VA Aid and Attendance for Assisted Living in Illinois

VA Aid and Attendance can raise an Illinois veteran's tax-free VA pension to as much as $29,093 a year, or $34,488 with a spouse.1,2 The benefit isn't paid to the facility. It's an increased monthly pension paid to the veteran or surviving spouse.3 And because the VA deducts unreimbursed medical expenses, which can include qualifying assisted-living charges, from the income it counts, a family that thought their income was too high may still qualify.1

This guide walks through what assisted living costs in Illinois, how much Aid and Attendance pays, why unreimbursed medical expenses can lower the income the VA counts against you, who qualifies, and how to get free help applying.

In This Guide

• Key Takeaways
• How Much Assisted Living Costs in Illinois
• How VA Aid and Attendance Helps Pay for Assisted Living in Illinois
• How Illinois Assisted Living Costs Lower Your Countable Income for Aid and Attendance
• Who Qualifies
• How Aid and Attendance Works with Illinois Medicaid (HFS)
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much Assisted Living Costs in Illinois

Assisted living in Illinois costs about $72,645 to $74,628 per year as a statewide median, according to the CareScout 2025 Cost of Care Survey. CareScout publishes two Illinois figures for a private one-bedroom unit: $74,628 a year (a reported $6,219 a month) in its median cost tables, and $72,645 a year in its March 2026 Illinois state release.4 Against the national median of $74,400 a year (about $6,200 a month), that runs from essentially at par to a little below. These are industry-survey medians, not government figures, and CareScout cautions that actual costs vary with individual care needs, provider availability, and local market conditions.4

Medicare doesn't pay for long-term care, the everyday help with dressing and bathing that an assisted living facility provides.6 Illinois Medicaid has the Supportive Living Program, a waiver that pays for services such as personal care and medication assistance in designated Supportive Living facilities, but the resident still pays room and board, and those facilities aren't the same as licensed assisted living establishments.7 The sections below cover where VA Aid and Attendance fits.

How VA Aid and Attendance Helps Pay for Assisted Living in Illinois

Aid and Attendance is an increased monthly VA pension for wartime veterans, and surviving spouses, who need help with daily activities.3 It's paid to the veteran or surviving spouse, and federal law exempts VA benefit payments from taxation.3,2

Here are the 2026 maximums, which the VA sets as yearly amounts:1

These are ceilings, not payments. The VA pays pension monthly: it subtracts your countable income from the applicable maximum annual rate, divides what's left by 12, and rounds down to the whole dollar.1 Even at the full rate, $29,093 a year for a veteran alone or $34,488 for a veteran with a spouse covers less than half of Illinois's median yearly assisted-living cost of $72,645 to $74,628.1,4

How Illinois Assisted Living Costs Lower Your Countable Income for Aid and Attendance

The medical costs you are already paying can help you qualify. VA Pension, including its Aid and Attendance increase, is needs-based: to be eligible, your yearly family income and net worth have to meet limits set by Congress.1 Because the benefit is keyed to income for VA purposes, you can deduct unreimbursed medical expenses (UMEs) from the income the VA counts.1

Only the portion of your unreimbursed medical expenses that exceeds 5 percent of the applicable maximum annual pension rate is deductible, and that floor is figured on the rate excluding any aid-and-attendance or housebound increase.1 The VA's own example puts that floor at $872 for a veteran with no spouse or child, and it rises for a veteran with dependents.1 So you subtract the floor from your annual medical costs, and the rest comes off the income the VA counts.

