VA Aid and Attendance can raise a wartime veteran's VA pension to as much as $29,093 a year, and the cost of in-home care can lower the income VA counts against that ceiling. Care from a relative or another member of the household doesn't stop VA from granting the allowance, either.

This guide explains what in-home care costs in Illinois, how much Aid and Attendance pays, who qualifies, and how the benefit works alongside Illinois Medicaid.

In This Guide

How Much In-Home Care Costs in Illinois

According to the CareScout 2025 Cost of Care Survey (released March 2026), in-home care in Illinois costs about $82,368 per year (about $36 an hour), a figure that assumes 44 hours of care a week. The 2025 survey merged the former homemaker and home-health-aide categories into a single "non-medical caregiver" line, so that figure covers non-medical help at home. For comparison, Illinois nursing-home costs run well below the national medians, while Illinois assisted living sits close to the national figure.

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.

Care isn't the only cost of staying at home, either. If the veteran owns the house, the Standard Homestead Exemption for Veterans with Disabilities (35 ILCS 200/15-169) reduces the equalized assessed value (EAV) of the primary residence on a sliding scale tied to the VA service-connected disability rating: a $2,500 EAV reduction at a rating of at least 30% but less than 50%, a $5,000 reduction at a rating of at least 50% but less than 70%, and at 70% or more the first $250,000 of EAV is exempt from taxation. It is claimed on Form PTAX-342 through the local assessment office, and it generally has to be filed each year. Two groups don't have to reapply annually: a veteran who qualifies through World War II service, and a veteran with a 100% combined service-connected rating who is deemed permanently and totally disabled. Our guide to the Illinois disabled veteran property tax exemption walks through who can claim it and how to file.

How VA Aid and Attendance Helps Pay for In-Home Care in Illinois

Aid and Attendance is an increased monthly VA pension for wartime veterans and surviving spouses who need help with daily activities. The increase works as a higher ceiling rather than a second payment: the Aid and Attendance rate replaces the basic pension rate instead of being paid on top of it.

Category Maximum Annual Pension Rate
Veteran alone Up to $29,093
Veteran with spouse Up to $34,488
Surviving spouse Up to $18,697

The VA publishes these maximums as annual amounts, called the Maximum Annual Pension Rate (MAPR), but pays pension monthly: it takes the MAPR that applies to you, subtracts your countable income, divides what's left by 12, and rounds down to the whole dollar. The MAPR is a ceiling, not a check: the VA bases the payment on the difference between your income for VA purposes and the MAPR that applies to you, so it is the maximum amount of pension payable rather than the amount everyone receives. Even at the full $29,093 a year for a veteran alone, or $34,488 for a veteran with a spouse, the benefit covers a meaningful share of Illinois's roughly $82,368-a-year in-home care cost, not all of it.,

How In-Home Care Costs Lower Your Countable Income

VA pension, including the Aid and Attendance increase, is a needs-based benefit: to be eligible, your yearly family income and net worth have to meet limits set by Congress. Out-of-pocket care costs, such as paying a home health aide, can count as unreimbursed medical expenses (UMEs) that reduce the income the VA counts, on the conditions below.

Only the portion of those expenses above 5% of the applicable maximum annual pension rate is deductible, and that floor is figured on the rate excluding the aid-and-attendance or housebound increase. The VA's own example puts the floor at $872 a year for a veteran with no spouse or child, and it rises for a veteran with dependents. So if a veteran pays $82,368 a year for in-home care, the qualifying portion above that floor can come off the income the VA counts, as long as the care meets the attendant rules that follow., In-home attendant care qualifies as long as the attendant provides health care or custodial care, and the payments must be commensurate with the number of hours the attendant actually spends with the person. The attendant also has to be a health care provider, unless the veteran needs aid and attendance or is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that a physical, mental, developmental, or cognitive disorder makes that care necessary.

Do You Qualify for Aid and Attendance?

To qualify for Aid and Attendance, a veteran generally must:

  • Not have received a dishonorable discharge
  • Meet the wartime service test, which the VA lists as three paths: if you started on active duty before September 8, 1980, at least 90 days on active duty with at least one day during wartime; if you started on active duty as an enlisted person after September 7, 1980, at least 24 months or the full period for which you were called or ordered to active duty (with some exceptions), with at least one day during wartime; or, for an officer who started on active duty after October 16, 1981, not having previously served on active duty for at least 24 months, with at least one day during wartime
  • Meet at least one of the VA's four age-or-disability conditions: be 65 or older; 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 or Supplemental Security Income
  • Need the regular aid and attendance of another person, which the VA judges under the criteria at 38 CFR 3.352(a): being unable to dress or undress or to keep yourself ordinarily clean and presentable, needing frequent adjustment of a special prosthetic or orthopedic appliance, being unable to feed yourself, being unable to attend to the wants of nature, or having a physical or mental incapacity that requires care or assistance on a regular basis to protect you from the hazards of your daily environment. Being bedridden, being a patient in a nursing home due to the loss of mental or physical abilities related to a disability, or having limited eyesight (5/200 or less in both eyes, or a visual field contracted to 5 degrees or less) also meets this test
  • Have yearly family income and net worth within the limits Congress sets; the net worth limit is $163,699 The net worth calculation includes your and your dependents' assets and income for VA purposes, and assets exclude your primary residence, your car, and basic home items like appliances

The VA enforces a 3-year look-back on assets transferred for less than fair market value before filing: a transfer of an asset that would otherwise have pushed net worth over the limit can bring a penalty period of up to 5 years. For a surviving spouse, the Survivors Pension uses the same $163,699 net worth limit.

