In Hawaii, a wartime veteran who needs regular help with daily tasks like bathing, dressing, or eating can qualify for up to $34,488 a year in 2026 through VA Aid and Attendance. That ceiling is for a veteran with one dependent, such as a spouse; a veteran alone can get up to $29,093 a year and a surviving spouse with no dependent child up to $18,697. VA pays the benefit monthly, and what you receive is the ceiling minus your countable income. It's one of the most underused VA benefits, and many Hawaii veterans and surviving spouses who qualify never apply because they don't know it exists.

This guide walks through who qualifies, how much you can receive, how to apply, and where to get help filing in Hawaii, including from the Hawaii Office of Veterans' Services.

In This Guide

What Is Aid and Attendance?

Aid and Attendance (A&A) is an enhanced VA pension benefit for wartime veterans and their surviving spouses who need help with everyday activities. It isn't a separate program. It's the same VA pension paid at a higher maximum rate when you need regular care, so the Aid and Attendance number is the maximum for the whole pension, not a supplement paid alongside the basic rate.

You may qualify if you need help with daily activities such as:

  • Bathing or showering
  • Dressing and undressing
  • Eating
  • Using the toilet
  • Adjusting prosthetic devices
  • Protecting yourself from everyday hazards

You can also qualify if you're bedridden, spend a large part of the day in bed because of illness, live in a nursing home due to mental or physical incapacity, or have severely limited eyesight (5/200 or less in both eyes even with glasses or contacts, or a visual field narrowed to 5 degrees or less).

A&A comes to you as part of your monthly VA pension payment, and VA benefit payments are tax-free under federal law., That money matters in Hawaii, where the cost of senior care runs among the highest in the nation: a private nursing home room ran about $196,735 a year in 2025, according to the CareScout 2025 Cost of Care Survey (an industry survey, not a government figure). A&A's ceiling of $34,488 a year for a veteran with one dependent won't cover a bill that size on its own, but it can meaningfully offset the cost of in-home help or assisted living while a family pieces together a care plan.,

Not sure whether your parent qualifies for Aid and Attendance? Chat with Brevy's care navigator.

Do You Qualify?

To receive Aid and Attendance, you have to meet all four of these requirements.

1. Wartime service. The service requirement depends on when the veteran entered active duty. Those who started active duty before September 8, 1980 need at least 90 days of active duty with at least one day during a recognized wartime period (such as World War II, the Korean War, the Vietnam War, or the Gulf War). Those who started active duty as an enlisted person after September 7, 1980 generally need at least 24 months of active duty, or the full period for which they were called or ordered to active duty, with at least one day during a wartime period. An officer who started active duty after October 16, 1981 and had not previously served on active duty for at least 24 months also meets the service test.

2. Discharge, plus age or disability. The veteran must not have a dishonorable discharge, and must meet at least one of four 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 (SSDI) or Supplemental Security Income (SSI). Any single one is enough, so a wartime veteran under 65 who receives SSI qualifies here without an adjudicated disability rating.

3. Need for assistance. The veteran or surviving spouse must need regular help with daily activities, be bedridden, be in a nursing home, or have severely limited eyesight as described above.

4. Net worth under $163,699. This is the 2026 limit. VA's net worth calculation counts the claimant's and their dependents' assets and their annual income, so comparing assets alone against the limit gives you the wrong answer. Your primary residence doesn't count. Neither do personal effects suitable to and consistent with a reasonable mode of life, which the regulation illustrates as appliances and family transportation vehicles, so the test is what fits a reasonable mode of life rather than a count of vehicles.,

Surviving spouses qualify too. If the veteran has passed away and the surviving spouse needs help with daily activities, they can apply for the Survivors Pension with Aid and Attendance, which has an annual ceiling in 2026 of $18,697 for a surviving spouse with no dependent child, or $22,304 with one dependent child.

2026 VA Aid and Attendance Rates in Hawaii

The VA calculates your payment as the difference between your countable income and the Maximum Annual Pension Rate (MAPR) for your category. With no countable income, you receive the full amount. VA publishes these as annual maximums but pays monthly: under its regulations, the monthly payment is the MAPR minus your countable income, divided by 12 and rounded down to the whole dollar. These rates are federal, so they're the same in Hawaii as anywhere else.

