VA Aid and Attendance raises the maximum VA pension for an eligible wartime veteran with no dependents to $29,093 a year, which can help pay for nursing home care in Maine. That is the ceiling on the whole pension, not an extra check on top of the basic rate of $17,441 a year. Maine nursing home costs rank among the highest in the country, 9th highest for a semi-private room. This guide explains what Aid and Attendance pays, who qualifies, how it interacts with MaineCare (Maine Medicaid), and how to apply for free through the Maine Bureau of Veterans' Services.

In This Guide

How Much a Nursing Home Costs in Maine

A semi-private nursing home room in Maine costs about $167,718 per year (roughly $13,976 per month), and a private room runs about $178,850 per year, both well above the national medians of approximately $114,975 and $129,575, according to the CareScout 2025 Cost of Care Survey. That puts Maine 9th highest in the country for a semi-private room and 10th for a private one. These are industry-survey medians, not government figures, and costs vary within the state and rise as care needs increase.

Room type Maine (annual) National median (annual)
Semi-private room $167,718 $114,975
Private room $178,850 $129,575

At these rates, a semi-private room in a Maine nursing home costs about $13,976 a month.

How VA Aid and Attendance Helps Pay for a Maine Nursing Home

Aid and Attendance is not a separate program. It is a higher VA pension rate, a Maximum Annual Pension Rate (MAPR), that applies to a veteran who gets a VA pension and needs another person's help with daily activities (such as bathing, feeding, and dressing) or who is a patient in a nursing home due to a loss of mental or physical abilities related to a disability.

For 2026 (rates effective December 1, 2025 through November 30, 2026), the maximum annual pension rates at the Aid and Attendance level are:

  • Veteran with no dependents: $29,093 per year, against a basic rate of $17,441 per year
  • Veteran with one dependent (such as a spouse): $34,488 per year, against a basic rate of $22,839 per year
  • Surviving spouse with no dependents: $18,697 per year, against a basic rate of $11,699 per year

Read those as ceilings on the total pension, not as the size of the Aid and Attendance increase. VA's rate tables state annual amounts, but pension is paid monthly: under 38 CFR 3.273, VA subtracts countable income from the annual rate and divides what remains by 12. A ceiling is not an award: the Maximum Annual Pension Rate is the maximum amount of pension payable, and VA pays the difference between a claimant's income for VA purposes and that limit, so a veteran with other income receives less than the figures above.

How Nursing Home Costs Lower Your Countable Income

VA pension, including Aid and Attendance, is needs-based. To be eligible, the veteran's yearly family income and net worth have to fall within limits set by Congress. Because the benefit is keyed to the income the VA counts, lowering that income is what can bring a veteran inside those limits.

The VA lets you subtract unreimbursed medical expenses from the income it counts, and out-of-pocket nursing home costs can count, but only the portion that exceeds 5% of your applicable MAPR. The expense has to be unreimbursed to be deductible (38 CFR 3.278(a) is explicit about that), so anything Medicare, MaineCare, or private insurance pays back does not count.

For 2026, that threshold is:

  • $872 per year for a veteran with no spouse or child
  • Higher for a veteran with dependents, because the floor is figured from a MAPR that includes the increase for family members but never the aid-and-attendance or housebound increase

Only the amount above that annual floor is deductible.

A nursing home bill is the simplest case in the whole rule. Under 38 CFR 3.278(d)(1), "Payments to hospitals, nursing homes, medical foster homes, and inpatient treatment centers (including inpatient treatment centers for drug or alcohol addiction), including the cost of meals and lodging charged by such facilities, are medical expenses." Room and board is in, and there is no separate certification step on this branch. The conditions in the other two branches of the same regulation do not carry over: 38 CFR 3.278(d)(2) governs an in-home attendant and has its own health-care-provider or clinician-certification test, and 38 CFR 3.278(d)(3) governs a care facility other than a nursing home, such as assisted living, where the clinician test is that the resident "needs to be in a protected environment" and meals and lodging pass through a separate gate. If your family member is in assisted living rather than a nursing home, those are the rules that apply, not this one.

