VA Aid and Attendance for In-Home Care in Maine

VA Aid and Attendance can help pay for in-home care in Maine, turning a monthly VA pension into real money toward an aide, a homemaker, or a family caregiver. If your loved one is a wartime veteran who needs help with daily activities, this benefit can cover a meaningful share of the cost of staying at home. The hard part is usually knowing it exists and how to claim it.

This guide walks through what in-home care costs in Maine, how much Aid and Attendance pays, how your care costs can actually help you qualify, and where to get free help applying.

In This Guide

• Key Takeaways
• How Much In-Home Care Costs in Maine
• How VA Aid and Attendance Helps Pay for In-Home Care in Maine
• How In-Home Care Costs Lower Your Countable Income for Aid and Attendance in Maine
• Who Qualifies
• Using Aid and Attendance to Pay a Family Caregiver
• How Aid and Attendance Works with Maine Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much In-Home Care Costs in Maine

Staying at home is not the cheap option in Maine. In-home care from a non-medical caregiver runs about $101,816 a year, roughly $8,485 a month, at about $45 an hour on a 44-hour week. That is the fourth-highest rate of any state and well above the national median of about $80,080.2 Moving does not obviously fix it: assisted living in Maine runs about $98,460 a year and a semi-private nursing home room about $167,718, both well above their national medians.2 In its 2025 survey, CareScout combined homemaker and home-health-aide pricing into a single non-medical caregiver category.2 These are CareScout 2025 industry-survey medians, not government figures; they are approximate, and costs vary across the state and rise as care needs grow.2

For many Maine families, that is well beyond what a fixed retirement income can absorb on its own. This is where Aid and Attendance comes in.

How VA Aid and Attendance Helps Pay for In-Home Care in Maine

Aid and Attendance is an increased monthly VA pension for wartime veterans and surviving spouses who need help with everyday activities.4 The VA adds it to the veteran's monthly pension payment, so it reaches the household as money the family can put toward a home health aide, a homemaker, or a caregiver.3

The VA sets these as maximum annual pension rates for December 1, 2025 through November 30, 2026 ($29,093 for a veteran alone, $34,488 for a veteran with a spouse, and $18,697 for a surviving spouse), and a monthly payment is that yearly award divided by 12.1

Read those figures as ceilings. The VA bases the payment on the difference between your income for VA purposes and the applicable maximum annual pension rate, so a household with other countable income receives less than the table shows.1 Even so, against a Maine in-home care bill of about $8,485 a month, $2,424 covers a meaningful share.2,1

How In-Home Care Costs Lower Your Countable Income for Aid and Attendance in Maine

VA Pension, including the Aid and Attendance increase, is needs-based: to be eligible, your yearly family income and net worth have to meet limits set by Congress.1 The deduction rules below are measured against a yearly figure called the Maximum Annual Pension Rate (MAPR), and the lower the income the VA counts, the better your position.

Here is the part families miss: continuing medical expenses, including in-home care, lower the income the VA counts. The expense has to be unreimbursed to be deductible at all, and you can only deduct the portion that exceeds 5% of your applicable MAPR, figured on the rate that includes any increase for family members but excludes the increase for aid and attendance or being housebound. For 2026 that floor is $872 a year for a veteran with no spouse or child, and it is higher for a veteran with dependents.1

In-home care carries its own conditions, and they are worth getting right before you file. Payments for help with activities of daily living and instrumental activities of daily living by an in-home attendant are medical expenses as long as the attendant provides the person with health care or custodial care, and the payments must be commensurate with the number of hours the provider actually attends to them.1 The attendant must be a health care provider, unless the person needs aid and attendance or is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that, because of a physical, mental, developmental, or cognitive disorder, the person requires the health care or custodial care that the in-home attendant provides.1 So a family hiring an unlicensed aide should expect to show either that the person needs aid and attendance or is housebound, or that written clinician statement.

Think of it in annual terms. If a veteran with no dependents pays for in-home care that meets those conditions, only the first $872 of that yearly cost is not deductible; everything above that floor reduces countable income.1 With in-home care running about $101,816 a year in Maine, that deduction can be large enough that someone whose income looked too high ends up qualifying.2 Keep the caregiver's hours and invoices, and the clinician's written statement if you need one, so the deduction is documented from the start.

Who Qualifies

To be eligible for Aid and Attendance, the veteran must:4

• Not have received a dishonorable discharge4
• Meet the wartime service test for when their service began. The VA lists three paths, and meeting one is enough. Active duty that started before September 8, 1980: at least 90 days of active duty with at least one day during a wartime period. Enlisted service that started after September 7, 1980: at least 24 months (with some exceptions), or the full period for which they were called or ordered to active duty, again with at least one day during wartime. Officer service that started after October 16, 1981: the veteran had not previously served on active duty for at least 24 months.4,1
• Meet at least one of four conditions: be 65 or older, have a permanent and total disability, be a patient in a nursing home for long-term care because of a disability, or be getting Social Security Disability Insurance or Supplemental Security Income. Any one of the four satisfies this test on its own, so a wartime veteran under 65 who receives SSI qualifies without a permanent and total disability rating.4
• Have a need for aid and attendance. The criteria include an inability to dress or undress or to keep oneself ordinarily clean and presentable, a frequent need to adjust special prosthetic or orthopedic appliances, an inability to feed oneself, an inability to attend to the wants of nature, or a physical or mental incapacity requiring care or assistance on a regular basis to protect against hazards of daily life. Being bedridden qualifies, as does being a patient in a nursing home because of a loss of mental or physical abilities related to a disability, or eyesight limited to 5/200 or less in both eyes or a visual field contracted to 5 degrees or less.4
• Have a net worth below $163,699 for 20264 The calculation includes the claimant's and dependents' assets and income for VA purposes, and assets exclude the primary residence, the car, and basic home items like appliances.1

