VA Aid and Attendance for In-Home Care in Delaware

VA Aid and Attendance can pay a Delaware veteran with no dependents a pension of up to $29,093 a year. VA describes it as monthly payments added to the amount of a monthly VA pension; in pension terms, it is a veteran's or surviving spouse's VA pension paid at a higher maximum rate, not a separate payment on top of it.1,2 For a family trying to keep a parent at home, the pension rules also recognize in-home care: payments to an in-home attendant can count as unreimbursed medical expenses that lower the income VA counts.1

This guide explains exactly how Aid and Attendance works for in-home care, how much it pays in 2026, who qualifies, and how to get free help filing the claim.

In This Guide

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

How Much In-Home Care Costs in Delaware

Delaware's long-term care costs run above the national medians in every residential setting, but in-home care is the exception. In the CareScout 2025 Cost of Care Survey (released March 2026, the most recent state-level data), homemaker and home health aide services are reported together as a single "non-medical caregiver" rate. Delaware's median is $35 an hour, exactly the national median, which comes to $80,080 a year, about $6,673 a month, at the survey's assumption of 44 hours of care a week.3

These are industry-survey medians, not government figures, and costs vary within the state and rise as care needs grow. At $35 an hour, even part-time help adds up fast.3

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

Aid and Attendance is the VA pension paid at a higher maximum rate when a qualifying veteran or surviving spouse meets VA's need-for-aid-and-attendance test, so the rates below are the ceiling on the whole pension, not an amount paid on top of the basic rate.1 VA's own description is monthly payments added to the amount of a monthly VA pension.2

Here is the ceiling on the benefit in 2026. These are the maximum annual pension rates effective December 1, 2025 through November 30, 2026, and a maximum is not a payment: VA pays the difference between the claimant's income for VA purposes and the limit.1

VA publishes these rates as annual amounts, but the pension is paid monthly. Under federal regulation 38 CFR 3.273, VA subtracts the claimant's countable income from the annual rate and divides what is left by 12, and 38 CFR 3.29(b) rounds that monthly amount down to the whole dollar.1

Set against Delaware's in-home care median of $35 an hour, or $80,080 a year for a 44-hour week, even the $29,093 maximum for a veteran with no dependents falls well short of the median cost of full-time care, and the actual payment is that maximum less countable income.3,1 Plan on the pension as one piece of how the family pays for care at home, not the whole of it.

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 Because the benefit is keyed to income, qualifying unreimbursed medical expenses can be deducted from countable income, which can make a family that looked "over income" eligible after all.

The rule has a floor. Only the portion of your unreimbursed medical expenses that exceeds 5% of the applicable Maximum Annual Pension Rate (MAPR) counts, and that 5% is figured without the Aid and Attendance or Housebound increase. For 2026, that floor is $872 per year for a veteran with no spouse or child, and it rises for a veteran with dependents.1 Payments to an in-home attendant for help with daily activities count as a deductible medical expense as long as the attendant provides health care or custodial care and the pay matches the hours worked. 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, because of a physical, mental, developmental, or cognitive disorder, the veteran requires that care.1

For example, in-home care in Delaware runs a median of $35 an hour, so a veteran who relies on an aide for daily tasks builds up sizable, recurring care costs over a year.3 For a veteran with no spouse or child, the part of those qualifying unreimbursed costs above $872 a year is deducted from countable income, which can lower it enough to qualify for the pension or increase the amount paid.1

Who Qualifies

To qualify for Aid and Attendance, a veteran generally must have no dishonorable discharge and meet all of the following:2

• Wartime service: if active duty began before September 8, 1980, at least 90 days of active duty with at least one day during a wartime period (such as World War II, Korea, Vietnam, or the Gulf War). An enlisted veteran who started after September 7, 1980 generally needs 24 months or the full period they were called or ordered to serve (with some exceptions), still with at least one day during wartime. An officer who started on active duty after October 16, 1981 and had not previously served on active duty for at least 24 months also qualifies on service with at least one day during wartime.2
• Age, disability, or benefit status: at least one of these must be true: 65 or older, a permanent and total disability, a patient in a nursing home for long-term care because of a disability, or getting Social Security Disability Insurance or Supplemental Security Income. Any one branch is enough; a wartime veteran under 65 on SSI meets this requirement without a permanent-and-total rating.2
• A need for aid and attendance: at least one of these: need another person's help with daily activities such as bathing, feeding, and dressing; have to stay in bed, or spend a large portion of the day in bed, because of illness; be a nursing home patient because of the loss of mental or physical abilities related to a disability; or have limited eyesight (even with glasses or contacts, 5/200 or less in both eyes, or a visual field narrowed to 5 degrees or less).2
• Yearly family income and net worth within the limits Congress sets. The net worth limit is $163,699 from December 1, 2025 to November 30, 2026. VA's net worth calculation includes the claimant's and their dependents' assets and income for VA purposes, and excludes the primary home, your car, and basic home items like appliances you would not take with you if you moved.2

