VA Aid and Attendance for In-Home Care in Illinois

VA Aid and Attendance pays up to $2,424 a month for a wartime veteran, and most families don't realize it can even pay a relative to provide the care.1 It's a monthly cash benefit paid directly to the veteran, who decides how to spend it: a home health aide, a homemaker, or a family member providing the care. For a wartime veteran or surviving spouse in Illinois who needs help with daily activities, it can be what keeps them at home.

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

• Key Takeaways
• How Much In-Home Care Costs in Illinois
• How VA Aid and Attendance Helps Pay for In-Home Care in Illinois
• How In-Home Care Costs Lower Your Countable Income
• Do You Qualify for Aid and Attendance?
• Using Aid and Attendance to Pay a Family Caregiver
• How Aid and Attendance Works with Illinois Medicaid
• How to Apply for VA Aid and Attendance Home Care in Illinois
• Frequently Asked Questions
• Learn More

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.2 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 somewhat below the national medians, while Illinois assisted living sits close to the national figure.2

These are industry-survey medians, not government figures, and costs are higher in the Chicago metro than downstate, climbing as care needs grow.2 This is exactly the kind of expense Aid and Attendance is designed to offset.

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.5 It is claimed on Form PTAX-342 through the local assessment office, and it has to be filed for each year.5 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.1 It is paid as cash directly to the veteran, who decides how to use it. Because it arrives as monthly cash, families commonly put it toward a home health aide, a homemaker, or a family caregiver.

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 12.1 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.1 At the full $2,424 a month for a veteran, the benefit covers a meaningful share of Illinois's roughly $82,368-a-year in-home care cost, and at the full $2,874 a month for a veteran with a spouse it covers even more.1,2 Keep in mind the VA pays the veteran; the veteran arranges and pays for the care.

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.1 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, which is why many veterans who look "too rich" on paper still qualify once their care bills are subtracted.

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.1 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.1 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.2 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.1 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.1

Do You Qualify for Aid and Attendance?

To qualify for Aid and Attendance, a veteran generally must:6

• Not have received a dishonorable discharge
• Meet the wartime service test, which the VA lists as three paths: for active duty that began before September 8, 1980, at least 90 days of active duty with at least one day during a wartime period; for enlisted service that began after September 7, 1980, at least 24 months (with some exceptions), or the full period for which you were called or ordered to active duty, 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 months1
• 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 because of 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 a net worth below $163,6996 The net worth calculation includes your and your dependent's assets and income for VA purposes, and assets exclude your primary residence, your car, and basic home items like appliances1

The VA enforces a 3-year look-back on assets transferred for less than fair market value before filing.6 A surviving spouse can qualify under the Survivors Pension using the same net worth limit.1

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.1 If you aren't sure which allowance fits your situation, an accredited Veteran Service Officer or VA.gov can tell you.

If your net worth is above $163,699, you are not automatically shut out.1 Recurring care costs paid out of savings lower your net worth over time, and an accredited Veteran Service Officer or an elder law attorney can help with net worth planning before you file.

Using Aid and Attendance to Pay a Family Caregiver

Many families want to keep care in the family, and there are two ways VA benefits make that possible. First, because Aid and Attendance is cash paid to the veteran, the veteran can simply use it to pay a relative who provides care.

Second, the Veteran-Directed Care (VDC) program gives the veteran a flexible monthly budget to hire their own caregivers, including family members.3 The veteran (or their representative) manages the budget, and a financial management services provider helps with the employer responsibilities that come with hiring.3 Veterans in the program may hire family, friends, and neighbors, including a spouse.3 VDC is a VA Geriatrics and Extended Care program, separate from the VA pension and its Aid and Attendance increase, so ask an accredited Veteran Service Officer how the two fit together in your case.3 To ask about VDC, contact your local VA medical center's social work or geriatrics department.

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 because the treatment of Aid and Attendance income isn't always applied consistently. 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 essentially all monthly income goes toward the cost of care, except for a personal needs allowance, Medicare premiums, and any protected allowance for a community spouse.4 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.4 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.4 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.4 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.4

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.4

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

You don't have to do this alone, and the steps below are straightforward once you know the order.

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 Assisted Living in Illinois
• How Aid and Attendance Pays for a Nursing Home 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.