VA Aid and Attendance for Assisted Living in Illinois

VA Aid and Attendance can pay up to $2,874 a month in tax-free pension income to an Illinois veteran or surviving spouse, money that can go straight toward an assisted living community's fees.1,2 The VA doesn't run assisted living facilities or pay them directly, but this benefit puts cash in the veteran's hands every month, and the way the VA counts unreimbursed medical expenses can help a family that thought their income was too high to qualify.

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 $74,628 per year, roughly $6,219 per month, as a statewide median, according to the CareScout 2025 Cost of Care Survey.3 That figure sits essentially at the national median of $74,400 a year (about $6,200 a month), but it's a statewide midpoint, and downstate costs differ from those in the Chicago metro.3

For most families, that monthly bill is the central problem. Assisted living isn't covered by Medicare, and Illinois Medicaid covers it only through limited waiver programs. So the cost usually comes out of the resident's own income and savings. That's exactly the gap VA Aid and Attendance is built to help close.

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.5 It's paid as tax-free cash directly to the beneficiary, so the money can go toward assisted-living fees, an in-home aide, or any other care the family chooses.2

Here's what the benefit pays in 2026:

The VA sets these maximums as annual amounts (a Maximum Annual Pension Rate of $29,093 for a veteran alone, $34,488 with a spouse, and $18,697 for a surviving spouse), and the monthly figures above are that yearly award divided by 12. Against an assisted-living bill of about $6,219 a month, a veteran's $2,424 covers roughly 40 percent of the median cost, and $2,874 for a married couple covers nearly half.1,3 It rarely pays the whole bill on its own, but combined with Social Security and savings, it can be the difference between affording a community and not.

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

The most misunderstood part of this benefit is that 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

There's a catch worth understanding: 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 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:4

• 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 (WWII, Korea, Vietnam, or 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.4
• 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.4 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.4
• Net worth under $163,699 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, which VA counts as one per claimant, plus personal effects suitable to and consistent with a reasonable mode of life, which the regulation illustrates as appliances and family transportation vehicles.4,1
• Need for aid and attendance: needing help with daily activities such as bathing, dressing, or feeding yourself; being bedridden; being in a nursing home due to incapacity; or having severely limited eyesight.4

The VA also enforces a 3-year look-back period on assets transferred for less than fair market value before filing, with a penalty period of up to 5 years.4 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)

Many Illinois families eventually need both Aid and Attendance and Medicaid, and the two programs 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.5

For nursing-home residents, Illinois uses a patient-liability, or applied-income, model: once a resident qualifies, essentially all of their monthly income must go toward the cost of care, except for a personal needs allowance (set at $60 per month for skilled nursing facility residents), Medicare premiums, and any protected allowance for a community spouse.5

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.5 Once a resident is eligible and living in a medical institution or intermediate care facility, though, income that was disregarded at eligibility must be counted in the share-of-cost calculation, so the Aid and Attendance amount does count toward the patient liability the resident owes the facility.5 Incurred medical expenses are not the only deduction, and they are not the first one. Under 42 CFR 435.725(c) the agency must 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, which the regulation says includes Medicare and other health insurance premiums, deductibles, or coinsurance; and (5) the full amount of any SSI and state supplement the resident continues to receive. Only what remains after all five reaches the facility, and each one is a deduction the agency is required to make rather than an allowance a family has to apply for. The spouse and family amounts are measured against state standards rather than a single federal figure, so ask HFS what they would be.5 That section covers people in medical institutions and intermediate care facilities. It does not settle what someone receiving home and community-based waiver services owes toward their care, so confirm that separately with HFS.5 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.5

How to Apply and Get Free Help

The steps below describe the pension route, the one this guide is about: the VA's condition is that "you may be eligible for this benefit if you get a VA pension."6 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.6
• 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 is not the form for a veteran whose Aid and Attendance would be added to monthly compensation, so ask an accredited representative which route fits before you file.6

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.6 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.6

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.7 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.7 Filing the Intent to File costs nothing and 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.7

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.5 On the pension route covered here, Aid and Attendance is paid as part of the VA pension rather than as a separate benefit, so an A&A claim sits inside that pension category.5 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.5

Compare Care Settings in Illinois

Aid and Attendance can help pay for any care setting. See how it works for the others:

• 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.