VA Aid and Attendance for Nursing Home Care in Delaware

VA Aid and Attendance can put up to $29,093 a year, about $2,424 a month, toward a nursing home in Delaware for a qualifying wartime veteran.1 Surviving spouses may qualify for up to $18,697 a year, about $1,558 a month, a meaningful offset in a state where nursing home costs are among the highest in the nation.

In This Guide

• How much a nursing home costs in Delaware
• How Aid and Attendance helps pay for it
• How nursing home costs lower your countable income
• Who qualifies
• The nursing-home pension cap when Medicaid pays
• How Aid and Attendance works with Delaware Medicaid
• How to apply and get free help
• Frequently asked questions

How Much a Nursing Home Costs in Delaware

Per the CareScout 2025 Cost of Care Survey (released March 2026), a private room in a Delaware nursing home costs about $181,588 a year, roughly $15,132 a month, the 9th highest of the 50 states. Nationally, the 2025 median is about $315 a day ($114,975 a year) for a semi-private room and $355 a day ($129,575 a year) for a private room. Delaware sits well above those national lines, making it one of the more expensive states for residential skilled nursing care.2

These are industry-survey medians, not government figures; costs vary within the state and rise as care needs grow.

How Aid and Attendance Helps Pay for a Nursing Home in Delaware

VA Aid and Attendance is a qualifying veteran's or survivor's VA pension paid at a higher maximum rate when the person needs help with daily activities, is bedridden, lives in a nursing home due to physical or mental incapacity, or has severely limited eyesight.5 It is not a separate program, and the higher figure is the ceiling on the entire pension, not a separate award tacked onto the basic rate.

The VA sets these maximums as annual amounts for 2026. Each one is a ceiling rather than a payment: VA bases the award on the difference between the claimant's income for VA purposes and the limit, so a veteran with countable income is paid less than the figure below.1

VA publishes these rates as annual maximums, so a monthly amount is the yearly award divided by 12.1

Against a Delaware private room running about $181,588 a year, the full single-veteran maximum of $29,093 would cover roughly 16 percent of the bill. A claimant whose countable income reduces the award covers a smaller share than that.2,1

How Nursing Home Costs Lower Your Countable Income

VA pension, including its Aid and Attendance increase, is a needs-based benefit. To be eligible, a veteran's yearly family income and net worth have to meet limits set by Congress. Because the benefit is keyed to income, large recurring care expenses can help a veteran qualify even when their income appears too high at first glance.1

Here is how it works: only the portion of unreimbursed medical expenses (UMEs) that exceeds 5 percent of the applicable Maximum Annual Pension Rate (MAPR) is deductible. That floor counts the increase for family members but not the increase for aid and attendance or housebound status, so it rises with dependents but never with the A&A allowance itself.1

For 2026, the VA puts the floor at $872 a year for a veteran with no spouse or child.1

Example: a single veteran has $22,000 in annual income and pays $181,588 a year for a Delaware nursing home. After subtracting the $872 floor, roughly $180,716 in nursing home expenses become deductible. That drives countable income far below the pension's income limits, so a veteran who looked over the limit on paper can still qualify.1

Under 38 CFR 3.278, payments for health, medical, hospitalization, and long-term care insurance premiums are medical expenses, and premiums for Medicare Parts A, B, and D and for long-term care insurance count as well.1 The nursing home fees a family pays out of pocket are unreimbursed medical expenses too.

Who Qualifies

To receive VA Aid and Attendance, a veteran must meet all of the following:5

1. Wartime service: a veteran who started active duty before September 8, 1980 needs at least 90 days of active duty with at least one day during a recognized wartime period (World War II, Korea, Vietnam, Gulf War/post-9/11); someone who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months, or the full period for which they were called or ordered to active duty (with some exceptions), with at least one day during wartime; and an officer who started active duty after October 16, 1981 must not have previously served on active duty for at least 24 months.
2. Discharge, plus age or status: no dishonorable discharge, and at least one of these must be true: at least 65 years old; 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 of the four satisfies this test on its own, so a wartime veteran under 65 who receives SSI qualifies here without a permanent-and-total rating.
3. Net worth under $163,699 (from December 1, 2025 through November 30, 2026): VA's net worth calculation includes the claimant's and their dependents' assets and annual income for VA purposes, so income counts toward the limit rather than assets alone. What it leaves out matters just as much: assets do not include the primary home, one personal vehicle, or basic home items like appliances you would not take with you if you moved, so the house you live in does not push you over the limit. What does count is counted net of debt, because assets are the fair market value of the real and personal property owned minus the amount of any mortgages, and VA may subtract unreimbursed medical and educational expenses when it assesses income for VA purposes and net worth. For a married veteran this is a household test rather than an individual one, because net worth includes the spouse's.5
4. Need for aid and attendance: requires help with daily activities (bathing, dressing, feeding), has to stay in bed or spend a large portion of the day in bed because of illness, is a patient in a nursing home due to mental or physical incapacity, or has severely limited vision.