Category Annual Rate (MAPR)
Veteran, no dependents $29,093
Veteran with one dependent (such as a spouse) $34,488
Two veterans married to each other (both A&A) $46,143
Surviving spouse, no dependents $18,697
Veteran, no dependents (Housebound) $21,313
Veteran, no dependents (basic pension) $17,441
Each additional dependent +$2,984

Medical expenses you aren't reimbursed for can reduce your countable income, which raises your benefit, but only the amount above 5% of your MAPR counts ($1,141 for a veteran with one dependent).

The Net Worth Limit and 3-Year Lookback

The 2026 net worth limit is $163,699. VA's calculation combines the claimant's and their dependents' assets (savings, investments, and property other than your home) with their annual income, so assets alone are not what gets measured against the limit. That income is counted after VA's deductions, such as unreimbursed medical expenses above 5% of your MAPR, not as gross income.

What counts: bank accounts, stocks, bonds, investment property, IRAs, and other financial assets, plus your annual income.

What doesn't count: your primary residence (a single-family unit, including its residential lot of up to 2 acres, or more if the extra land isn't marketable), plus personal effects suitable to and consistent with a reasonable mode of life, which the regulation illustrates as appliances and family transportation vehicles. That matters for Hawaii veterans who own their homes but live on a modest fixed income.

The 3-Year Lookback Rule

The VA reviews any assets you transferred for less than fair market value in the 36 months before VA receives your claim. Under 38 CFR 3.276, that window never includes any date before October 18, 2018. If you gave away or sold assets below market value to get under the net worth limit, the VA may impose a penalty period of up to five years during which you won't receive pension benefits. Putting money into an annuity, a trust, or another investment that lowers your net worth also counts as a transfer for less than fair market value, unless you can cash out the whole balance for your own use, in which case VA counts it as net worth.

If you're thinking about transferring assets, talk to a VA-accredited attorney or an elder law attorney first. Our guide to the VA net worth limit and look-back shows how a penalty is calculated.

How to Apply for VA Aid and Attendance in Hawaii

The steps below describe the pension route, the one VA sums up as "You may be eligible for this benefit if you get a VA pension." Form 21-2680 also covers Aid and Attendance that will be added to your monthly compensation, so a veteran already receiving VA disability compensation files that exam form without the pension application in step 3.

1
Step 1

File an Intent to File if you're still gathering information

A claimant who isn't ready to submit the full claim can send VA Form 21-0966 (Intent to File) first. The VA says submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.

2
Step 2

Get a medical examination

A medical examiner fills out the examination information section of VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), documenting which daily activities you need help with and why. Be thorough. The more detail about specific limitations, the stronger the claim.

3
Step 3

Complete the pension application

A wartime veteran pursuing the pension route who isn't already receiving VA pension also files VA Form 21P-527EZ (Application for Veterans Pension), which covers service history, income, net worth, and medical conditions. This is the wartime, means-tested pension application, so it isn't the form for someone whose Aid and Attendance would be added to VA disability compensation instead.

4
Step 4

Submit everything

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, and a Hawaii Office of Veterans' Services counselor can help you prepare the claim. Filing online lets you save your progress and track the claim.

5
Step 5

Wait for a decision

Asked how long a decision takes, the VA answers "It depends." It works through claims in the order it receives them, unless a claim requires priority processing. A complete application with strong medical documentation leaves the VA less to follow up on, and incomplete submissions are a common source of delay.

File as early as you can, because filing sets your potential start date. An Intent to File gives you up to one year to complete the claim, and if the VA then approves it, you may be able to get retroactive payments, so the time you spend waiting need not be lost income. An OVS Veterans Services Counselor can help you prepare the claim and review the medical service records behind it.,

Documents to Gather First

  • DD-214 (discharge papers) showing wartime service dates
  • Medical records documenting the need for daily help
  • Income documentation (Social Security and pension statements)
  • Asset information (bank and investment statements)
  • Marriage certificate, if claiming as a veteran with a spouse
  • Death certificate, if applying as a surviving spouse

Help in Hawaii: the Office of Veterans' Services

You don't have to file this claim alone, and you should never pay to file an initial VA claim. Help with your claim is available through the state.

The Hawaii Office of Veterans' Services (OVS)

The Hawaii Office of Veterans' Services, known as OVS, provides VA claims assistance to veterans, their dependents, and survivors. Its listed services include helping prepare VA claims, filing VA appeals, representing veterans at VA hearings, and reviewing medical service records. OVS describes advocacy as the primary service it offers, and it may take action on behalf of veterans, their families, and survivors to secure the rights, benefits, and services they are due. OVS doesn't decide your VA claim itself (the federal VA does that), but its counselors can prepare and develop the evidence the VA needs.