Example (annual): A single veteran has $28,000 in annual income (Social Security and a small pension). His out-of-pocket nursing home costs run $120,000 per year. Subtracting the $872 floor leaves $119,128 deductible, far more than the $28,000 in income. The income the VA counts comes to $0, so if he meets every other requirement below, his pension could reach the full Aid and Attendance ceiling of $29,093 a year at the 2026 veteran rate.

Who Qualifies

To qualify for VA pension with Aid and Attendance, a veteran must meet all of the following:

Wartime service. The service requirement turns on when the veteran entered active duty, not on which war. 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 wartime period (VA recognizes the Mexican Border period, World War I, World War II, the Korean conflict, the Vietnam War era, and the Gulf War, which runs through a future date to be set by law or presidential proclamation). A veteran who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months of active duty, or the full period for which they were called or ordered to active duty, again with at least one day during wartime. A third branch covers an officer who started on active duty after October 16, 1981 and had not previously served on active duty for at least 24 months, also with at least one day during wartime.

No dishonorable discharge, and one of four age or disability tests. The veteran must not have received a dishonorable discharge, and must satisfy at least one of these four, any one of which is enough on its own: at least 65 years old; a permanent and total disability; a patient in a nursing home for long-term care because of a disability; or getting Social Security Disability Insurance or Supplemental Security Income. The nursing-home and SSDI/SSI branches stand alone, so a wartime veteran under 65 who receives SSI qualifies here without any adjudicated permanent-and-total rating.

Net worth under $163,699. The calculation takes in the claimant's and dependents' assets and income for VA purposes, and assets exclude the primary residence, the car, and basic home items. A 3-year look-back applies to asset transfers for less than fair market value, and it never reaches back before October 18, 2018. The look-back covers the 36 months before VA receives the pension claim. If, in that window, a claimant transfers for less than fair market value an asset that was part of their net worth and that, had it not been transferred, would have caused or partially caused net worth to exceed the limit, VA assesses a penalty period of up to 5 years.

Need for aid and attendance. VA says at least one of these must be true: needing another person to help with daily activities like bathing, feeding, and dressing; having to stay in bed, or spend a large portion of the day in bed, because of illness; being a patient in a nursing home due to the loss of mental or physical abilities related to a disability; or limited eyesight (even with glasses or contact lenses, 5/200 or less in both eyes, or concentric contraction of the visual field to 5 degrees or less). Separately, under 38 CFR 3.352(a) VA considers factors including inability to dress or undress or keep clean and presentable, frequent need to have a special prosthetic or orthopedic appliance adjusted, inability to feed oneself, inability to attend to the wants of nature, and a physical or mental incapacity requiring regular care or assistance to stay safe from the hazards of daily life; being bedridden is also a proper basis. Not every factor has to be found, and the need has to be regular, not constant.

VA publishes a separate rate table for the Survivors Pension, with an Aid and Attendance rate of $18,697 a year for a surviving spouse with no dependents.

The $90/Month Nursing-Home Pension Cap

A critical federal rule applies once MaineCare takes over the bill. When a veteran who has neither a spouse nor a child is covered by a Medicaid plan for services furnished by a nursing facility, no VA pension above $90 per month may be paid to or for that veteran for any period after the month of admission to the facility. That is 38 U.S.C. 5503(d)(2); 38 U.S.C. 5503(d)(5)(A) applies the same limit to a surviving spouse who has no child, and VA implements it at 38 CFR 3.551(i). The subsection expires January 31, 2033.,

The two texts start the cap in different months. The statute counts from the month after admission, while 38 CFR 3.551(i) counts from the month after Medicaid payments begin. If MaineCare approval came months after a private-pay admission, confirm with VA which date it applied to your award. A veteran is not liable to repay pension VA paid above the cap because VA was unable or failed to reduce it, unless the veteran willfully concealed the information VA needed.

The facility does not get to claw that $90 back. Under 38 U.S.C. 5503(d)(3), the payment a nursing facility receives under a Medicaid plan may not be reduced by any amount of pension the veteran is permitted to keep.

