VA Aid and Attendance for In-Home Care in Arkansas

VA Aid and Attendance can help pay for in-home care in Arkansas, and most families don't realize how flexible it is. It's a monthly cash benefit paid directly to the veteran, who decides how to spend it: a home health aide, a homemaker, or even a family member providing the care. For a wartime veteran or surviving spouse who needs help with daily activities, it can be what keeps them at home.

This guide explains what in-home care costs in Arkansas, how much Aid and Attendance pays, who qualifies, and how the benefit works alongside Arkansas Medicaid.

In This Guide

• Key Takeaways
• How Much In-Home Care Costs in Arkansas
• How Aid and Attendance Helps Pay for In-Home Care in Arkansas
• How In-Home Care Costs Lower Your Countable Income
• Who Qualifies
• Using Aid and Attendance to Pay a Family Caregiver for In-Home Care in Arkansas
• How Aid and Attendance Works with Arkansas Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much In-Home Care Costs in Arkansas

In-home care in Arkansas costs less than a nursing home, which runs about $89,425 a year for a semi-private room, but the bills still add up.2 According to the CareScout 2025 Cost of Care Survey (released March 2026, the most recent state-level data), a non-medical caregiver providing in-home personal care in Arkansas costs about $57,200 per year, or $25 an hour, based on a 44-hour-per-week schedule.2 That's well below the national median, but still a heavy load for a fixed income.

Costs vary within the state and rise as care needs grow.2 This is exactly the kind of expense Aid and Attendance is designed to offset.

How Aid and Attendance Helps Pay for In-Home Care in Arkansas

Aid and Attendance is an increased monthly VA pension for wartime veterans and surviving spouses who need help with daily activities.5,1 It is paid as cash directly to the veteran, who decides how to use it. Because it is paid to the beneficiary as part of the monthly pension, families commonly put it toward a home health aide, a homemaker, or a family caregiver.

These are VA's Maximum Annual Pension Rates for December 1, 2025 through November 30, 2026. VA publishes them as yearly amounts, but pension is paid monthly: VA subtracts your countable income from the annual rate, divides what's left by 12, and rounds down to the whole dollar.1 Read those as ceilings rather than promises: the MAPR is the maximum amount of pension payable, and VA bases the payment on the difference between the claimant's income for VA purposes and that limit, so a household with countable income receives less than the table shows.1

At up to $29,093 a year for a veteran, the benefit can cover a large share of Arkansas's roughly $57,200 yearly cost for in-home care, and the $34,488 ceiling for a veteran with a spouse covers more of it.1,2 Keep in mind the VA pays the veteran; the veteran arranges and pays for the care.

How In-Home Care Costs Lower Your Countable Income

VA pension, including the Aid and Attendance increase, is a needs-based benefit: to be eligible, your yearly family income and net worth have to fall within limits set by Congress.1 Out-of-pocket care costs, such as paying a home health aide, count as unreimbursed medical expenses (UMEs) that reduce the income the VA counts, which is why many veterans who look "too rich" on paper still qualify once their care bills are subtracted.

Only the portion of those expenses above 5% of your applicable maximum annual pension rate (MAPR) is deductible.1 As the VA puts it, you may deduct only the amount that's above 5% of your MAPR amount, which is $872 for a veteran with no spouse or child.1 That floor rises if you have dependents, but it never reflects the aid and attendance or housebound increase. So if a veteran pays $57,200 a year for in-home care, nearly all of it counts against income once the first $872 is set aside. Payments to an in-home attendant for help with daily and instrumental activities are medical expenses as long as the attendant provides health care or custodial care, and the payments must be commensurate with the number of hours the provider attends to the person.1 The attendant must be a health care provider unless the veteran needs aid and attendance or is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that, due to a physical, mental, developmental, or cognitive disorder, the individual requires the health care or custodial care that the in-home attendant provides.1