OVS staffs Veterans Services Counselors at offices across the islands, and each office has its own phone number rather than one statewide line: on Oahu, Tripler Army Medical Center at (808) 433-0420 and the Daniel K. Akaka VA Clinic in Kapolei at (808) 458-5072; on Hawaii island, Hilo at (808) 369-3538 and Kailua-Kona at (808) 844-6664; Kauai at (808) 369-3535; and Maui, Molokai and Lanai at (808) 369-3541. Offices open weekdays from 7:45am to 4:30pm (closed noon to 1:00pm), and all but Tripler are by appointment only.

The Yukio Okutsu State Veterans Home

The Yukio Okutsu State Veterans Home in Hilo, on the island of Hawaii (the Big Island), is one of the two state veterans homes OVS points veterans to. It is a post-acute care and rehabilitation service provider designed specifically to serve the special needs of veterans, offering personalized 24-hour skilled nursing care, residential long-term placement, and dedicated short-term rehabilitation services. Interested veterans can contact the home at (808) 961-1500 or speak with their primary care physician. The other is the Daniel K. Akaka State Veterans Home, a 120-bed facility on a seven-acre property in Kapolei, and OVS asks interested veterans there to fill out the form it links from its State Veteran Homes page. For a veteran weighing nursing or rehabilitation care, an A&A award can help cover costs whether they stay at home or move into one of these homes.

Hawaii's Veteran Population

Hawaii is home to a substantial veteran population. The VA's National Center for Veterans Analysis and Statistics puts it at 104,765 in its FY2023 Hawaii state summary, a modelled estimate rather than a head count, while the Census Bureau's 2020-2024 American Community Survey estimate is lower, at 87,697. With that many veterans spread across the islands, it's worth contacting OVS early rather than waiting until a care crisis forces the issue.

A word of caution: be wary of companies that charge fees to help with VA claims. VA-accredited attorneys may charge for appeals, but no one should charge you to file an initial claim, whether you get help from OVS or a Veterans Service Organization like the VFW, American Legion, or DAV.

How Aid and Attendance Works with Hawaii Medicaid

Aid and Attendance and Hawaii Medicaid, administered through Med-QUEST, are run separately, under different rules. A veteran can receive both at the same time, but the two count money differently, so a few points are worth understanding.

  • Hawaii's own rule exempts A&A when Med-QUEST decides eligibility. Medicaid looks at the VA money in two separate steps. Hawaii is a Section 209(b) state, so it isn't automatically bound by SSI income rules, but its own regulation, HAR §17-1724.1-39, lists the VA aid and attendance and housebound allowances as exempt unearned income when deciding the financial eligibility of a MAGI-excepted individual. Ask Med-QUEST which eligibility category applies to you. Hawaii must also let you deduct incurred medical expenses through spenddown to reach the eligibility level.
  • Once you're eligible, how A&A figures in your share of cost isn't settled. In a nursing facility, the federal rule that reaches Hawaii, 42 CFR 435.733, says income disregarded at eligibility must be considered when income is applied to the cost of care, after deductions that start with a personal needs allowance (federal law sets a $30-a-month floor, not necessarily Hawaii's amount). Hawaii's own cost-share rule, HAR §17-1724.1-63, applies countable income after deducting a personal needs allowance, amounts for a community spouse and dependent family members, and incurred medical expenses Medicaid doesn't cover, but it doesn't say whether an allowance exempt at eligibility is part of that countable income. Ask Med-QUEST how it treats a full-rate A&A amount in your case.
  • For a single veteran in a Medicaid-paid nursing home, the pension can drop to $90 a month. Federal law caps the pension at $90 a month, for any month after the month of admission, for a veteran with no spouse or child (or a surviving spouse with no child) whose nursing facility care a Medicaid plan covers. That $90 is an aid and attendance allowance rather than income, and Medicaid's payment to the facility can't be reduced by it. The cap does not reach a State home for which VA pays a nursing home per diem, so whether it applies at a Hawaii State Veterans Home depends on that payment; ask an accredited Veterans Service Officer. For a Medicaid-eligible veteran with no spouse or child (or a surviving spouse with no child) in a State veterans home receiving that per diem, a separate federal rule counts any pension above $90 a month, including the aid and attendance amount, as income only to apply that excess to the home's cost of nursing care; confirm with Med-QUEST how it applies to your stay.
  • Check what Medicaid covers where you'll live. A&A comes to you as part of your monthly VA pension payment. Moving to assisted living? Ask Med-QUEST which costs your plan covers there, including room and board.
  • The VA already counts unreimbursed medical expenses. When the VA calculates your pension, it may subtract medical expenses you aren't reimbursed for, but only the amount above 5% of your Maximum Annual Pension Rate.
  • Timing matters. Because the exact income and asset treatment depends on the specific Med-QUEST program and current limits, talk to a Hawaii benefits counselor who understands both programs, and confirm details with Med-QUEST, before you file.