What the federal cap does not settle is how the $90 lines up with Maine's personal needs allowance. The personal needs allowance is a separate deduction applied under each state's post-eligibility treatment of income. For institutionalized individuals in SSI states, 42 CFR 435.725(c)(1) requires the agency to deduct "a personal needs allowance that is reasonable in amount for clothing and other personal needs of the individual while in the institution," which "must be at least" $30 a month for an aged, blind, or disabled individual. That is a federal floor, not the amount a given state sets. Whether the retained $90 comes in addition to a state's personal needs allowance or instead of it is governed by that state's own post-eligibility rules and varies; it does not stack everywhere. Rhode Island, for example, treats the $90 as the veteran's personal needs allowance and provides it instead of the state allowance, so a Rhode Island veteran in this situation has $90 protected in total. Do not assume the two add together in Maine. Maine's nursing-facility cost-of-care steps do carry one VA-specific amount: for individuals below the categorical income limit, the MaineCare Eligibility Manual subtracts $40.00 a month, or $130.00 for, among others, those receiving the reduced $90.00 VA pension who are not in a VA facility. Ask the Maine DHHS Office for Family Independence how the $90 is treated in your case before you budget around it.

The cap is tied to those conditions. It does not reach a veteran paying privately, or a veteran who has a spouse or a child.

It also does not reach a State veterans home for which VA makes per diem payments for nursing home care, because the statute leaves those homes out of its definition of "nursing facility." For that setting, federal Medicaid law (42 U.S.C. 1396a(r)(1)(B)) has its own rule: for a veteran with no spouse or child, or a surviving spouse with no child, pension above $90 a month, including any Aid and Attendance or unreimbursed-medical-expense payment, is counted as income only for applying that excess to the home's cost of nursing home care. Maine's own manual draws a similar line for a State Veteran's Nursing Home resident with no dependents. Whether a particular Maine State Veterans Home receives that VA per diem is something to check with an accredited Veteran Service Officer, not assume.

How VA Aid and Attendance Works with Maine Medicaid

VA pension with Aid and Attendance and MaineCare (Maine's Medicaid program, administered by the Maine Department of Health and Human Services) are separate programs with different income and asset rules. A senior may qualify for and receive both at the same time, but they interact.

Under general federal rules, VA pension is treated as income for Medicaid purposes, except that the portion attributable to Aid and Attendance (the increased amount VA pays because the veteran or survivor needs help with daily activities) is generally not counted as income when determining Medicaid long-term-care eligibility, because SSA states that VA aid and attendance and housebound allowances are not income for SSI purposes. Maine is not among the 8 states SSA identifies as using the more restrictive 209(b) option, so that SSI rule is the baseline here.

The step after eligibility, the cost-of-care calculation for someone already eligible and living in a facility, runs on a different federal rule. 42 CFR 435.725, which applies to "individuals in medical institutions and intermediate care facilities" in SSI states, says "Income that was disregarded in determining eligibility must be considered in this process," so an Aid and Attendance amount disregarded at eligibility does not automatically stay out of that calculation and can raise what the resident owes. A state's own post-eligibility rules can exempt the Aid and Attendance portion, though, so the state rule has to be checked.

Maine's rule is in the MaineCare Eligibility Manual (10-144 C.M.R. Chapter 332, Part 17, Section 3.4.59). It excludes as income the portion of a VA pension or compensation paid as Aid and Attendance, a Housebound Allowance, or for unusual medical expenses, and it names two exceptions, both about the cost of care. Benefits above $90.00 a month count toward the cost of care for a State Veteran's Nursing Home resident who is a veteran or surviving spouse with no dependents. And there is no exclusion when figuring the cost of care in a residential care facility, cost reimbursement boarding home, or adult family care home. Section 3.4.59 names no exception for an ordinary nursing facility, but the manual's nursing-facility cost-of-care steps do not say how an Aid and Attendance amount is treated, so a resident of an ordinary nursing facility should confirm with the Maine DHHS Office for Family Independence whether any of it counts toward their cost of care. For Home and Community Based Waiver participants the manual is direct: Aid and Attendance pensions and those based on unusual medical expenses are not used to determine the cost of care.

Whatever income does count toward a nursing-facility resident's cost of care is reduced by required deductions, and those 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." Because these 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.

