A wartime veteran in Illinois with no dependents who qualifies for VA Aid and Attendance has a 2026 pension ceiling of up to $29,093 a year. For a surviving spouse with no dependents the ceiling is up to $18,697 a year. Those are maximums rather than payments, because the VA pays the difference between a claimant's income for VA purposes and the limit.

In This Guide

  • How much a nursing home costs in Illinois
  • How Aid and Attendance helps pay for it
  • How nursing home costs lower your countable income
  • Who qualifies
  • The nursing-home pension cap for Medicaid residents
  • How Aid and Attendance works with Illinois Medicaid
  • How to apply and get free help
  • Frequently asked questions

How Much a Nursing Home Costs in Illinois

Per the CareScout 2025 Cost of Care Survey (rates collected July through November 2025 and published March 2026), a semi-private room in an Illinois nursing home costs about $99,645 a year, roughly $8,304 a month. A private room runs about $110,595 a year, roughly $9,216 a month. Illinois nursing home costs run well below the national medians of about $114,975 for a semi-private room and $129,575 for a private room.

These are industry-survey medians, not government figures. CareScout collects rates by metropolitan area and cautions that actual costs vary with a person's care needs, provider availability, and local market conditions.

How Aid and Attendance Helps Pay for It

VA Aid and Attendance is an increase to a qualifying veteran's or survivor's VA pension when the person needs help with daily activities, is bedridden, lives in a nursing home due to physical or mental incapacity, or has severely limited eyesight. It is not a separate program; it is a higher pension rate.

VA publishes these rates as annual maximums. Under 38 CFR 3.273, VA works out the monthly payment by subtracting countable income from the annual rate and dividing what is left by 12, rounding down to the whole dollar under 38 CFR 3.29(b). For 2026 the ceilings are:

Situation Maximum annual rate
Veteran with no dependents Up to $29,093/year
Veteran with one dependent Up to $34,488/year
Surviving spouse (no dependents) Up to $18,697/year

Each of those is a ceiling, not a check. The VA bases the payment on the difference between the claimant's income for VA purposes and the limit, so a veteran with countable income is paid less than the maximum. One monthly figure VA itself publishes is the look-back penalty period rate of $2,874, which 38 CFR 3.276(e)(1) defines as the Aid and Attendance rate for a veteran with one dependent, divided by 12 and rounded down to the nearest whole dollar.

Against an Illinois semi-private nursing home room at about $99,645 a year, the single-veteran ceiling of $29,093 a year is a partial offset, not full coverage, and the actual payment is lower still for a veteran with countable income.

How Nursing Home Costs Lower Your Countable Income

VA pension, including its Aid and Attendance increase, is a needs-based benefit. To be eligible, the veteran's yearly family income and net worth must meet limits set by Congress. Because the benefit is keyed to income for VA purposes, a claimant can lower that income by deducting unreimbursed medical expenses.

Here is how it works: only the portion of unreimbursed medical expenses (UMEs) that exceeds 5 percent 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. VA puts that floor at $872 a year for a veteran with no spouse or child, and it rises for a veteran with dependents.

Payments to a nursing home, including the cost of meals and lodging the facility charges, are medical expenses under 38 CFR 3.278(d)(1). A single veteran paying about $99,645 a year for an Illinois nursing home out of pocket is carrying care costs far above that floor. In the regulation's own Example 1 (38 CFR 3.274(f)(3)), a claimant with $9,000 of annual income who pays $29,000 a year in unreimbursed nursing-home fees has annual income reduced to zero. For an eligible veteran with no countable income left, the payment is the full ceiling, $29,093 a year for a veteran with no dependents.

Which charges the VA will accept as medical expenses is set out at 38 CFR 3.278, which counts health, medical, hospitalization, and long-term care insurance premiums, including premiums for Medicare Parts A, B, and D. You report these expenses on VA Form 21P-8416 (Medical Expense Report), which covers medical expenses you paid and were not reimbursed for and don't expect to be.