For the bigger picture of how Hawaii pays for care, start with our Medicaid Planning Strategies guide.

Frequently Asked Questions

How much does VA Aid and Attendance pay in Hawaii in 2026?

The maximum depends on your situation. VA sets annual ceilings: a veteran alone can get up to $29,093 a year, a veteran with one dependent, such as a spouse, up to $34,488, and a surviving spouse with no dependent child up to $18,697. Your actual payment is the ceiling minus your countable income. These are federal rates, identical in Hawaii. Unreimbursed medical expenses above 5% of the ceiling can lower your countable income and raise your benefit.

Where can I get help applying in Hawaii?

Contact your nearest Hawaii Office of Veterans' Services office to reach a Veterans Services Counselor, who can help you prepare the claim. Each office has its own number; on Oahu, the Tripler office is (808) 433-0420. You should never pay to file an initial claim.

Can I receive Aid and Attendance and Hawaii Medicaid at the same time?

Yes. Hawaii Medicaid runs through Med-QUEST, and Hawaii's own regulation lists the VA aid and attendance allowance as exempt income when it decides financial eligibility for a MAGI-excepted individual. Whether a full-rate allowance counts toward a nursing facility resident's cost share isn't settled by Hawaii's rule, so ask Med-QUEST. A veteran with no spouse or child whose nursing facility care Medicaid covers can see the pension capped at $90 a month after the month of admission, unless the facility is a State home receiving VA's nursing home per diem. Confirm details, including whether your plan covers assisted living room and board, with Med-QUEST and a benefits counselor before applying, because timing can affect eligibility.

How long does it take to get approved?

Asked how long a decision takes, the VA answers "It depends." It processes claims in the order it receives them, unless a claim requires priority processing. What you can control is completeness, so have the medical examiner be detailed on VA Form 21-2680 and submit all supporting documents at once. Because an Intent to File sets a potential effective date, and an approved claim may bring retroactive payments, getting something on file early matters even when the wait is long.

What if my Aid and Attendance claim is denied?

You have options, and you don't have to start over. If the VA denies your claim or grants less than you expected, you can ask for a review three ways: a Supplemental Claim (submit new and relevant evidence), a Higher-Level Review (a higher-level reviewer re-examines the case for an error or a difference of opinion, and no new evidence can be submitted), or an appeal to the Board of Veterans' Appeals. For most benefits you have one year from the date on your decision letter to request a Higher-Level Review or a Board appeal, and the letter states your deadline. A Supplemental Claim can be filed at any time, though the VA recommends filing within one year to keep your effective date. An OVS Veterans Services Counselor can help you prepare and file the review, and you can reach the VA benefits hotline at 800-827-1000 (TTY: 711).,

Learn More

MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. Care TypesAssisted Living in HawaiiAssisted living in Hawaii is among the nation's costliest and rising fast. How OHCA licenses it, what care costs, and what Med-QUEST does and doesn't cover. Care TypesNursing Homes in HawaiiNursing homes in Hawaii in 2026: a private room runs about $196,735/year, among the highest in the nation. What it costs, who pays, and how to vet a facility. Care TypesMemory Care in HawaiiHawaii issues no separate memory care license, and its assisted living rule sets no dementia standard. Here's what to vet yourself, what it costs, and who pays. Care TypesThe Cost of Senior Care in HawaiiWhat senior care costs in Hawaii in 2026: assisted living runs about $145,065 to $145,155 a year, the highest in the U.S. See every setting and how to pay. Care TypesAssisted Living vs. Nursing Home in HawaiiAssisted living vs. a nursing home in Hawaii comes down to level of care and who pays. Compare 2025 costs and how Med-QUEST covers long-term care.
Your next step Find personalized help applying for VA Aid and Attendance in Hawaii at brevy.com.

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.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.