VA Aid and Attendance for Memory Care in Illinois

For an Illinois veteran with no dependents facing memory care costs, VA Aid and Attendance raises the 2026 maximum annual pension rate to $29,093.1 VA describes Aid and Attendance as monthly payments added to the amount of a monthly VA pension.2 Memory care is a specialized form of assisted living for people with Alzheimer's disease and other dementias, and a resident pays for the room or apartment and may need to pay extra for any special care.3

In This Guide

• Key Takeaways
• How Much Memory Care Costs in Illinois
• How Aid and Attendance Helps Pay for Memory Care in Illinois
• How the Care-Need Test Applies to a Veteran With Dementia
• How Memory Care Costs Lower Your Countable Income
• Who Qualifies
• How Aid and Attendance Works with Illinois Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much Memory Care Costs in Illinois

The CareScout 2025 Cost of Care Survey (released March 2026) publishes two medians for a year of assisted living in a private, one-bedroom unit in Illinois: $74,628 (about $6,219 a month) in its cost tables, and $72,645 in its Illinois state data release. Plan on roughly $72,645 to $74,628 a year rather than a single figure.4,5 Memory care is a specialized form of assisted living for people with Alzheimer's and other dementias, and on top of the cost of the room or apartment, a resident may need to pay extra for any special care.3

How Aid and Attendance Helps Pay for Memory Care in Illinois

Aid and Attendance is an increased rate of the VA pension for veterans, and surviving spouses, who need help with daily activities.6,7

The VA publishes these as Maximum Annual Pension Rates, effective December 1, 2025 through November 30, 2026. The figures below are the maximum pension with Aid and Attendance, not a separate Aid and Attendance payment on top of them: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

Because the VA subtracts your income for VA purposes from the maximum rate, the income your household already has reduces the award, so run the arithmetic on your own household rather than assuming the maximum.1

How the Care-Need Test Applies to a Veteran With Dementia

The VA bases the care-need decision on the actual requirement of personal assistance from others, so a dementia diagnosis alone doesn't settle it; what the veteran needs help with does.2

To qualify on care need, at least one of these must be true: needing another person to help with daily activities like 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 because of a loss of mental or physical abilities related to a disability; or eyesight of 5/200 or less in both eyes even with glasses or contacts, or a visual field contracted to 5 degrees or less.2 In deciding that need, the VA's rule at 38 CFR 3.352(a) has it consider factors including being unable to dress or undress or to keep yourself ordinarily clean and presentable, being unable to feed yourself, being unable to attend to the wants of nature, and a physical or mental incapacity that requires care or assistance on a regular basis to protect you from the hazards or dangers of your daily environment. Not all of those factors need to be found before the VA can grant the benefit, and the evidence needs to show a regular need for aid and attendance rather than a constant one. Under 38 CFR 3.352(c), care given by a relative or another member of the household doesn't prevent the award.2

On the claim itself, that need is documented on VA Form 21-2680, whose examination section a medical examiner must fill out.6

How Memory Care Costs Lower Your Countable Income

The VA pension is needs-based: to be eligible, your yearly family income and net worth have to meet limits set by Congress.1 Because eligibility is keyed to income for VA purposes, lowering the income the VA counts can bring you inside those limits, and you lower it by deducting unreimbursed medical expenses.

Which charges the VA will accept as medical expenses is set out in its rules at 38 CFR 3.278, and those rules cover more than doctor visits: health, medical, hospitalization, and long-term care insurance premiums all count, as do premiums for Medicare Parts A, B, and D.1 A memory care community's bill doesn't count automatically, though. Payments to a nursing home, including its meals and lodging, are medical expenses. For a memory care community run as a care facility other than a nursing home, such as assisted living, the rule at 38 CFR 3.278(d)(3) has conditions. Payments for health care from a health care provider count. Help with daily activities from anyone else counts if your loved one receives health care or custodial care in the facility and either needs aid and attendance (or is housebound) or has a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist state in writing that, because of a cognitive or other disorder, they need to be in a protected environment. Meals and lodging count if the facility provides or contracts for that care, or if one of those clinicians states in writing that your loved one must live there (or in a similar facility) to receive that care from an outside provider or from family or friends. The facility must be licensed if Illinois requires that type of facility to be, and a residential facility must have care providers on staff 24 hours a day.1 Have an accredited Veteran Service Officer read the invoices with you, because whether each charge counts turns on these conditions.

There's one rule to know: 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 The practical upshot: a veteran whose income looks too high to qualify can come within the limit once deductible medical expenses come off the income the VA counts.1

Who Qualifies

To be eligible for Aid and Attendance, the veteran must:2

• Have qualifying wartime service. How much service is required depends on when the veteran started active duty. A veteran who started active duty before September 8, 1980 needs 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). A veteran who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months, or the full period for which they were called or ordered to active duty, again with at least one day during wartime. A veteran who was an officer and started active duty after October 16, 1981 meets this test if they hadn't previously served on active duty for at least 24 months, also with at least one day during wartime.
• Have no dishonorable discharge, and meet at least one of these four: 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 or Supplemental Security Income. Any one of the four satisfies this test on its own, so a wartime veteran under 65 who receives SSI meets this test.
• Need aid and attendance: needing another person to help with daily activities like 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 because of a loss of mental or physical abilities related to a disability, or having eyesight of 5/200 or less in both eyes (or a visual field of 5 degrees or less). The VA also weighs whether a physical or mental incapacity means you need regular care to protect you from everyday hazards.2
• Have yearly family income and net worth within the limits Congress sets. The net worth limit is $163,699 from December 1, 2025 to November 30, 2026.2 The net worth calculation includes the claimant's and dependents' assets and income for VA purposes, and assets exclude the primary residence, the car, and basic home items like appliances you wouldn't take with you if you moved.2,1

