VA Aid and Attendance can help pay for in-home care in California, and it's one of the most flexible benefits a veteran can use. It's a monthly cash payment that goes straight 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 make staying at home affordable.

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

In This Guide

How Much In-Home Care Costs in California

In-home care in California is expensive, in line with the state's high overall cost of care. Per the CareScout 2025 Cost of Care Survey (released March 2026), a non-medical caregiver in California runs a median of about $91,520 per year (roughly $7,627 per month, or about $40 an hour on a 44-hour-per-week basis), well above the national non-medical caregiver median of about $80,080 per year. Beginning with its 2025 survey, CareScout (formerly Genworth) reports a single non-medical caregiver category rather than separate home health aide and homemaker figures. Rates vary across the state, so confirm local pricing with providers.

Costs run far higher in Los Angeles, Orange County, and the Bay Area than in inland and rural areas. This is exactly the kind of expense Aid and Attendance is designed to offset.

How Aid and Attendance Helps Pay for In-Home Care

Aid and Attendance is an increased monthly VA pension for wartime veterans and surviving spouses who need help with daily activities. It is paid as cash directly to the veteran, who decides how to use it. There is no requirement to spend it at a particular agency, so it can pay for a home health aide, a homemaker, or a family caregiver.

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

At up to $2,424 a month for a veteran, and up to $2,874 for a veteran with a spouse, the benefit can cover a meaningful share of California's high in-home care costs. 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: the VA pays the difference between your countable income and a set annual limit. Continuing, 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 the applicable annual pension limit is deductible. For 2026 that floor is about $872 per year for a veteran with no dependents and $1,141 per year for a veteran with one dependent. So a veteran paying for in-home care can deduct nearly the entire annual cost once the first roughly $872 is set aside. In-home and attendant care qualify as deductible expenses when the veteran has a documented need for that care.

Who Qualifies

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

  • Have served at least 90 days of active duty with at least one day during a wartime period
  • Be 65 or older, or permanently and totally disabled
  • Need help with daily activities such as bathing, dressing, or feeding, or be housebound
  • Have a net worth below $163,699 (this limit includes assets and annual income but excludes the primary home and vehicle)

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

Using Aid and Attendance to Pay a Family Caregiver

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.

Second, the Veteran-Directed Care (VDC) program gives the veteran a flexible monthly budget to hire their own caregivers, including family members. The veteran (or their representative) decides who provides care and how to spend the budget, and a financial management service handles payroll and taxes. Unlike many Medicaid programs, VDC has no blanket ban on hiring a spouse. To ask about VDC, contact your local VA medical center's social work or geriatrics department.

How IHSS Can Also Pay for In-Home Care

California's In-Home Supportive Services (IHSS) program is the Medi-Cal-funded route that pays for in-home care directly, and for many veterans it can work alongside Aid and Attendance. IHSS provides in-home personal care to eligible aged, blind, and disabled Californians as an alternative to out-of-home care, and it can pay a family member to provide that care.

To qualify, the recipient must have full-scope Medi-Cal, be 65 or older (or blind or disabled), live in their own home, and have an assessed need for help with daily activities, documented by a county social worker. California is one of a small number of states that lets a spouse be paid as an IHSS provider, through the IHSS-Plus Option, and parents can be paid to care for a minor child with disabilities. Provider pay is set county by county and must be at least California's minimum wage, which rose to $16.90 an hour on January 1, 2026.

Because Aid and Attendance is a federal VA benefit and IHSS runs through Medi-Cal, a veteran may be able to use both, but VA pension income counts toward Medi-Cal's financial tests, so the timing and order of applications matters. A benefits counselor who understands both programs should review your case first.

How Aid and Attendance Works with Medi-Cal

VA Aid and Attendance is a federal benefit administered separately from Medi-Cal, California's Medicaid program; the two have different agencies, applications, and rules, and a veteran can receive both at the same time. For VA pension purposes, unreimbursed medical expenses such as in-home care can be deducted from countable income, which can raise the Aid and Attendance amount.

Medi-Cal applies its own income and asset tests, and as of January 1, 2026 the asset limit for the aged, blind, and disabled non-MAGI programs returned to $130,000 for an individual and $195,000 for a couple under AB 116. Because VA pension income is treated as income for Medi-Cal, it can affect a Medi-Cal share of cost or long-term-care financial eligibility, so the order and timing of applications matters. A benefits counselor who understands both programs should review your case before you apply.

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 a doctor's exam documenting the need for help. If you are not already receiving a VA pension, also file VA Form 21P-527EZ (Application for Veterans Pension). Claims commonly take 3 to 6 months.

Don't do this alone. California's accredited County Veterans Service Offices (CVSOs) prepare and submit VA pension and Aid and Attendance claims, develop the evidence, and represent you on appeals at no cost. CalVet also provides claims review and appeals representation, and you should never have to pay to file an initial VA claim.

If your claim is denied, you don't have to accept it. A CVSO or CalVet can help you file a VA appeal at no cost, develop stronger evidence, and represent you through the process. Find the office nearest you through the CalVet CVSO locator.

Frequently Asked Questions

Can I use Aid and Attendance to pay for a home health aide in California?

Yes. Aid and Attendance is paid as cash to the veteran, who can use it for a home health aide, a homemaker, or other in-home care. With in-home care in California running a median of about $91,520 per year, the benefit of up to $2,424 (or up to $2,874 with a spouse) helps offset the bill.

Does the VA provide the in-home care directly?

No. The VA pays the veteran a monthly cash benefit; the veteran arranges and pays for the care. That's what makes the benefit flexible enough to cover an agency aide or a family caregiver.

Can my income be too high to qualify if I'm paying for care?

Often not. Out-of-pocket in-home care counts as an unreimbursed medical expense that lowers the income the VA counts, but only the portion above about $872 a year (or $1,141 with one dependent) is deductible. Large care bills can reduce countable income enough to qualify.

Can I get both Aid and Attendance and Medi-Cal?

Yes, the two are separate programs and can be received together. Because VA pension income can affect a Medi-Cal share of cost, have a benefits counselor who understands both programs review your case before applying.

Compare Care Settings in California

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

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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