The VA also reviews assets transferred for less than fair market value in the 3 years before the claim, and a transfer inside that window can trigger a penalty period of up to 5 years.4 Surviving spouses of wartime veterans can qualify under the Survivors Pension, with a 2026 Aid and Attendance rate of $18,697 a year and the same $163,699 net worth limit.1

Using Aid and Attendance to Pay a Family Caregiver

Many families want a son, daughter, or other relative to provide the care. Because Aid and Attendance is paid as part of the veteran's monthly pension payment, the household can put that money toward a caregiver.3 A spouse is the exception worth knowing about: the VA Pension and Aid and Attendance benefit carries a prohibition on paying a spouse to provide the care, which the separate Veteran-Directed Care program below does not.5

There is also a separate VA program built for this. Veteran-Directed Care gives a veteran a flexible budget to hire their own caregivers, including family members, with help from an Aging and Disability Network agency and a financial management service that handles payroll.5 Unlike some Medicaid programs, Veteran-Directed Care has no blanket ban on hiring a spouse.5 Ask your VA medical center's social work team whether it is available in your area.

How Aid and Attendance Works with Maine Medicaid

A veteran or surviving spouse in Maine can potentially receive both the VA Aid and Attendance enhanced pension and MaineCare, Maine's Medicaid program administered by the Maine Department of Health and Human Services, but the two programs interact and can offset each other.6 Under general federal rules, VA pension is treated as income for Medicaid purposes, except that the portion attributable to Aid and Attendance, money paid specifically because the veteran needs help with daily activities and has unreimbursed medical expenses, is generally not counted as income when determining MaineCare long-term care eligibility. That exclusion applies at the eligibility step only: once a person is eligible and living in a nursing facility or other medical institution, income disregarded in determining eligibility must be counted in the post-eligibility share-of-cost calculation (42 CFR 435.725), so the Aid and Attendance amount does count at that stage. Before any of it reaches the facility, 42 CFR 435.725(c) requires MaineCare to deduct five amounts from the resident's income, in the order the regulation sets them out: (1) a personal needs allowance the resident keeps for clothing and other personal needs; (2) for a resident with only a spouse at home, an amount for that spouse's maintenance needs; (3) for a resident with a family at home, an amount for the family's maintenance needs; (4) incurred expenses for medical or remedial care that no third party will pay; and (5) any SSI and state supplementary payments the resident keeps receiving. All five are deductions the state has to make, not benefits a family applies for. That section covers people in medical institutions and intermediate care facilities, so it does not set this calculation for someone receiving home and community-based waiver services, whose share of cost is governed by separate rules.6

Because the programs are income- and asset-tested and the rules are complex, applicants should confirm how their specific benefits interact with MaineCare through the Maine DHHS Office for Family Independence or a Maine Bureau of Veterans' Services officer before relying on both.6

How to Apply and Get Free Help

Apply using 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 to document the care need.3 That form covers Aid and Attendance whether the increase will be added to monthly pension benefits or to monthly compensation.3 The steps here are the pension route, the one that applies if the veteran gets a VA pension: a wartime veteran pursuing that route who is not already receiving a VA pension files VA Form 21P-527EZ (Application for Veterans Pension), the wartime, means-tested pension application, alongside the 21-2680.3 If you are still gathering information, you can file VA Form 21-0966 (Intent to File) first, because submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.3 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 representative can file for you. As for how long a decision takes, the VA's own answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.3

Do not do this alone. The Maine Bureau of Veterans' Services employs Veteran Service Officers who help Maine veterans and their families apply for VA pension and the Aid and Attendance enhanced pension at no cost, submitting hundreds of claims each month and winning millions of dollars in awards for veterans and their families.7 You can reach the Bureau's central office at 207-287-7020 or find a field or itinerant Veterans' Services Office to get started.7 Their help is free.7

What to Do If Your Claim Is Denied

A denial is not the end of the road. If the VA denies your Aid and Attendance claim or awards less than expected, that initial decision opens three decision review options: a Supplemental Claim (file new and relevant evidence), a Higher-Level Review (a higher-level reviewer looks at the case, with no new evidence), or a Board Appeal to the Board of Veterans' Appeals. For most VA benefits, a Higher-Level Review or a Board Appeal must be elected within one year of the date on the decision letter; certain benefits have shorter limits, so check the deadline printed on your own letter.8 A Supplemental Claim can still be filed after that year, but there is a cost to waiting: 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 practice that can cost back pay all the way to your original claim date, so file inside the year even though the door stays open.8 A Maine Bureau of Veterans' Services officer can help you file a Supplemental Claim or appeal at no cost, just as with the original claim.7

Compare Care Settings in Maine

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 Maine
• How Aid and Attendance Pays for a Nursing Home in Maine
• How Aid and Attendance Pays for Memory Care in Maine

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.