VA Aid and Attendance can help a wartime veteran or surviving spouse pay for care at home, whether that's a hired home health aide, a homemaker, or in many cases a family member doing the caregiving. The benefit is a monthly pension payment that arrives as cash, so the family decides how to use it. And because Aid and Attendance is paid to the veteran rather than to a facility, in-home care is one of the most flexible ways to put it to work.

This guide explains how that works in 2026: how in-home care costs lower the income the VA counts, how the separate Veteran-Directed Care program lets you pay a family caregiver, how much Aid and Attendance pays, who qualifies, and how to apply.

In This Guide

Does the VA Pay for In-Home Care?

Not directly, in the sense that the VA does not send a payment to a home care agency on a pension recipient's behalf. What it does is pay a qualifying veteran or surviving spouse a monthly pension benefit. The Aid and Attendance increase to that pension is meant for people who need help with daily activities, and many of them are aging at home rather than in a facility.

The money arrives as cash to the beneficiary, and the family decides how to spend it. For a veteran staying at home, that often means hiring a home health aide or a homemaker, or contributing toward the cost of a family member's caregiving. Because the benefit follows the veteran rather than the setting, in-home care is one of the most flexible ways to use it.

How Aid and Attendance Pays for In-Home Care

VA Pension, including its Aid and Attendance increase, is a needs-based benefit. The VA pays the difference between your countable income and the applicable Maximum Annual Pension Rate, or MAPR, set by Congress. If your countable income is low, the VA pays you more; if it's high, the VA pays you less or nothing. So the key to the whole benefit is your countable income, not your gross income.

Because the benefit is keyed to countable income, you're allowed to lower that income by deducting continuing, unreimbursed medical expenses, or UMEs. The cost of in-home care can count as a UME. That deduction is what makes a veteran whose income looks too high on paper actually qualify, because once a recurring cost like a home health aide is subtracted, countable income can drop sharply or fall to zero.

The 5% rule

There's an important limit. You cannot deduct every dollar of medical expense. Only the portion of your UMEs that exceeds 5% of the applicable MAPR is deductible. For 2026, that 5% threshold is $872 for a veteran with no dependents (5% of the $17,441 MAPR) and $1,141 for a veteran with one dependent (5% of the $22,839 MAPR). The floor scales with the veteran's own MAPR category. In plain terms, the first several hundred dollars of medical expense each year don't count toward the deduction; everything above that floor does.

When in-home care costs count

In-home care counts as a deductible UME when there is a genuine need for that care. The cost of an in-home attendant is deductible when the attendant provides health care or custodial care (help with daily activities like bathing, dressing, eating, and managing medications) and the individual qualifies for Aid and Attendance or housebound status, or a physician or similar provider certifies the need for that care. Other recurring medical costs are deductible as well, including care by health care providers, prescription and non-prescription medications, medically necessary supplies, and health insurance premiums such as Medicare Parts A, B, and D and long-term care insurance.

The practical upshot is the one that matters most to families: a veteran whose income appears too high to qualify can still qualify once those recurring care costs are deducted from countable income.

Paying a Family Caregiver With Veteran-Directed Care

Aid and Attendance is paid as cash, so a family can choose to use it to compensate a relative who provides the care. But there's also a separate, dedicated VA program worth knowing about: Veteran-Directed Care (VDC).

Veteran-Directed Care gives veterans of all ages a flexible monthly budget, based on clinical need, to hire and manage their own caregivers, including family members, friends, and neighbors. Unlike some Medicaid self-direction programs, VDC has no blanket prohibition on hiring a spouse. The veteran, or a representative acting for them, manages the budget with help from a supporting agency, and uses it to arrange the mix of care and services that keeps them safely at home.

VDC is administered through VA health care rather than the pension, so it's a separate track from Aid and Attendance, but the two can complement each other, with the pension adding monthly cash and VDC providing a managed caregiving budget.

Want to understand how to pay a family member for caregiving? Chat with Brevy to map out the options.

2026 Aid and Attendance Amounts

These are the maximum monthly Aid and Attendance pension amounts for the rate period running December 1, 2025 through November 30, 2026. The actual amount paid is the maximum minus your countable income, which is why the medical-expense deduction above matters so much.

Category Maximum Monthly Amount
Veteran alone Up to $2,424
Veteran with spouse Up to $2,874
Surviving spouse Up to $1,558

These figures are set by Congress and adjusted each year with the cost-of-living increase, typically around December 1. If you're reading this later in the benefit year, the numbers above still apply through November 30, 2026.

Who Qualifies

Aid and Attendance does not require a service-connected disability. It is built on the Veterans Pension program, so it carries that program's wartime-service and needs-based requirements. To qualify, the veteran must:

  • Have wartime service. At least 90 days of active duty with at least one day during a recognized wartime period (WWII, Korea, Vietnam, or the Gulf War / post-9/11 era). Gulf War service requires 24 months of continuous active duty or the full period called to active duty.
  • Be 65 or older, or permanently and totally disabled.
  • Need help with daily activities. This includes needing help with tasks like bathing, dressing, or feeding oneself; being bedridden; being a patient in a nursing home due to mental or physical incapacity; or having severely limited eyesight.
  • Have net worth under $163,699 (2026). Net worth combines assets and annual income, but excludes the primary home, vehicles, and basic household items.

The VA also applies a 3-year look-back period on assets transferred for less than fair market value before filing, with a penalty period that can run up to five years. If you've recently given away assets or set up a trust, talk to an accredited representative before applying.

How to Apply

You apply for Aid and Attendance with two forms:

  1. VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance). A doctor completes this to document the need for assistance.
  2. VA Form 21P-527EZ (Application for Veterans Pension), if you're not already receiving VA pension.

You can submit the forms online at va.gov, by mail, or through an accredited representative. To find an accredited claims agent or attorney, use the VA's search tools or contact a Veterans Service Organization. Processing times vary, and in practice claims often take three to six months or longer. To ask about Veteran-Directed Care, contact your VA medical center's social work or caregiver support staff.

Ready to start an Aid and Attendance application? Chat with Brevy's care navigator for a quick eligibility check.

Frequently Asked Questions

Yes. Aid and Attendance is paid as monthly cash to the qualifying veteran or surviving spouse, who can use it for a home health aide, a homemaker, or other in-home care. The cost of that care also counts as an unreimbursed medical expense that lowers countable income, which can increase the benefit.

In two ways. Because Aid and Attendance is paid as cash, a family can choose to use it to compensate a relative who provides care. Separately, the Veteran-Directed Care program gives a flexible budget to hire your own caregivers, including family members and even a spouse, with no blanket prohibition on hiring a spouse.

Often, yes. Pension is based on countable income, and continuing unreimbursed medical expenses (including in-home care costs) reduce that countable income, but only the portion above 5% of your applicable MAPR is deductible. Because ongoing care costs add up, they can substantially reduce or even zero out countable income, which can make a veteran who looked ineligible on paper qualify.

The maximum monthly Aid and Attendance amount is up to $2,424 for a veteran alone, up to $2,874 for a veteran with a spouse, and up to $1,558 for a surviving spouse. The amount you actually receive is the maximum minus your countable income.

Learn More

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

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