The VA's rate table also lists a Housebound rate separate from the Aid and Attendance rate, $21,313 a year for a veteran with no dependents against $29,093 with Aid and Attendance. If you aren't sure which allowance fits your situation, an accredited Veteran Service Officer or VA.gov can tell you.

If your savings look like they put you above $163,699, run the real calculation before you rule yourself out. Net worth adds your assets to your yearly income after deductible expenses, including unreimbursed medical expenses, are subtracted, so large care bills shrink the income side of the test. An accredited attorney, claims agent, or Veterans Service Organization representative can help you file the claim.

When a Family Member Provides the Care

There are two ways a relative's care can fit into VA benefits. First, under 38 CFR 3.352(c), the fact that a relative or another member of the household provides the needed aid and attendance doesn't prevent VA from granting the Aid and Attendance allowance.

Second, the Veteran-Directed Care (VDC) program gives an enrolled veteran a flexible budget, managed by the veteran or their representative, to hire and supervise their own workers. Veterans in the program may hire family, friends, and/or neighbors to provide services. Enrolled veterans are eligible if they are eligible for community care, meet the clinical criteria for the service, and VDC is available where they live. VA medical centers deliver it through local aging and disability network agencies, such as an Area Agency on Aging, where an options counselor helps assess needs, plan services, and arrange fiscal management services. VDC is a VA Geriatrics and Extended Care program for home and community based services. Ask an accredited Veteran Service Officer how it fits with an Aid and Attendance claim in your case, and ask your local VA medical center whether VDC is offered near you.

How Aid and Attendance Works with Illinois Medicaid

For an Illinois senior who needs Medicaid to pay for long-term care, Aid and Attendance and Medicaid interact, and for a veteran who qualifies for both, the math can get confusing fast. Illinois Medicaid is administered by the Illinois Department of Healthcare and Family Services (HFS), and for nursing-home residents it uses a patient-liability model, in which what the resident owes the facility is worked out from their income after a set of deductions. 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.

Illinois is one of eight states that elected the more restrictive 209(b) option, meaning it uses at least one eligibility rule stricter than SSI's, so the federal rule for what a nursing-home resident pays after qualifying is 42 CFR 435.733, the post-eligibility section for states with more restrictive requirements than SSI. It covers people in medical institutions and intermediate care facilities, and it says income that was disregarded at eligibility must be counted at this stage. The Illinois Department of Human Services (IDHS) policy manual, at PM 15-04-04, sets out the same step: after eligibility, it adds back any exempt or disregarded income that wasn't used in the eligibility decision, subtracts its listed deductions, and then adds any non-exempt resources above the resource disregard to arrive at what the person owes the facility. So if VA is still paying Aid and Attendance at the full rate and that amount was exempt or disregarded when Illinois decided eligibility, it comes back into the income budgeted toward what the resident owes, after those deductions. Neither IDHS page names Aid and Attendance specifically, so confirm how a particular award is budgeted with IDHS.

Under 435.733, the agency deducts these 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 must be at least $30 a month for an aged, blind, or disabled person and 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. The Illinois manual's own list runs in a similar order: after any employment-related deductions, the personal needs allowance (or a veteran benefit disregard), then the community spouse and family maintenance allowances, then medical premiums and other non-covered medical expenses, among others, so ask IDHS what the spouse and family allowances would be in your case. Because 435.733 is written for people in medical institutions and intermediate care facilities, ask HFS separately how income is applied if the veteran gets home and community-based waiver services instead.

If a nursing home is ever part of the plan, know one more federal limit before you budget around the full pension. When a veteran with no spouse or child (or a surviving spouse with no child) is in a nursing facility with Medicaid paying, no more than $90 a month in pension is paid for any period after the month of admission, and the facility's Medicaid payment can't be reduced by that $90. The IDHS manual tells caseworkers to deduct a $90 disregard in place of the $60 personal needs allowance, starting with the first calendar month VA checks are reduced to $90. The cap doesn't apply to a veteran with a spouse or child, and the law excludes a State home where VA pays a per diem for nursing home care, so check any Illinois Veterans Home stay against that rule with an accredited Veteran Service Officer. For a State veterans home that does receive that VA per diem, a separate federal Medicaid rule applies to a veteran with no spouse or child (or a surviving spouse with no child): any pension above $90 a month, including Aid and Attendance, counts as income only for applying that excess to the home's cost of the veteran's nursing home care.

