VA Aid and Attendance for Nursing Home Care in Indiana

An Indiana veteran who needs nursing home care can use VA Aid and Attendance to put up to $2,424 a month toward the bill, and a surviving spouse may receive up to $1,558 a month.1 That can reduce a Hoosier family's out-of-pocket cost by tens of thousands of dollars a year.

In This Guide

• How much a nursing home costs in Indiana
• 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 Indiana Medicaid
• How to apply and get free help
• Frequently asked questions

How Much a Nursing Home Costs in Indiana

Per the CareScout 2025 Cost of Care Survey (the successor to the Genworth survey and the most recent state-level data, released March 2026), Indiana ranks among the least expensive states for senior living and care, with median nursing home costs at or below the national medians of about $114,975 a year (roughly $9,581 a month) for a semi-private room and $129,575 a year for a private room.2

These are industry-survey medians, not government figures; costs vary within the state, with the Indianapolis metro and northern markets generally running higher than rural areas.2

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 a nursing home near the national median of about $9,581 a month, Aid and Attendance at the single-veteran rate of $2,424 covers roughly a quarter 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 actually help a veteran qualify.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 roughly $114,975 a year for a nursing home near the national median,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 wipes out countable income entirely, making them eligible for the full Aid and Attendance rate of $2,424/month.1

Nursing home fees (including meals and lodging charged by the facility) 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. During that penalty period, which depends on the amount transferred and can last up to five years, the VA will not pay pension benefits.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

The $90/Month Nursing-Home Pension Cap

Sorting out VA pension and Medicaid at the same time is genuinely confusing, and this is the rule that trips up the most families, so it is worth understanding before either application goes in.

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 Indiana 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 avoid losing benefits.

How Aid and Attendance Works with Indiana Medicaid

VA Aid and Attendance and Indiana Medicaid are separate programs run by different agencies under different rules, and a veteran can sometimes qualify for both. For VA pension purposes, the VA calculates countable income after subtracting qualifying unreimbursed medical and care expenses, which is why many veterans who pay for nursing home care qualify.4

Indiana Medicaid covers long-term care for low-income aged, blind, and disabled (ABD) Hoosiers through institutional (nursing facility) coverage and home- and community-based pathways, including, as of July 1, 2024, the Indiana PathWays for Aging program for members age 60 and older, administered by the Family and Social Services Administration's Office of Medicaid Policy and Planning (OMPP). Under general federal rules, VA pension (including the Aid and Attendance increase) is generally counted as income for Medicaid, and large out-of-pocket nursing home costs can reduce the income that counts for the VA benefit.4

Because how a VA pension is treated for Indiana Medicaid eligibility depends on the specific Medicaid pathway and a household's circumstances, families should confirm their situation with a County Veterans Service Officer and the Indiana Medicaid eligibility office before relying on any single rule.4

How to Apply and Get Free Help

To apply for Aid and Attendance, you will need:7

• 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.7

Free help in Indiana: The Indiana Department of Veterans Affairs (IDVA) and its network of certified County Veterans Service Officers (CVSOs) provide free, accredited help filing VA pension and Aid and Attendance claims. CVSOs complete federal and state benefit applications on behalf of veterans, dependents, and survivors at no cost.8 Visit in.gov/veterans to locate your county service officer. To find an accredited attorney or claims agent, you can also search VA's accreditation database at va.gov/ogc/apps/accreditation.

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

Compare Care Settings in Indiana

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 Indiana
• How Aid and Attendance Pays for In-Home Care in Indiana
• How Aid and Attendance Pays for Memory Care in Indiana

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.