VA Aid and Attendance for Nursing Home Care in Illinois

A wartime veteran in Illinois who qualifies for VA Aid and Attendance can put up to $2,424 a month toward a nursing home bill in 2026, and a surviving spouse up to $1,558 a month.1 That can cut a family's out-of-pocket 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 added to a qualifying veteran's or survivor's basic 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.

For 2026, the maximum monthly rates are:1

Against an Illinois nursing home running about $8,304 a month, Aid and Attendance at the single-veteran rate covers 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. The VA pays the difference between a veteran's countable income and the applicable Maximum Annual Pension Rate (MAPR). Because the benefit is keyed to countable income, 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 MAPR is deductible from countable income. For 2026, those annual floors are:1

• $872 a year for a veteran with no dependents (5% of the $17,441 MAPR)1
• $1,141 a year for a veteran with one dependent (5% of the $22,839 MAPR)1

Example: because a single veteran pays about $99,645 a year for an Illinois nursing home out of pocket,2 nearly the entire bill (everything above the $872 floor) counts as a deductible unreimbursed medical expense.1 For most veterans in that situation, that drives countable income far below the MAPR threshold, making them eligible for the full Aid and Attendance rate of $2,424/month.1

Nursing home fees (including meals and lodging) qualify as UMEs under 38 CFR 3.278, as do health insurance premiums and other out-of-pocket medical costs.

Who Qualifies

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

1. Wartime service: 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).
2. Age or disability: age 65 or older, OR permanently and totally disabled.
3. Net worth under $163,699 (for 2026): this limit combines assets and annual income; it excludes the primary home, vehicles, and basic household items.5
4. Need for aid and attendance: requires help with daily activities (bathing, dressing, feeding), is bedridden, 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 at up to $1,558/month.1 Illinois veterans who are unsure whether their service qualifies can have an accredited Illinois Department of Veterans' Affairs service officer verify their wartime dates and net worth for free before filing.6

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.7

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.7

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 applied to the cost of care. 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 treat the $90 pension as a small personal-needs supplement. 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.7

How to Apply and Get Free Help

To apply for Aid and Attendance, you will need:8

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), completed by a physician documenting the need for assistance.
• VA Form 21P-527EZ (Application for Veterans Pension), if the veteran is not already receiving VA pension.

Forms can be submitted online at va.gov, mailed to the VA, or filed through an accredited representative. Processing often takes three to six months.8

Free help in Illinois: The Illinois Department of Veterans' Affairs (IDVA) provides free VA-accredited Veteran Service Officers across the state who help veterans find and apply for federal benefits including VA pension and the Aid and Attendance enhancement. Many Illinois counties additionally operate Veterans Assistance Commissions (VACs) that also offer free claims help.6 Visit veterans.illinois.gov to locate the nearest service office, or contact IDVA directly to be connected with a service officer.

If the VA denies a claim, the decision is not final. Within one year of the decision letter, an accredited service officer can file a Supplemental Claim with new evidence or request a Higher-Level Review of the original decision, at no cost.9

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.