Because this treatment depends on your situation and how the benefit is characterized, confirm with HFS, the Illinois Department of Human Services (which determines Medicaid eligibility), or an accredited Veteran Service Officer before relying on it.

How to Apply for VA Aid and Attendance Home Care in Illinois

You don't have to do this alone.

1
Step 1

Get a medical exam

Have a medical examiner fill out the examination information section of VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), documenting the need for help with daily activities.

2
Step 2

File an Intent to File if you are still gathering information

Submitting VA Form 21-0966 (Intent to File) first can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.

3
Step 3

File the pension application, if you are taking the pension route

The VA's condition for this route is that you may be eligible for this benefit if you get a VA pension, so a wartime veteran pursuing the pension who is not already receiving one also files VA Form 21P-527EZ (Application for Veterans Pension). You can file online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office. Form 21-2680 also serves veterans on VA disability compensation: the VA describes it as applying for Aid and Attendance that will be added to your monthly compensation or pension, so if you get compensation rather than pension, ask a Veteran Service Officer which forms your claim needs.

4
Step 4

Get free help from a Veteran Service Officer

The Illinois Department of Veterans' Affairs runs full-time and part-time offices across the state staffed by VA-trained and VA-accredited Veteran Service Officers, who provide free assistance to veterans and their dependents and survivors, both in applying for federal and state benefits and in providing resources related to compensation and pension, which is where an Aid and Attendance claim sits. Find the nearest office through IDVA's online locator at veterans.illinois.gov/serviceoffices.html, and call ahead, because IDVA says not every service is offered at every location; if your county isn't listed, contact IDVA's main office. If getting to an office is hard, IDVA says its offices can serve veterans remotely and that no benefit requires a face-to-face visit, and it offers a VSO Support Request form to have a Veteran Service Officer contact you.

5
Step 5

Wait for a decision, and appeal if needed

Asked how long a decision takes, the VA's answer is "It depends." It processes claims in the order received, unless a claim requires priority processing. If your claim is denied, ask your IDVA Veteran Service Officer, whose help is free, about your next steps.

Frequently Asked Questions

Can I use Aid and Attendance to pay for a home health aide in Illinois?

Aid and Attendance raises the monthly VA pension paid to the veteran. What you pay a home health aide also matters to the claim: payments to an in-home attendant who provides health or custodial care can count as unreimbursed medical expenses that lower the income VA counts, on the conditions described above. With in-home care in Illinois running about $82,368 a year, a benefit capped at $29,093 a year (or $34,488 with a spouse) covers a meaningful share of the cost, not all of it.,

Does the VA provide the in-home care directly?

Not through Aid and Attendance. It is part of VA pension, which provides monthly payments to the veteran. Separately, where it's available, VA's Veteran-Directed Care program gives enrolled veterans a flexible budget to hire and supervise their own workers at home.

Can my income be too high to qualify if I'm paying for care?

Not necessarily. Out-of-pocket in-home attendant care can count as an unreimbursed medical expense that lowers the income the VA counts, but only the portion above 5% of your applicable maximum annual pension rate is deductible, a floor the VA illustrates as $872 a year for a veteran with no spouse or child. Large care bills that meet the attendant rules can reduce the income the VA counts enough to qualify.

Can I get both Aid and Attendance and Illinois Medicaid?

Yes, a veteran can have both, but the two programs interact, and how Aid and Attendance is counted depends on the stage and setting. If a veteran with no spouse or child later moves into a nursing facility with Medicaid paying, federal law caps the VA pension at $90 a month after the month of admission, although the cap excludes a State veterans home where VA pays a per diem for nursing home care. Because the income treatment depends on your situation, confirm with HFS, the Illinois Department of Human Services, or an accredited Veteran Service Officer.

Compare Care Settings in Illinois

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

Learn More

VA BenefitsVA Aid and Attendance in IllinoisVA Aid and Attendance in Illinois for 2026: who qualifies, the $34,488 yearly maximum for a veteran with a spouse, how to apply, and free IDVA filing help. VA BenefitsVA Benefits for Senior Care in IllinoisIllinois veterans can access VA home care, Aid and Attendance pension, the five state veterans homes, and community care. See which fits, and how to apply. Care TypesHome Care vs Home Health in IllinoisHome care vs. home health in Illinois: home health is skilled, Medicare-covered care; home care is non-medical help Medicare won't pay for at home. VA BenefitsHow VA Aid and Attendance Pays for Assisted LivingHow VA Aid and Attendance helps pay for assisted living: the 2026 annual pension limits, the medical-expense rule, who qualifies, and how to apply. VA BenefitsVA Benefits for Senior Care: A Complete GuideA complete guide to VA benefits for senior care: long-term care, Aid and Attendance, pensions, DIC, and home grants for older veterans and surviving spouses.
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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.

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