VA looks back 3 years (36 months) from the date it receives the pension claim, and transferring a covered asset for less than fair market value in that window can bring a penalty period of up to 5 years, so it is worth planning ahead.2 A surviving spouse may be eligible for Aid and Attendance through the Survivors Pension, which has its own rates.1

When a Family Caregiver Provides In-Home Care in Delaware

If a relative is the one helping a parent bathe, dress, or eat, that does not rule out the benefit. Under 38 CFR 3.352(c), the performance of the necessary aid and attendance by a relative or another member of the household will not prevent VA from granting the additional allowance.2 That rule is about qualifying for Aid and Attendance; it does not say how the pension may be spent or that paying a relative counts as a medical expense.

If you want a VA program that lets a veteran hire family members as caregivers, ask your VA medical center about Veteran-Directed Care (VDC). VDC gives an enrolled veteran a flexible budget, managed by the veteran or a representative, to hire and supervise their own workers, including family, friends, and neighbors, with a local aging and disability agency arranging fiscal management services.5 Any enrolled veteran who is eligible for community care and meets the clinical criteria can use VDC where it is available. VDC is a VA Geriatrics and Extended Care program, not part of the Aid and Attendance pension.5

How Aid and Attendance Works with Delaware Medicaid

For Delaware seniors who later need long-term care Medicaid, how the VA money is treated matters. The rules sit in Delaware's Administrative Code, Title 16, chapter 20000 (Medicaid Long Term Care), published under the Department of Health and Social Services.6 That chapter counts a VA pension as unearned income, but handles the Aid and Attendance and Housebound allowances differently: "These allowances do not meet the definition of income because they are assistance for medical and social services," and "The payments are not included in the post eligibility calculation."6

In practice that means the allowance stays out of the Medicaid math at both steps. It is not counted as income when Delaware decides whether a person qualifies, and it is not added into the post-eligibility calculation that sets what a person owes toward their cost of care. The chapter adds that "Aid and Attendance payments may be used for whatever purpose the veteran wishes without penalty," and that "The veteran is free to make this income available to the community spouse."6 One federal rule changes the picture if care later moves to a nursing home: a veteran with no spouse or child (or a surviving spouse with no child) whose nursing-facility care is covered by Medicaid can be paid no more than $90 a month in VA pension after the month of admission, and Delaware does not count that $90 as income.6 That cap does not apply in a State veterans home that receives VA per diem payments. There, for the same veteran or surviving spouse, a separate federal rule counts pension above $90 a month for a resident who has been found eligible for Medicaid, including any Aid and Attendance portion, as income only to apply it toward the home's cost of nursing care, so a State veterans home resident should confirm with Delaware Medicaid how the federal and Delaware rules apply together.6 Income rules and limits change, so confirm a veteran's specific situation with Delaware Medicaid and a veterans service officer.6

How to Apply and Get Free Help

To apply, you submit Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination information section a medical examiner must fill out to document the need for help. The VA describes that form as the way to apply for Aid and Attendance benefits "that will be added to your monthly compensation or pension benefits," so it serves two routes: an increase added to disability compensation, and the pension route the steps here describe.7 On the pension route, the VA's condition is "You may be eligible for this benefit if you get a VA pension," so a wartime veteran pursuing that route who is not already receiving a VA pension also files Form 21P-527EZ (Application for Veterans Pension).7 You can file online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office, and an accredited attorney, accredited claims agent, or accredited Veterans Service Organization representative can help you file. Asked how long a decision takes, the VA answers "It depends," and adds that it processes claims in the order it receives them, unless a claim requires priority processing.7

Do not do this alone. Delaware veterans can get free help filing VA claims, including Compensation and Pension claims, from Veteran Service Officers at the Delaware Office of Veterans Services, who are State of Delaware employees trained and accredited by the VA.4 The office states that an accredited Veteran Service Organization representative will never charge for claims services. Accreditation alone is not what makes the help free, though: VA adds that an accredited attorney or claims agent can charge you fees for their services.4 You can reach the office at (302) 739-2792 to schedule an appointment with your county service officer.4

Compare Care Settings in Delaware

See how Aid and Attendance works with other care settings in Delaware:

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

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.