VA Aid and Attendance for Nursing Home Care in Illinois

A wartime veteran in Illinois who qualifies for VA Aid and Attendance has a 2026 pension ceiling of up to $29,093 a year, about $2,424 a month.1 For a surviving spouse the ceiling is up to $18,697 a year, about $1,558 a month.1 Those are maximums rather than payments, because the VA pays the difference between a claimant's income for VA purposes and the limit.1 At the top of that range, the benefit cuts a family's out-of-pocket nursing home cost by tens of thousands of dollars a year.

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 (the most recent state-level data, released 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 somewhat below the national medians of about $114,975 for a semi-private room and $129,575 for a private room.2

These are industry-survey medians; costs vary within the state, with the Chicago metro generally running higher than downstate Illinois.

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.5 It is not a separate program; it is a higher pension rate.

VA publishes these rates as annual maximums, so a monthly amount is the yearly award divided by 12. For 2026 the ceilings are:1

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.1 The one monthly figure VA states outright is the penalty period rate of $2,874, which 38 CFR 3.276(e)(1) defines as the veteran-with-one-dependent Aid and Attendance rate divided by 12 and rounded down.1

Against an Illinois nursing home running about $8,304 a month, the single-veteran ceiling of $29,093 a year, about $2,424 a month, covers at most roughly 29 percent of the cost, a meaningful offset that keeps some families from spending down their savings as quickly.2

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 eligibility is keyed to income for VA purposes, large recurring care expenses can help a veteran qualify even when their income appears too high at first glance.1

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.1 The VA's own example puts that floor at $872 a year for a veteran with no spouse or child, and it rises for a veteran with dependents.1

Example: a single veteran paying about $99,645 a year for an Illinois nursing home out of pocket2 is carrying care costs many times that floor, so deductible expenses can pull the income the VA counts far down and open the door to the full Aid and Attendance ceiling of $29,093 a year, about $2,424 a month.1

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.1 Rather than assume which lines on a nursing home invoice count, have an accredited Veteran Service Officer go through the bills with you.

Who Qualifies

To receive VA Aid and Attendance, a veteran must meet all of the following:5

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 (World War II, Korea, Vietnam, Gulf War/post-9/11). 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.
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 those four satisfies this test, and the last two stand on their own: a wartime veteran under 65 who receives SSI qualifies without any adjudicated permanent-and-total rating.
3. Net worth under $163,699 (for 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.5
4. Need for aid and attendance: requires 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 applies a 36-month look-back on asset transfers for less than fair market value. Transfers made on or after October 18, 2018 that fall within this window can trigger a penalty period.5

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, about $1,558 a month.1 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.4

The $90/Month Nursing-Home Pension Cap

This is one of the most important planning facts for families weighing both VA pension and Medicaid.

When a single veteran with no spouse or dependent children 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)).3 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.3

What this means practically: if a veteran enters a nursing home that Illinois Medicaid is already paying for, the VA pension does not continue at the full Aid and Attendance rate. Families who plan to use Aid and Attendance to help pay for a nursing home before Medicaid coverage begins, or who will pay privately for part of the stay, should coordinate both applications carefully before the veteran enters a Medicaid-funded facility.6

An accredited VA representative or elder law attorney can help families map out the timing to preserve benefits.

How Aid and Attendance Works with Illinois Medicaid

The hardest part for most families is timing: VA pension and Illinois Medicaid are run by different agencies on different clocks, and the order you apply in can change how much of the VA benefit the family actually keeps.6

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: 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.4

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.6 The exclusion is also about qualifying, not about what the resident owes. The federal share-of-cost rule, 42 CFR 435.725, is written for institutionalized individuals in SSI states: where it applies, income that was disregarded in determining eligibility becomes part of the income from which the required deductions are made, and it can raise the amount the resident owes the facility. That rule does not settle the question in Illinois. As a 209(b) state, and separately for home and community based waiver services, Illinois sets its own post-eligibility rules, so check the Illinois rule rather than assuming the federal result. Where 42 CFR 435.725 does govern, the deduction is not open-ended either: the agency deducts "Amounts for incurred expenses for medical or remedial care that are not subject to payment by a third party", and the category covering care recognized under State law but not covered by the state plan is "subject to reasonable limits the agency may establish". Because this treatment depends on the specific situation, families should confirm with HFS, Illinois DHS, or an accredited Veteran Service Officer before relying on it.4

The order of applications matters. Some families apply for Aid and Attendance first to help cover private-pay nursing home costs, then move to Medicaid once assets are spent down, knowing the VA pension will drop to $90 a month once Medicaid begins paying. Others need Medicaid immediately and accept the $90 cap from the start. Whether that retained $90 comes in addition to Illinois's personal needs allowance or in place of it is governed by Illinois's own post-eligibility rules, so confirm it with HFS or a Veteran Service Officer rather than assuming the two amounts add together.3 There is no single right sequence; it depends on the veteran's income, assets, and how soon Medicaid coverage is needed. An accredited Veteran Service Officer or elder law attorney can map the timing to preserve the most benefit.6

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:7

• 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. This is the wartime, means-tested pension application, so a veteran seeking Aid and Attendance on top of VA disability compensation is not the person who files it.
• VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance), which a nursing home claim will also need to have filled out.

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.7

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.4 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.4 Use IDVA's online VSO locator at veterans.illinois.gov to find the nearest service office.4

If the VA denies a claim, the decision is not final. 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.8 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.8 For most VA benefits, a Higher-Level Review or a Board Appeal has to be elected within one year of the date the agency of original jurisdiction issues notice of its decision, though certain VA benefits carry time limits shorter than a year and the decision letter names the deadline that applies. A Supplemental Claim can be submitted at any time after that notice, though the VA recommends filing within one year to keep your effective date: 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 (38 CFR 3.2500(h)(2)), 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.8 An accredited attorney, claims agent, or Veterans Service Organization representative can help you file, with the VA's search tool to find one.8

Never pay someone to file an initial VA claim. Accredited representatives are prohibited from charging fees for this service.

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 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.