The practical upshot is significant: a veteran whose income looks too high at first glance can still qualify once unreimbursed medical expenses are deducted from the income the VA counts.1 An assisted living bill doesn't count automatically just because the resident lives there. Under 38 CFR 3.278(d)(3), payments for help with daily activities count when the resident receives health or custodial care in the facility and either needs aid and attendance, is housebound, or has a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist state in writing that, due to a physical, mental, developmental, or cognitive disorder, they need to be in a protected environment. Meals and lodging count only if the facility provides or contracts for that care, or one of those clinicians states in writing that the resident must live in that facility (or a similar one) to get care from an outside provider or from family or friends. The facility itself must be licensed if the state requires that type of facility to be, and a residential facility must have care providers on staff 24 hours a day.1 Which charges the VA will accept as medical expenses is set out in its rules at 38 CFR 3.278, so bring your assisted-living invoices to an accredited Veteran Service Officer and have them confirm what counts before you assume the answer either way.1

Who Qualifies

To receive Aid and Attendance, the veteran must meet four basic tests:5

• Wartime service, and no dishonorable discharge: the veteran must not have received a dishonorable discharge, and at least one of three service tests must be true. Started active duty before September 8, 1980, and served 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). Started active duty as an enlisted person after September 7, 1980, and served 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. Or was an officer who started active duty after October 16, 1981 and had not previously served on active duty for at least 24 months, with at least one day during wartime.5
• Age, disability, or benefit status: the veteran must meet at least one of four alternatives, any one of which is enough on its own: 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.5 A permanent and total rating is not the only disability route: a wartime veteran under 65 who receives SSI meets this test with no adjudicated rating at all.5
• Net worth within the $163,699 limit for 2026. The VA's net worth calculation includes the claimant's and their dependents' assets and their annual income for VA purposes, not assets alone, and it excludes the primary residence (a single-family unit, including a residential lot of up to 2 acres, or more if the extra acreage 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.5,1
• Need for aid and attendance: needing another person to help with daily activities such as bathing, feeding, and dressing; having to stay in bed, or spend a large portion of the day in bed, because of illness; being a patient in a nursing home due to the loss of mental or physical abilities related to a disability; or having limited eyesight (even with glasses or contact lenses, 5/200 or less in both eyes, or a visual field contracted to 5 degrees or less).5

The VA also applies a 3-year look-back period, the 36 months before it receives the claim, to assets transferred for less than fair market value. If a transfer like that would otherwise have pushed net worth over the limit, the VA can impose a penalty period of up to 5 years.5 If your family moved money or gave away assets in the last few years, it's natural to worry that you've already disqualified yourself. Don't assume the worst. An accredited Veteran Service Officer or elder law attorney can walk through exactly what the look-back and any penalty calculation mean for your specific timeline, rather than leaving you to guess.

How Aid and Attendance Works with Illinois Medicaid (HFS)

For an Illinois veteran who also needs Medicaid to pay for long-term care, Aid and Attendance and Medicaid interact in ways worth understanding before you rely on either. Illinois Medicaid is administered by the Illinois Department of Healthcare and Family Services (HFS), and eligibility is determined by the Illinois Department of Human Services.3

For nursing-home residents, Illinois Medicaid uses a patient-liability, or applied-income, model, in which what the resident owes the facility is worked out from income after a set of deductions. One of them is a personal needs allowance, which Illinois sets at $60 a month for skilled nursing facility residents.3

As a general federal rule, VA pension income is generally counted as income for Medicaid, but the portion that consists of Aid and Attendance paid for unreimbursed medical expenses may be treated differently and is often excluded from the income counted toward the Medicaid income limit.3

What a nursing-home resident owes after qualifying is a separate step. Illinois is one of eight states that chose the more restrictive 209(b) option, so the federal post-eligibility rule that reaches it is 42 CFR 435.733, the section for states using more restrictive requirements than SSI, not 42 CFR 435.725, which is written for SSI states.3 For a resident of a medical institution or intermediate care facility, 435.733 says income that was disregarded at eligibility must be considered, and it requires the agency to deduct five amounts from the resident's total income, in this order: (1) a personal needs allowance, reasonable in amount for clothing and other personal needs while in the institution, which Illinois sets at $60 a month for skilled nursing facility residents; (2) for a resident with only a spouse at home, an additional amount for the maintenance needs of that spouse; (3) for a resident with a family at home, an additional amount for the maintenance needs of that family; (4) amounts for incurred expenses for medical or remedial care not subject to payment by a third party; and (5) the full amount of any SSI and state supplement the resident continues to receive.3