Who Qualifies

To receive VA Aid and Attendance, a veteran must meet all of the following:

  1. Wartime service and discharge: the veteran must not have been discharged dishonorably. 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 recognized wartime period (such as World War II, the Korean conflict, the Vietnam War era, 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, with at least one day during wartime. An officer who started active duty after October 16, 1981 must not have previously served on active duty for at least 24 months, and also needs at least one day during wartime.
  2. Age or status: at least 65 years old, OR a permanent and total disability, OR a patient in a nursing home for long-term care because of a disability, OR getting Social Security Disability Insurance or Supplemental Security Income. Any one of the four satisfies this test: a wartime veteran under 65 who receives SSI, for example, meets it without a permanent and total disability, though the other three requirements still apply.
  3. Income and net worth within VA's limits: yearly family income within the limits Congress sets, and net worth at or below $163,699 (December 1, 2025 to November 30, 2026). VA's net-worth calculation combines the claimant's and their dependents' assets and annual income; it excludes the primary home, a vehicle, and basic household items.
  4. Need for aid and attendance: at least one of these is true: the veteran needs help with daily activities (bathing, dressing, feeding), has to stay in bed or spend a large portion of the day in bed because of illness, is a patient in a nursing home due to mental or physical incapacity, or has severely limited vision.

The VA also looks back at asset transfers made in the 36 months before it receives the pension claim. The window never reaches back before October 18, 2018. A transfer inside it draws a penalty period of up to 5 years only if the asset was part of net worth, was transferred for less than fair market value, and would otherwise have caused or partially caused net worth to exceed the limit.,

Surviving spouses of qualifying wartime veterans may be eligible for the Survivors Pension with Aid and Attendance, capped at up to $18,697 a year for a survivor with no dependents. Illinois veterans who are unsure whether their service qualifies can get free assistance from an accredited Illinois Department of Veterans' Affairs service officer before filing.

The $90/Month Nursing-Home Pension Cap

For anyone weighing both VA pension and Medicaid, this cap is a planning fact, not a footnote.

When a veteran with no spouse or child is receiving Medicaid-covered nursing facility care, federal law generally limits VA pension, including the Aid and Attendance amount, to no more than $90 per month for any period after the month of admission (38 U.S.C. 5503(d)(2)). The same cap applies to a surviving spouse with no child (38 U.S.C. 5503(d)(5)(A)). VA's own regulation, 38 CFR 3.551(i), dates the cap from the month after Medicaid payments begin rather than the month after admission, so a veteran admitted as a private payer before Medicaid started should confirm with VA which month the reduction runs from. The cap also does not reach a State veterans home for which VA pays a per diem for nursing home care (38 U.S.C. 5503(d)(1)(B)); there, for a veteran with no spouse or child, a separate federal Medicaid rule counts pension above $90 a month, including any Aid and Attendance amount, as income only for applying that excess to the home's cost of the veteran's care (42 U.S.C. 1396a(r)(1)(B)). Where the $90 cap does apply, the veteran keeps that $90 as personal funds, and by statute the Medicaid payment to the facility cannot be reduced by it, so it is not a contribution toward nursing home costs.,

What this means practically: if a veteran with no spouse or child enters a nursing home that Illinois Medicaid is already paying for, the VA pension does not continue at the full Aid and Attendance rate. Because of that, the order and timing of the VA and Medicaid applications matter, and are worth planning with a VA-accredited representative or an elder law attorney before the veteran enters a Medicaid-funded facility.

How Aid and Attendance Works with Illinois Medicaid

VA pension and Illinois Medicaid are run by different agencies under different applications and rules, and the order and timing of applying for each matter and depend on the state's Medicaid rules.