The VA also applies a 3-year look-back, 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 caused or partly caused net worth to exceed the limit, the VA assesses a penalty period of up to five years, so don't give away or move assets to qualify without getting advice first.2

How Aid and Attendance Works with Illinois Medicaid

For an Illinois senior who also needs Medicaid to pay for long-term care, Aid and Attendance and Medicaid interact.7

In Illinois, Medicaid is administered by the Department of Healthcare and Family Services (HFS). For nursing-home residents it uses a patient-liability (applied-income) model, in which what the resident owes the facility is worked out from income after a set of deductions. As a general federal rule, VA pension income is generally counted as income for Medicaid, but the portion of a VA pension 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.7 Eligibility is only the first step. Illinois is one of eight states that chose the more restrictive section 209(b) option, so the federal rule for what a nursing-facility resident owes after eligibility is 42 CFR 435.733, and the Illinois Department of Human Services (IDHS), which determines Medicaid eligibility, sets out the same step in its Policy Manual at PM 15-04-04. Both bring income that was exempt or disregarded when eligibility was decided back into the budget. So if VA is still paying Aid and Attendance at the full rate and that amount was set aside at eligibility, it is budgeted toward what the resident owes the facility, after the deductions below. Neither IDHS page names Aid and Attendance specifically, so confirm how a particular award is budgeted with IDHS.7 Under 42 CFR 435.733 the agency must deduct five amounts from the resident's total income, in this order: (1) a personal needs allowance that is reasonable in amount for clothing and other personal needs while in the institution, at least $30 a month under the federal rule, 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 that are not subject to payment by a third party; and (5) the full amount of any SSI and state supplement the resident continues to receive. What the resident owes the facility is figured from what remains, and each of these is a deduction the agency is required to make. Ask IDHS what the spouse and family amounts would be in your case.7 Section 435.733 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.7

Two federal statutes change this for many veterans in a nursing facility. If a veteran with neither a spouse nor a child is covered by Medicaid for nursing facility services, VA pays no more than $90 a month in pension for any period after the month of admission, and the same cap applies to a surviving spouse with no child (38 U.S.C. 5503(d)(2) and (d)(5)(A)).7 Under 38 U.S.C. 5503(d)(3), the Medicaid payment to the facility may not be reduced by that $90.7 IDHS deducts the $90 in place of the $60 personal needs allowance once the resident shows proof that the VA check has been reduced. A veteran with a spouse or a child is outside the cap.7 The cap's definition of a nursing facility excludes a State home for which VA makes per diem payments for nursing home care. For a veteran or surviving spouse without dependents in a State veterans home that receives that per diem, a separate rule (42 U.S.C. 1396a(r)(1)(B)) counts any pension over $90 a month, including Aid and Attendance, as income only to apply that excess to the home's cost of care. Whether a particular Illinois State Veterans Home falls in that group depends on whether VA makes that per diem payment, so check with an accredited Veteran Service Officer.7

Because this treatment depends on the specific situation and how the benefit is characterized, confirm it with HFS, IDHS, or an accredited Veteran Service Officer before relying on the combination.7

How to Apply and Get Free Help

The steps below are the pension route, the one this guide covers: the VA says "You may be eligible for this benefit if you get a VA pension and you meet at least 1 of these requirements." Aid and Attendance is not pension-only, though. VA Form 21-2680 is used to claim 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 a pension files that form to have the increase added to the compensation; the pension application below belongs to the pension route.6

On the pension route you apply with these VA forms:6

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination section a medical examiner must fill out documenting the need for help.
• VA Form 21P-527EZ (Application for Veterans Pension), which is the pension claim itself, for a wartime veteran who isn't already receiving a VA pension.
• VA Form 21-0966 (Intent to File), optional and first, if you're still gathering information. Submitting an intent to file, the VA says, "can secure the earliest possible effective date for any retroactive payments you may be eligible to receive."
• VA Form 21P-8416 (Medical Expense Report), for reporting medical expenses you paid for yourself or a family member in your household and weren't reimbursed for and don't expect to be, which is where memory care costs that qualify as medical expenses go.

You can file online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office, and an accredited attorney, accredited claims agent, or accredited Veterans Service Organization representative can help you file.6 Asked how long a decision takes, the VA answers "It depends," and adds that it processes claims in the order it receives them, unless a claim requires priority processing.6

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.7 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.7 IDVA runs full-time and part-time (itinerant) offices statewide; find your nearest one using IDVA's online VSO locator at veterans.illinois.gov/serviceoffices.html. 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.7

Compare Care Settings in Illinois

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

• 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 In-Home 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.