Who Qualifies

To qualify for Aid and Attendance, a veteran generally must:5

• Meet the wartime service test, which turns on when service began. VA lists three paths. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty with at least 1 day during a wartime period. A veteran who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months (VA writes it "with some exceptions"), or the full period for which they were called or ordered to active duty, again with at least 1 day during wartime. A veteran who started active duty as an officer after October 16, 1981 qualifies on this path if they had not previously served on active duty for at least 24 months.5
• Have a discharge that was not dishonorable5
• Meet at least one of four age or disability tests: be at least 65 years old; have a permanent and total disability; be a patient in a nursing home for long-term care because of a disability; or be getting Social Security Disability Insurance or Supplemental Security Income. Any one of the four satisfies this test on its own, so a wartime veteran under 65 who receives SSI qualifies without a permanent and total rating.5
• Meet one of the aid and attendance criteria: needing another person's help on a regular basis with activities such as dressing and undressing, keeping clean and presentable, feeding oneself, or attending to the wants of nature, or needing care on a regular basis to stay safe from the hazards of daily life; or having to stay in bed, or spend a large portion of the day in bed, because of illness; or being a patient in a nursing home because of a loss of mental or physical abilities related to a disability; or having eyesight of 5/200 or less in both eyes, or a visual field contracted to 5 degrees or less5
• Have a net worth below $163,699, a calculation that includes the claimant's and dependents' assets and income for VA purposes and excludes the primary residence, the car, and basic home items1 (the home's exclusion covers a residential lot of up to 2 acres, so marketable land beyond that counts as an asset)1

The VA enforces a 3-year look-back on assets transferred for less than fair market value before filing.5 A surviving spouse can qualify under the Survivors Pension using the same net worth limit.1

Using Aid and Attendance to Pay a Family Caregiver for In-Home Care in Arkansas

Many families want to keep care in the family, and there are two ways VA benefits make that possible. First, because Aid and Attendance is cash paid to the veteran, the veteran can simply use it to pay a relative who provides care. VA's own rule says a relative or another member of the household providing the aid and attendance does not prevent VA from granting the allowance.5

Second, the Veteran-Directed Care (VDC) program gives an enrolled veteran a flexible budget, managed by the veteran or their representative, to hire and supervise their own workers so they can keep living at home or in their community.3 Through that budget, enrolled veterans may also hire family, friends, and/or neighbors to provide services.3 VA medical centers deliver VDC through aging and disability network agencies, such as an Area Agency on Aging, where an options counselor provides an assessment and care planning, arranges fiscal management services, and offers ongoing counseling and support.3 An enrolled veteran is eligible if they are eligible for community care, meet the clinical criteria for the service, and VDC is available where they live.3 Before you count on a particular arrangement, ask an accredited Arkansas Veterans Service Officer or the VA social worker handling the referral to confirm it for your situation. To ask about VDC, contact your local VA medical center's social work or geriatrics department.

How Aid and Attendance Works with Arkansas Medicaid

VA pension with Aid and Attendance and Arkansas Medicaid are separate programs that can work together when a veteran needs long-term care.6 The Arkansas Department of Human Services administers Arkansas Medicaid and its long-term services and supports, and Arkansas is an income-cap state, so applicants over the income limit may still qualify by using a qualified income trust (Miller trust).6