VA Aid and Attendance and Illinois Medicaid are separate programs that can interact for a veteran needing long-term care. Illinois Medicaid is administered by the Department of Healthcare and Family Services (HFS), and Medicaid eligibility is determined by the Illinois Department of Human Services (DHS). For nursing home residents, Illinois Medicaid uses a patient-liability (applied-income) model: what the resident owes the facility is worked out from their income after a set of deductions. Those deductions include a personal needs allowance (set at $60 per month for skilled nursing facility residents), maintenance allowances for a spouse or family at home, and medical premiums and other medical expenses Medicaid does not cover.

Under general federal rules, VA pension income is generally counted as income for Medicaid. 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. That exclusion comes from SSI income methodology, and Illinois is one of eight states (with Connecticut, Hawaii, Minnesota, Missouri, New Hampshire, North Dakota, and Virginia) that use Medicaid eligibility criteria more restrictive than SSI, so the Illinois rule governs whether the Aid and Attendance amount counts at the eligibility step. The exclusion is also about qualifying, not about what the resident owes. Because Illinois is a 209(b) state, the federal rule for what a nursing-facility resident owes is 42 CFR 435.733, which says "Income that was disregarded in determining eligibility must be considered in this process" and then deducts the personal needs allowance, any spouse or family allowance, and "Amounts for incurred expenses for medical or remedial care that are not subject to payment by a third party". Illinois's own manual takes the same step: IDHS Policy Manual PM 15-04-04 starts the post-eligibility budget from the income used to decide eligibility plus any exempt or disregarded income left out at that stage, subtracts the deductions above, then adds any non-exempt resources over the resource disregard to set the amount the resident owes the facility. So if VA is still paying Aid and Attendance at the full rate and that amount was exempt when Illinois decided eligibility, it comes back into the income budgeted toward the resident's bill, after those deductions. Neither IDHS page names Aid and Attendance specifically, so families should confirm how a particular award is budgeted with HFS, Illinois DHS, or an accredited Veteran Service Officer before relying on it.

The order of applications matters. A veteran with no spouse or child who counts a full Aid and Attendance pension into a Medicaid-covered nursing home budget will not receive it, because once the cap applies VA pays at most $90 a month; a veteran who has a spouse or a child is outside the cap. In Illinois, that retained $90 takes the place of the $60 personal needs allowance rather than adding to it: once the veteran or surviving spouse shows proof that VA has cut the benefit to $90, IDHS deducts a $90 veteran benefit disregard, starting with the first calendar month the VA checks are reduced, and does not also deduct the $60. Because the right sequence depends on the state's Medicaid rules, an accredited Veteran Service Officer or elder law attorney is worth consulting before applying.

How to Apply and Get Free Help

The steps below are the pension route, the one VA's own eligibility condition points to: you may be eligible for this benefit if you get a VA pension. A veteran who receives VA disability compensation rather than pension is on a different track, because VA Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation. To apply for Aid and Attendance through the pension, you will need:

  • VA Form 21-0966 (Intent to File), if you are still gathering information. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.
  • 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 documenting the need for assistance. This is also the form VA uses for Aid and Attendance added to monthly compensation.
  • VA Form 21P-527EZ (Application for Veterans Pension), if a wartime veteran pursuing the pension route is not already receiving VA pension.
  • VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance), which a nursing home claim also needs; a nursing home official uses it to verify that the veteran is a patient in a qualifying extended care facility.

You can apply 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 help you file the claim.

Free help in Illinois: The Illinois Department of Veterans' Affairs (IDVA) runs full-time and part-time offices across the state staffed by Veteran Service Officers whom IDVA describes as trained and accredited by the U.S. Department of Veterans Affairs to 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. VA describes Aid and Attendance as a monthly payment added to the amount of a monthly VA pension, so an A&A claim sits inside that pension category. Use IDVA's online VSO locator at veterans.illinois.gov to find the nearest service office. Not every office offers every service, so call the nearest one first, and if your county isn't listed, contact IDVA's main office.

