, and potential legal tools that comply with Tennessee rules. The goal is to slow resource depletion while maintaining eligibility for needed services and preserving a legacy where possible.
Local Medicaid and Long-Term Care Planning Services in Etowah
Jay Johnson Law Firm provides local support for Medicaid and long-term care planning in Etowah and McMinn County. We assist with eligibility assessments, document preparation, benefit applications, and coordination with care facilities. Our team takes time to listen to your concerns, explain options under Tennessee law, and develop a practical plan that aligns with your family’s priorities. We are available to meet in person or by phone to review records, answer questions, and take the next steps to protect your loved one’s care and financial wellbeing.
Why Choose Jay Johnson Law Firm for Planning Assistance
Choosing the right legal partner means working with a firm that understands local procedures and the realities families face when arranging long-term care. Jay Johnson Law Firm focuses on clear communication, careful planning, and hands-on assistance during applications and follow-up. We help clients gather documentation, prepare required legal forms, and coordinate with agencies and care providers so that processes move forward efficiently. Our approach prioritizes practical results and support during what can be a stressful time for families.
Our work emphasizes responsiveness and client-centered planning designed to address both financial and personal priorities. We explain options in plain language, prepare necessary legal instruments, and guide families through Medicaid’s rules and timelines. By anticipating common issues and coordinating with relevant professionals, we aim to reduce delays and simplify transitions into care. Families we work with appreciate a steady, organized approach that treats each situation with respect and confidentiality.
We also provide ongoing support as circumstances evolve, revising plans when necessary to reflect health changes, asset adjustments, or new family developments. This continuity helps ensure documents remain current and strategies remain aligned with benefit rules and family goals. Our team is available to answer questions, explain next steps, and represent clients in communications with Medicaid caseworkers or care facilities, helping to achieve practical solutions for long-term care needs.
Contact Us to Discuss Your Planning Options
How the Planning Process Works at Our Firm
Our planning process begins with a thorough intake to understand finances, health needs, and family objectives. We review documents, discuss timelines, and identify immediate steps to secure benefits or protect assets. Following the initial assessment, we prepare tailored legal instruments, advise on appropriate asset management strategies, and guide you through the Medicaid application and appeals process if needed. Throughout, we maintain open communication and provide clear next steps so you know what to expect at each stage of the process.
Step One: Initial Assessment and Document Review
The first step focuses on gathering financial, medical, and legal documents to assess Medicaid eligibility and planning needs. We evaluate bank statements, property records, insurance policies, and medical documentation to build a full picture of the applicant’s situation. This assessment identifies immediate priorities and potential obstacles, and helps determine whether a focused or comprehensive plan is appropriate. Clear documentation from the outset speeds applications and improves the likelihood of timely benefits.
Gathering Financial and Medical Records
Collecting accurate financial and medical records is essential to determining eligibility and creating an effective plan. We work with families to compile statements, asset listings, care bills, and physician reports that demonstrate need and support applications. Accurate records reduce processing delays and provide a factual basis for eligibility decisions. We also help identify any documents that may need updating or correction before submission to benefits offices.
Initial Legal Document Preparation
During the first stage we prepare or update core legal documents such as powers of attorney, advance directives, and preliminary planning documents that may be required to manage finances and healthcare decisions. These documents provide clear authority to act on behalf of the person in need and clarify wishes about medical care. Having these instruments in place early helps avoid guardianship proceedings and supports smoother administration of benefits and care planning.
Step Two: Strategy Development and Implementation
After reviewing your situation, we develop a strategy that balances eligibility considerations with asset protection and family priorities. This stage may include restructuring asset ownership, establishing appropriate trusts or protections where lawful, and planning the timing of applications and transfers to comply with Tennessee rules. We explain the expected timelines and potential impacts, then implement agreed-upon actions while keeping you informed. The goal is to create a defensible, practical plan to obtain benefits and preserve resources.