How to Apply and Get Free Help

The steps below are the pension route, the one this guide is about: VA's condition for these benefits is "You may be eligible for this benefit if you get a VA pension." VA Form 21-2680 also covers Aid and Attendance "that will be added to your monthly compensation or pension benefits," so a veteran who draws VA disability compensation rather than pension still files that examination form, but not the pension application below.

On the pension route, you will need these VA forms:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance). A medical examiner must fill out the examination information section, documenting the need for assistance.
  • VA Form 21P-527EZ (Application for Veterans Pension). This is the wartime, means-tested pension application, filed by a wartime veteran pursuing the pension route who is not already receiving a VA pension.
  • VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance). A nursing-home claim will also need this form filled out.
  • VA Form 21-0966 (Intent to File), if you are still gathering information and want to start the clock first. VA says "Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive."

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 help you file the claim. Asked how long a decision takes, VA answers "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.

Free help in Maine: The Maine Bureau of Veterans' Services (MBVS) employs Veteran Service Officers at field and itinerant offices across the state who help veterans and families apply for VA pension and Aid and Attendance at no cost. The Bureau's central office can be reached at 207-287-7020. Visit maine.gov/veterans to find your nearest Veterans' Services Office.

Frequently Asked Questions

Does being in a Maine nursing home automatically qualify a veteran for Aid and Attendance?

Being a patient in a nursing home due to a loss of mental or physical abilities related to a disability is one qualifying condition. The veteran must still get a VA pension, which means meeting the wartime service, income, and net worth requirements, and must have no dishonorable discharge plus at least one of four tests: 65 or older, permanently and totally disabled, in a nursing home for long-term care because of a disability, or receiving SSDI or SSI. Placement alone does not create eligibility.

Can a Maine veteran receive both Aid and Attendance and MaineCare?

Sometimes. For a veteran who has neither a spouse nor a child and whose nursing facility services are covered by MaineCare, the federal statute bars any VA pension above $90 a month after the month of admission (VA's regulation counts from the month Medicaid payments begin, so confirm the date with VA). A State veterans home that receives VA per diem is outside that cap. Whether that $90 is on top of Maine's Medicaid personal needs allowance or in place of it depends on Maine's post-eligibility rules, so confirm with a Bureau VSO and Maine DHHS before applying.

Are Maine nursing home costs high enough to always exceed the 5%-of-MAPR deduction threshold?

At Maine's median nursing home costs (around $13,976 per month semi-private), a full year of out-of-pocket nursing home costs runs far above the annual unreimbursed-medical-expense threshold of $872 (veteran with no spouse or child), and only the amount above that floor is deductible.,

How long does Aid and Attendance take?

Asked how long a decision takes, VA answers "It depends." It works through claims in the order it receives them, unless a claim requires priority processing. A Maine Bureau of Veterans' Services officer can help you file the claim at no cost.

Compare Care Settings in Maine

Aid and Attendance can help pay for any care setting. See how it works for the others:

Learn More

VA BenefitsVA Aid and Attendance in MaineVA Aid and Attendance in Maine for 2026: who qualifies, the $34,488 yearly rate for a veteran with a spouse, how to apply, and free help from Maine VSOs. VA BenefitsVA Benefits for Senior Care in MaineA guide to VA senior care benefits in Maine: home care, nursing homes, Aid and Attendance, the six Maine Veterans' Homes, and how to access them in 2026. VA BenefitsState Veterans Homes in MaineMaine law keeps six veterans homes open. See who qualifies (including spouses and Gold Star parents), how a stay is paid for, and when VA pays in full. Care TypesNursing Homes in MaineNursing homes in Maine in 2026: a semi-private room runs about $167,718 a year, above the national median. What it costs, who pays, and how to vet a facility. VA BenefitsHow VA Aid and Attendance Pays for Assisted LivingHow VA Aid and Attendance helps pay for assisted living: the 2026 annual pension limits, the medical-expense rule, who qualifies, and how to apply. VA BenefitsVA Benefits for Senior Care: A Complete GuideA complete guide to VA benefits for senior care: long-term care, Aid and Attendance, pensions, DIC, and home grants for older veterans and surviving spouses.
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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.

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