If the VA denies a claim or decides it for less than expected, you can ask for a review. After an initial decision you have three review options: a Supplemental Claim, which files new and relevant evidence the VA did not have before; a Higher-Level Review, in which a higher-level reviewer looks at the case with no new evidence; and a Board Appeal to a Veterans Law Judge at the Board of Veterans' Appeals. You elect one of the three rather than filing several: under 38 CFR 3.2500(b), only one of those reviews may be pending on the same claim or issue at a time, so a second cannot be filed while the first is pending final adjudication. That menu is tied to the decision in front of you, not permanent: after a Higher-Level Review decision the choices are a Supplemental Claim or a Board Appeal (there is no second Higher-Level Review), and after a Board decision, a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, which has to be filed within 120 days of the date on the Board's decision letter. That one has two filing rules worth knowing. It is filed with the Court, not with the VA. And a notice of appeal that is properly addressed to the Court and mailed is deemed received on the date of the U.S. Postal Service postmark, provided that postmark is legible, so mailing inside the 120 days is enough even if delivery runs past it. The one-year deadline runs from the date on the letter for the decision being reviewed: a Higher-Level Review must be requested within one year of a decision on an initial claim or Supplemental Claim, and a Board Appeal within one year of a decision on an initial claim, Supplemental Claim, or Higher-Level Review. One exception is a simultaneously contested claim, where several people claim a benefit only one of them can receive: there the only route is a Board Appeal, filed within 60 days of the date VA issues notice of the decision. A Supplemental Claim can otherwise be submitted at any time after VA issues notice of a decision, but timing carries a cost: a Supplemental Claim the VA receives more than one year after the date on the decision notice takes an effective date no earlier than the date the VA receives it, and continuous pursuit of the claim is broken unless the VA grants an extension of the one-year period for good cause (38 CFR 3.109(b)). In plain terms, the door stays open, but filing after the one-year mark can cost back pay reaching to the original claim date. An accredited attorney, claims agent, or Veterans Service Organization representative can help you file, with the VA's search tool to find one.

Never pay anyone a fee to file an initial VA claim. Under 38 U.S.C. 5904(c)(1), accredited attorneys and claims agents may not charge for work done before VA issues notice of its initial decision, and VA-recognized Veterans Service Organization representatives help with claims free of charge.

Frequently Asked Questions

Does living in a nursing home automatically qualify a veteran for Aid and Attendance?

Being a patient in a nursing home due to mental or physical incapacity meets the Aid and Attendance need criterion, but a veteran must also meet the wartime service, discharge, income, and net worth requirements. Nursing home residence for long-term care because of a disability also satisfies VA's age-or-status test, which a veteran can otherwise meet by being 65 or older, having a permanent and total disability, or getting SSDI or SSI. Meeting one criterion does not guarantee approval, so it is worth having a service officer confirm all four before filing.

Can a surviving spouse use Aid and Attendance to help pay for a nursing home?

A surviving spouse of a qualifying wartime veteran may be eligible for the Survivors Pension with Aid and Attendance, whose 2026 maximum for a survivor with no dependents is $18,697 a year. That maximum is a ceiling rather than a payment, because the VA pays the difference between the survivor's income for VA purposes and the limit. The deceased veteran must have met the wartime service rules and not been dishonorably discharged, the survivor must not have remarried after the veteran's death, and the same $163,699 net worth limit applies.

What happens to Aid and Attendance if the veteran goes on Illinois Medicaid?

If a single veteran with no dependents enters a Medicaid-covered nursing facility, federal law generally reduces VA pension (including Aid and Attendance) to $90 a month. That is why the order and timing of the two applications matter, and why an accredited VSO or elder law attorney is worth consulting before either one goes in.

How long does a VA Aid and Attendance claim take?

The VA's own answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing. VA tells veterans to gather their information before filling out the application. For a Veterans Pension claim, VA asks you to submit, or give it permission to gather, your DD214 or other separation documents, your service treatment records, and medical evidence related to the illness or injury.

Compare Care Settings in Illinois

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

Learn More

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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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