VA Aid and Attendance for Nursing Home Care in Delaware

VA Aid and Attendance can put up to $2,424 a month toward a nursing home in Delaware for a qualifying wartime veteran.1 Surviving spouses may receive up to $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, a jump of nearly 37 percent over the prior survey and among the highest in the country. 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 an increase added to a qualifying veteran's or survivor's basic VA pension 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; it is a higher pension rate.

For 2026, the maximum monthly rates are:1

Against a Delaware private room running about $15,132 a month, Aid and Attendance at the single-veteran rate covers roughly 16 percent of the cost, cutting the annual out-of-pocket burden by about $29,000.2,1

How Nursing Home Costs Lower Your Countable Income

VA pension, including its Aid and Attendance increase, is a needs-based benefit. The VA pays the difference between a veteran's countable income and the applicable Maximum Annual Pension Rate (MAPR). Because the benefit is keyed to countable 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 MAPR is deductible. For 2026, those annual floors are:1

• $872 a year for a veteran with no dependents (5% of the $17,441 MAPR)1
• $1,141 a year for a veteran with one dependent (5% of the $22,839 MAPR)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 MAPR threshold, making the veteran eligible for the full Aid and Attendance rate.1

Nursing home fees (including meals and lodging) qualify as UMEs under 38 CFR 3.278, as do health insurance premiums and other out-of-pocket medical costs.

Who Qualifies

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

1. Wartime service: 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).
2. Age or disability: age 65 or older, OR permanently and totally disabled.
3. Net worth under $163,699 (for 2026): this limit combines assets and annual income; it excludes the primary home, vehicles, and basic household items.5
4. Need for aid and attendance: requires help with daily activities (bathing, dressing, feeding), is bedridden, 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 at up to $1,558/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 This reduced amount is treated as a personal-needs allowance, not a contribution toward nursing home costs.

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 (administered by the Division of Medicaid and Medical Assistance, DMMA, within Delaware Health and Social Services) are separate programs that can interact.4

Under the general rule for Delaware Medicaid, basic VA pension counts as income for Medicaid eligibility. The Aid and Attendance and Housebound allowances paid above the basic pension are generally not counted toward the Delaware Medicaid income limit. Delaware long-term-care Medicaid also allows certain unreimbursed medical expenses, such as Medicaid-noncovered medical equipment, dentures, hearing aids, and private health insurance premiums, to be protected from the income a resident must pay toward facility care.4

Income rules and limits change; a veteran's specific situation should be confirmed with DMMA and a VA-accredited Veteran Service Officer.4

How to Apply and Get Free Help

To apply for Aid and Attendance, you will need:6

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), completed by a physician documenting the need for assistance.
• VA Form 21P-527EZ (Application for Veterans Pension), if the veteran is not already receiving VA pension.

Forms can be submitted online at va.gov, mailed to the VA, or filed through an accredited representative. Processing often takes three to six months.6

Free help in Delaware: The Delaware Commission of Veterans Affairs / 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 DOS_OVS@delaware.gov or (302) 739-2792 to schedule an appointment.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.