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), a semi-private nursing home room in Indiana runs about $8,942 a month, roughly $107,310 a year, and a private room about $10,326 a month, roughly $123,918 a year.2 That ranks Indiana 38th and 33rd among the states, below national medians of about $9,581 a month ($114,975 a year) for a semi-private room and $129,575 a year for a private room. Indiana is mid-to-cheap on nursing home care rather than at the bottom of the range.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 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.

For 2026, the VA sets these ceilings as Maximum Annual Pension Rates, so the monthly figure is the yearly rate divided by 12:1

Read those figures as ceilings rather than payments. A Maximum Annual Pension Rate is the maximum amount of pension payable, and the VA pays the difference between your income for VA purposes and that limit, so a household with countable income is awarded less than the table shows.1

Against Indiana's median semi-private room of about $8,942 a month, Aid and Attendance at the single-veteran rate of $2,424 covers about 27 percent of the cost, a meaningful offset that keeps some families from spending down their savings as quickly.2 Read that 27 percent as the top of the range: income the VA counts is the same income that reduces the award, so a household with other income is awarded less than $2,424 and covers a correspondingly smaller share of the bill.1 It does not have to cover the whole bill to be worth claiming, and the next section explains why a nursing home bill usually pushes that award toward the top of the range.

How Nursing Home Costs Lower Your Countable Income

VA pension, including its Aid and Attendance increase, is a needs-based benefit: to be eligible, a veteran's yearly family income and net worth must fall under limits set by Congress. Because eligibility is keyed to income for VA purposes, 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, and that floor rises with dependents but never with the Aid and Attendance or housebound increase.1 For 2026, the VA puts the floor at $872 a year for a veteran with no spouse or child.1

Example: a single veteran paying Indiana's median of roughly $107,310 a year for a semi-private nursing home room2 can deduct nearly the entire bill, about $106,438, since everything above the $872 floor counts as an unreimbursed medical expense.1 For most veterans in that situation, the deduction brings the income VA counts far below the limit, which is what opens the door to the benefit.3

Nursing home fees a veteran actually pays out of pocket count as UMEs that reduce the income VA counts,3 as do payments for health, medical, hospitalization, and long-term care insurance premiums, including premiums for Medicare Parts A, B, and D (38 CFR 3.278).1

Who Qualifies

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

1. Discharge and wartime service: the veteran's discharge must not be dishonorable. 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. That same 24-month rule covers an officer who started active duty after October 16, 1981 and had not previously served on active duty for at least 24 months.
2. Age or status: at least one of four conditions, any one of which satisfies the test on its own: the veteran is at least 65 years old; has a permanent and total disability; is a patient in a nursing home for long-term care because of a disability; or is getting Social Security Disability Insurance or Supplemental Security Income. A permanent and total rating is not the only route, so a wartime veteran under 65 who receives SSI meets this requirement without one.
3. Net worth under $163,699 (for 2026): VA's net worth calculation combines the claimant's and their dependents' assets and annual income, not assets alone, and the primary home and a vehicle are excluded.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)).4 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.4

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.3

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). At the eligibility step, Indiana applies SSI income methodologies for aged, blind, and disabled applicants (42 CFR 435.601), because Indiana is not one of the eight states that elected the more restrictive 209(b) option. Under SSI methodology, VA aid and attendance and housebound allowances are not income, so only the basic pension counts toward the Medicaid income limit. Large out-of-pocket nursing home costs, meanwhile, can reduce the income that counts for the VA benefit.3 Eligibility is only the first step, though. Where 42 CFR 435.725 governs, which on its face is post-eligibility treatment of income for institutionalized individuals in SSI states and covers individuals in medical institutions and intermediate care facilities, income that was disregarded in determining eligibility is considered again in the post-eligibility share-of-cost calculation, and an Aid and Attendance amount not counted at the eligibility step can raise what the resident owes toward the cost of their care.6 The deductions from that income are not open-ended: 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."6 That federal rule does not settle post-eligibility for home- and community-based waiver services, so a family using a waiver should check Indiana's own rule rather than assume the same result.6

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.3

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), with the examination information section filled out by a medical examiner documenting the need for assistance.
• VA Form 21P-527EZ (Application for Veterans Pension), on the pension route: VA's condition for these application steps is "You may be eligible for this benefit if you get a VA pension," so a wartime veteran pursuing the pension who is not already receiving one files this form. Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation, so a veteran who receives VA disability compensation rather than pension does not use 21P-527EZ.7
• 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.7

If you are still gathering information, you can file VA Form 21-0966 (Intent to File) first: submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.7

You can apply 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. On how long a decision takes, VA's answer is "It depends," and it processes claims in the order it receives them unless a claim requires priority processing.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. These certified County Veteran Service Officers are there to assist with information and the preparation of paperwork at no cost.8 Visit in.gov/dva 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. An accredited Veterans Service Organization representative, including a County Veterans Service Officer, works your claim for free at every stage. An accredited attorney or claims agent may charge a fee, but only for work after VA issues an initial decision, never for preparing or filing the initial claim.

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.