The VA also applies a 36-month look-back on asset transfers for less than fair market value. Transfers made on or after October 18, 2018 can trigger a penalty period of up to five years.5

Surviving spouses of qualifying wartime veterans may be eligible for the Survivors Pension with Aid and Attendance, capped at $18,697 a year, about $1,558 a month.1

The $90/Month Nursing-Home Pension Cap

This is one of the most important planning facts for families weighing both VA pension and Medicaid.

When a single veteran with no spouse or dependent children is receiving Medicaid-covered nursing facility care, federal law generally limits VA pension, including the Aid and Attendance amount, to no more than $90 per month for any period after the month of admission (38 U.S.C. 5503(d)(2), implemented at 38 CFR 3.551).3 That cap turns on a defined term rather than on the everyday sense of a nursing home: for purposes of the subsection, 38 U.S.C. 5503(d)(1)(B) defines "nursing facility" as one described in section 1919 of the Social Security Act "other than a facility that is a State home with respect to which the Secretary makes per diem payments for nursing home care pursuant to section 1741(a) of this title", and 38 CFR 3.551(i) states the rule without repeating that definition, so a Medicaid-covered stay in a State veterans home for which VA pays per diem should be checked against the statutory definition rather than assumed to fall under the $90 rule.3 VA states that where it awards the $90 rate, "your facility can't count this monthly payment as income toward your cost of care" and "You would keep the full $90 for personal expenses." That federal treatment caps the pension and keeps it out of the facility's cost-of-care calculation; how the retained $90 relates to a state's Medicaid personal needs allowance is set by that state's own post-eligibility rules.3

What this means practically: if a veteran enters a nursing home that Delaware Medicaid is already paying for, the VA pension does not continue at the full Aid and Attendance rate. Given Delaware's high nursing home costs, families should coordinate both applications carefully before the veteran enters a Medicaid-funded facility. An accredited VA representative or elder law attorney can help map out the timing to preserve as much benefit as possible.3

How Aid and Attendance Works with Delaware Medicaid

VA Aid and Attendance and Delaware long-term-care Medicaid are separate programs that can interact. How Delaware Medicaid treats VA money is set out in Delaware's Administrative Code, Title 16, chapter 20000 (Medicaid Long Term Care), published under the Department of Health and Social Services.4

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."4

So in Delaware the allowance is left out at both steps. It is not counted as income when eligibility is decided, and it is not added into the post-eligibility calculation that determines the resident's liability toward the 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."4

The chapter also records the effect of the Veterans' Benefits Act of 1992 for a veteran, or a surviving spouse with no children, residing in a Medicaid nursing facility: the VA Improved Pension is limited to $90 a month, that $90 is not counted as income in either the eligibility or the post-eligibility process, and there is no interaction between the reduced pension and the personal needs allowance.4

Income rules and limits change; a veteran's specific situation should be confirmed with Delaware Medicaid and a veterans service officer.4

How to Apply and Get Free Help

The steps below describe the pension route, the one most Delaware nursing-home families use: VA says you may be eligible for this benefit if you get a VA pension. VA Form 21-2680 is also used to apply for Aid and Attendance "that will be added to your monthly compensation or pension benefits," so a veteran who receives VA disability compensation rather than a pension uses the same examination form on the compensation side and does not file the wartime pension application below.6

To apply on the pension route, you will need:6

• 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 documenting the need for assistance.
• VA Form 21P-527EZ (Application for Veterans Pension), filed by a wartime veteran pursuing the pension route who is not already receiving a VA pension. On this route the Aid and Attendance amount takes the form of a higher Maximum Annual Pension Rate rather than a second payment stacked on the basic rate.
• VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance), which will also need to be filled out for a nursing-home claim.6
• VA Form 21-0966 (Intent to File), which a claimant still gathering information can submit 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."6

You can apply online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office; an accredited attorney, accredited claims agent, or accredited Veterans Service Organization representative can also help you file.6

Free help in Delaware: The Delaware Office of Veterans Services employs VA-accredited Veteran Service Officers who help with pension and Aid and Attendance claims at no charge. Veterans can reach the office at (302) 739-2792 to schedule an appointment with their county service officer. The office says it will never charge for claims services.7 Accreditation on its own is not a promise of free help, though: VA says the services an accredited Veterans Service Organization representative provides on a VA benefit claim are always free, but that an accredited attorney or claims agent can charge fees for their services.7 Visit vets.delaware.gov for more information.

Never pay someone to file an initial VA claim. Accredited representatives are prohibited from charging fees for this service.

Compare Care Settings in Delaware

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 Delaware
• How Aid and Attendance Pays for In-Home Care 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.