Illinois's own policy manual sets out the same step. The Illinois Department of Human Services manual (PM 15-04-04) adds back any exempt or disregarded income that wasn't used to decide eligibility, subtracts its listed deductions, among them the personal needs allowance, the community spouse and family maintenance allowances, and medical premiums and other non-covered medical expenses, then adds any non-exempt resources above the resource disregard to set what the resident owes the facility.3 So if an Aid and Attendance amount the VA is still paying at the full rate was exempt or disregarded when Illinois decided eligibility, both rules bring it back into the income budgeted toward what the resident owes the facility, after those deductions. Neither Illinois manual page names Aid and Attendance specifically, so confirm with the Illinois Department of Human Services how a particular award is budgeted.3 The federal section covers residents of medical institutions and intermediate care facilities. For someone receiving home and community-based waiver services, confirm separately with HFS what they owe toward their care.3

One federal limit matters before you count a pension into a nursing-home budget. If a veteran with no spouse or child, or a surviving spouse with no child, is covered by Medicaid for nursing-facility care, the VA pays no more than $90 a month in pension for any period after the month of admission, and Medicaid's payment to the facility can't be reduced by that $90.3 Illinois's manual handles the same case: once the veteran or surviving spouse shows proof that the monthly VA benefit has been cut to $90, the caseworker deducts a $90 disregard in place of the $60 personal needs allowance, starting with the first month the VA checks drop.3 The cap doesn't reach a veteran who has a spouse or child, and the law excludes a State Veterans Home where the VA pays a per diem for nursing home care, so check a specific stay with an accredited Veteran Service Officer rather than assume the cap applies.3 Because this treatment depends on the specific situation and how the benefit is characterized, you should confirm with HFS, the Illinois Department of Human Services, or an accredited Veteran Service Officer before counting on it.3

How to Apply and Get Free Help

The steps below describe the pension route, the one this guide is about: the VA says you may be eligible "if you get a VA pension and you meet at least 1 of these requirements," meaning the aid-and-attendance needs listed under Who Qualifies.8 That route uses two VA forms:

• VA 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 assistance. This form covers both routes: the VA describes it as applying for Aid and Attendance benefits "that will be added to your monthly compensation or pension benefits," so a veteran who receives VA disability compensation rather than pension still uses it.8
• VA Form 21P-527EZ (Application for Veterans Pension), which is the wartime, means-tested pension application. A wartime veteran pursuing the pension route who isn't already receiving a VA pension files this alongside the examination form. It belongs to the pension route, so ask an accredited representative which route fits before you file.8

You can submit the forms 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 file for you.8 Asked how long a decision takes, the VA's answer is "It depends," and it adds that it processes claims in the order it receives them unless a claim requires priority processing, so it's worth applying as soon as the need arises, even while your loved one is already in assisted living.8

File an Intent to File first to protect your start date. Before you send the full application, you can notify the VA of an Intent to File using VA Form 21-0966, which sets a potential effective date for your benefits.9 If the claim is later approved, you may be able to receive retroactive payments, and you then have one year to complete and file the full claim.9 An Intent to File protects that potential start date, but no money arrives until the claim is decided, so families should plan to pay assisted-living costs out of pocket while it's pending.9

Don't do this alone. The Illinois Department of Veterans' Affairs (IDVA) says its Veteran Service Officers are trained and accredited by the U.S. Department of Veterans Affairs to provide free assistance to veterans and their dependents and survivors, covering both applying for federal and state benefits and resources related to compensation and pension.3 The VA describes Aid and Attendance as a monthly payment added to the amount of a monthly VA pension, so an A&A claim falls inside that pension category.3 IDVA runs full-time and part-time (itinerant) offices across the state, and the IDVA service office locator lists them so you can find the nearest one. IDVA notes that not every office offers every service and asks you to contact the nearest one about what it offers, and it says no benefit requires a face-to-face visit.3

Compare Care Settings in Illinois

See how Aid and Attendance works in other care settings in Illinois:

• How Aid and Attendance Pays for a Nursing Home in Illinois
• How Aid and Attendance Pays for In-Home Care in Illinois
• How Aid and Attendance Pays for Memory Care in Illinois

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.