Structuring Assets and Timelines
Structuring assets and planning timelines carefully helps align personal goals with Medicaid rules. We evaluate how asset titles, account types, and income streams influence eligibility, and recommend lawful strategies to reduce exposure while preserving essential resources. Timing considerations, such as the look-back period, influence when particular actions should be taken. Our guidance focuses on practical steps that comply with regulations and protect family interests to the extent possible under the law.
Applying for Benefits and Coordinating with Agencies
We assist with preparing and submitting Medicaid applications, gathering supporting medical documentation, and communicating with caseworkers to address questions or requests for additional information. Coordination with agencies and long-term care facilities is a key part of this stage, ensuring that paperwork is complete and accurate. Our involvement helps reduce processing delays and supports clearer communication between the family and benefit administrators during the application process.
Step Three: Ongoing Support and Plan Adjustments
After benefits are in place, ongoing monitoring and occasional adjustments may be necessary to address changes in health, assets, or personal circumstances. We provide follow-up support to update documents, respond to benefit reviews or appeals, and advise on any necessary modifications to maintain eligibility. This ongoing attention helps keep plans aligned with evolving needs and ensures documentation remains current for caregivers and institutions.
Monitoring Eligibility and Compliance
Regular monitoring of eligibility and compliance with program rules helps prevent unexpected interruptions in benefits. We assist clients in tracking changes to income, assets, and living arrangements that could affect eligibility, and provide recommendations for corrective steps when necessary. Proactive review reduces the likelihood of retroactive penalties and supports continuous access to needed services.
Adjusting Plans as Needs Evolve
As health and family circumstances change, plans may need to be adjusted. We help modify powers of attorney, advance directives, and financial arrangements to reflect new realities and ensure ongoing protection. This includes advising on potential appeals, responding to agency requests, and updating strategies to preserve resources while meeting current care needs. Adaptable planning provides peace of mind and practical paths forward.
Frequently Asked Questions About Medicaid and Long-Term Care Planning
How does Medicaid eligibility work for long-term care in Tennessee?
Medicaid eligibility for long-term care in Tennessee depends on meeting both medical and financial criteria. Medical eligibility requires documentation that the applicant needs a level of care provided in a nursing facility or equivalent services, and this usually involves evaluations from physicians and care providers. Financial eligibility focuses on income and countable assets, with specific thresholds and rules that determine qualification. Applicants must provide detailed records and cooperate with state caseworkers during the review process. The review often examines sources of income, bank accounts, property ownership, and certain transfers of assets within a look-back period. Spousal protections and exemptions may apply to preserve a spouse’s income and housing. Because rules can be technical and timing matters, preparing accurate documentation and understanding applicable exemptions helps speed the process and improve the likelihood of approval.
What assets are counted when applying for Medicaid nursing home benefits?
Countable assets for Medicaid typically include funds in bank and investment accounts, certain vehicles, and ownership interests in property. Some assets may be exempt, such as a primary residence within specific limits, personal belongings, and certain retirement accounts depending on circumstances. Determining which items are countable requires reviewing titles, beneficiary designations, and the specific rules that apply in Tennessee. Because the classification of assets affects eligibility, families should inventory holdings and seek guidance on lawful approaches to preserve exempt resources. Documentation that clearly shows ownership and value reduces delays. Understanding exemptions and permissible transfers helps families make informed decisions about asset management while pursuing benefits.
Can giving away assets affect Medicaid eligibility?
Yes, giving away assets can impact Medicaid eligibility if transfers are made during the look-back period and are not otherwise exempt. Transfers intended to qualify for Medicaid may trigger a penalty period during which the applicant is ineligible for benefits. The state reviews transfers for uncompensated conveyances and applies rules to calculate any resulting penalty. However, not all transfers cause penalties, and some transfers follow legitimate planning paths that are permissible under law. Because the consequences of transfers can be significant, families should document the purpose of transfers and consider timing carefully. Professional guidance can help identify lawful alternatives and avoid unintended penalties while aligning with personal goals.
What is the look-back period and how does it affect planning?