Under the general federal rule, the basic VA pension counts as income, but the Aid and Attendance and housebound portions paid to cover the cost of care are generally treated as unreimbursed-medical-expense income that is excluded from countable income.6 Arkansas's Medical Services Policy Manual carries that exclusion past the eligibility decision for nursing-facility care: it says Aid and Attendance paid in the full amount (not reduced to $90) is excluded when DHS makes the initial eligibility determination and is also excluded from the income applied to the facility's Medicaid vendor payment. So in Arkansas, a full-rate Aid and Attendance amount, such as one paid to a veteran who has a spouse or a child, isn't applied to the nursing-facility cost of care.6 For a veteran with no spouse or child, Medicaid coverage of nursing-facility care can also shrink the pension itself: federal law caps it at $90 a month after the month of admission, the same cap applies to a surviving spouse with no child, and the facility's Medicaid payment cannot be reduced by that $90.6 A veteran with a spouse or child is outside the cap, and a stay in a State Veterans Home for which VA pays a nursing-home per diem is outside it too, so check a particular stay with an accredited Veterans Service Officer before budgeting.6 In a State Veterans Home that receives that per diem, a separate federal rule applies once the resident is eligible for Medicaid: for a veteran with no spouse or child (or a surviving spouse with no child), pension above $90 a month is counted as income only to apply that excess to the home's cost of care, so a resident should ask Arkansas DHS how that rule and Arkansas's own exclusion apply together to their stay.6 The income DHS counts doesn't all reach the facility either, and incurred medical expenses are not the only thing taken out of it. For a resident of a nursing facility or other medical institution, 42 CFR 435.725(c) requires DHS to deduct five amounts from the resident's total income, in this order: first, a personal needs allowance, reasonable in amount, for the resident's clothing and other personal needs while in the institution; second, for a resident with only a spouse at home, an additional amount for that spouse's maintenance needs; third, for a resident with a family at home, an additional amount for the family's maintenance needs; fourth, amounts for incurred expenses for medical or remedial care that no third party will pay; and fifth, the full amount of any SSI and state supplement payments the resident continues to receive.6 Arkansas sets that personal needs allowance at $40 for most facility residents; a single veteran, or the spouse of a veteran with no dependents, whose VA pension has been reduced to $90 keeps the full $90 as the allowance instead, with no additional $40.6 All five are deductions the agency must make, not benefits a family applies for, and only what remains after them reduces what Medicaid pays the facility, so a spouse still living at home should have DHS compute that maintenance allowance rather than assume the pension goes entirely to the nursing home.6 That section covers residents of medical institutions, and Arkansas's exclusion above is written for nursing-facility care, so neither tells a family getting care at home through a home and community-based waiver what its share of cost is; ask DHS how yours is worked out rather than assuming the nursing-facility arithmetic applies.6 Because the exact treatment varies by case, confirm how your specific VA benefit is counted with Arkansas DHS or an accredited veterans service officer before applying.6

How to Apply and Get Free Help

To apply for Aid and Attendance, submit VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), with the examination information section filled out by a medical examiner to document the need for help.7 That form covers Aid and Attendance that will be added to either your monthly pension or your monthly compensation, so it is the starting point either way.7

The remaining steps here are the pension route, the one most in-home care families use: VA's condition for it is that you may be eligible for this benefit if you get a VA pension.7 A wartime veteran pursuing that route who is not already receiving a VA pension also files VA Form 21P-527EZ (Application for Veterans Pension), which is the means-tested wartime pension application.7 If you are still gathering information, submit VA Form 21-0966 (Intent to File) first: VA says submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.7 Asked how long a decision takes, VA answers, "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.7

Don't do this alone. The Arkansas Department of Veterans Affairs and its network of district and county Veterans Service Officers assist veterans and their families in applying for federal and state benefits, including managing pension claims.4 Arkansas VSOs are employed by ADVA and must be accredited through the U.S. Department of Veterans Affairs, and the VA says the services an accredited VSO representative provides on a benefit claim are always free.4

To act now, find your nearest county Veterans Service Officer through the Arkansas Department of Veterans Affairs, locate an accredited representative through the VA's official directory, or call the VA benefits hotline at 800-827-1000 (TTY: 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.8,4

If your claim is denied, you have three ways to challenge the decision: file a Supplemental Claim with new and relevant evidence the VA did not have before, request a Higher-Level Review, in which a higher-level reviewer looks at the case again to decide whether an error or a difference of opinion changes the decision, or appeal to the Board of Veterans' Appeals.8 The same Arkansas Veterans Service Officer who filed your claim can represent you in an appeal or hearing, and an accredited VSO representative's services are free.4 For most VA benefits, a Higher-Level Review or Board appeal must be requested within one year of the date on your decision letter, and the letter itself states your deadline, so don't wait.8

Compare Care Settings in Arkansas

Aid and Attendance can help pay for any care setting. See how it works for the others:

• How Aid and Attendance Pays for Assisted Living in Arkansas
• How Aid and Attendance Pays for a Nursing Home in Arkansas
• How Aid and Attendance Pays for Memory Care in Arkansas

Learn More

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.