The look-back period is a defined timeframe before a Medicaid application during which asset transfers are reviewed to determine whether they were made for less than fair market value. If such transfers occurred, they can result in a penalty period delaying eligibility. The length and application of the look-back varies by program and jurisdiction, so understanding Tennessee’s particular rules is important for timing any transfers or restructuring of assets. Planning that accounts for the look-back period helps avoid costly mistakes. Strategies may include timing of asset movements, choosing permissible exemptions, and documenting legitimate reasons for transfers. Early planning provides more options to manage timing and reduce the risk of a penalty period.
How can I protect my spouse’s income and living arrangements?
Protecting a spouse’s income and living arrangements involves careful planning under rules designed to prevent undue hardship. Tennessee includes spousal protections that allow a community spouse to retain a minimum level of income and assets so they can continue to live independently while the institutionalized spouse seeks benefits. Planning assesses income flows, housing needs, and allowable transfers to preserve essential support for the spouse at home. Legal documents and clear financial planning are part of this protection. By reviewing income sources, beneficiary designations, and available exemptions, families can structure affairs to support the non-institutionalized spouse while meeting Medicaid eligibility rules for the spouse needing care. Communication and timely action help maintain stability during transitions.
Do I need a power of attorney and advance directive for long-term care planning?
Yes, having a durable power of attorney and advance directive is important for long-term care planning. A durable power of attorney for finances allows a trusted person to manage financial matters if the individual becomes unable to do so, while an advance directive provides instructions for medical care and names someone to make healthcare decisions. These documents help avoid guardianship proceedings and ensure that decisions reflect the person’s wishes. Preparing these documents in advance supports continuity of care and financial management. They also provide clear authority to act during Medicaid applications and when interacting with care providers or facilities. Regularly reviewing and updating these documents ensures they remain aligned with current preferences and circumstances.
What steps should I take if my loved one needs immediate nursing care?
If a loved one needs immediate nursing care, begin by documenting medical necessity and obtaining physician statements that support the need for institutional care. Gather financial records and identification documents to prepare for a Medicaid application or to explore alternative payment options. Communicating with the facility’s admissions coordinator and a Medicaid caseworker can help clarify required paperwork and timelines. At the same time, secure essential legal documents like powers of attorney and healthcare proxies if they are not already in place. Quick organization of records and prompt communication with relevant agencies can reduce administrative delays and ensure the person receives appropriate care while benefits are pursued.
How long does the Medicaid application process usually take?
The Medicaid application process timeline varies based on the completeness of documentation and the complexity of the applicant’s financial situation. When applications are submitted with full supporting records, approvals can occur more quickly, but delays are common when additional verification or clarifying information is required. The state reviews assets, income, and medical necessity, which can take several weeks or longer depending on caseloads and the need for supplemental documentation. To speed the process, compile accurate financial and medical records, respond promptly to requests from caseworkers, and provide clear authorizations for agencies to communicate with designated family members or legal representatives. Ongoing follow-up and coordination with the facility and Medicaid office can reduce processing time.
Will Medicaid pay for in-home care as well as nursing home care?
Medicaid covers a range of long-term care services under different state programs, and in many cases benefits can help pay for in-home care as well as nursing facility care. Eligibility criteria and covered services depend on medical need and the particular Medicaid program. For some individuals, home and community-based services are available that allow care to be provided outside of institutions, preserving independence when appropriate. Determining whether in-home services are covered requires evaluating the applicant’s needs and available program options. Early planning and coordination with providers and caseworkers can help identify appropriate services and support an application for home-based care when it is a viable alternative to facility placement.
Can veterans benefits be used alongside Medicaid for long-term care?
Veterans benefits may provide additional assistance for veterans and surviving spouses to help cover the cost of long-term care, and these benefits can sometimes be used alongside Medicaid to enhance resources. Programs such as the Aid and Attendance benefit help eligible veterans with daily living expenses, and coordination between benefits can improve overall support for care. Eligibility requirements and application steps differ from Medicaid and require separate documentation. Combining veterans benefits with Medicaid requires careful planning to maximize available resources while complying with both programs’ rules. Evaluating eligibility for veterans benefits early and integrating them into a broader plan can improve financial outcomes and expand available care options for veterans and their families.