VA Aid and Attendance for Nursing Home Care in Maine

VA Aid and Attendance raises an eligible wartime veteran's maximum VA pension to $29,093 a year (about $2,424 a month) to 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.1 Maine nursing home costs rank among the highest in the country, and most families paying those bills out of pocket have never heard of this benefit. 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

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

How Much a Nursing Home Costs in Maine

A semi-private nursing home room in Maine costs about $167,718 per year (roughly $13,977 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. Maine consistently ranks among the most expensive states for nursing home care in the country. These are industry-survey medians, not government figures, and costs vary within the state and rise as care needs increase.2

At these rates, a year in a Maine nursing home can cost more than $13,000 a month.2 VA pension at the Aid and Attendance rate, up to $2,424 a month, can take a meaningful bite out of that expense.1

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 needs help with daily activities (such as bathing, dressing, eating, or adjusting prosthetic devices) or who is a patient in a nursing home due to a loss of mental or physical abilities related to a disability.5

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

• Veteran with no dependents: $29,093 per year, about $2,424 per month, against a basic rate of $17,441 per year
• Veteran with one dependent (such as a spouse): $34,488 per year, about $2,874 per month, against a basic rate of $22,839 per year
• Surviving spouse with no dependents: $18,697 per year, about $1,558 per month, against a basic rate of $11,699 per year1

Read those as ceilings on the total pension, not as the size of the Aid and Attendance increase. VA publishes the rates as annual amounts only; a monthly payment is the yearly award divided 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.1

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.1

For 2026, that threshold is:1

• $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 increase1

Only the amount above that annual floor is deductible. Maine's nursing home costs are high enough that they will almost always exceed the threshold by a wide margin, making the deduction particularly powerful for Maine veterans.

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 families often hear about belong to the other two branches of the same regulation and 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.1

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, well inside the limit, and the veteran can qualify for Aid and Attendance, worth up to $29,093 a year ($2,424 a month) at the 2026 veteran rate.1

Who Qualifies

To qualify for VA pension with Aid and Attendance, a veteran must meet all of the following:5

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 (World War II, Korea, Vietnam and the Gulf War are the periods VA gives as examples). 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.5

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.5

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 on or after October 18, 2018; the resulting penalty period may not exceed 5 years.1

Need for aid and attendance. VA applies the criteria at 38 CFR 3.352(a). A veteran can meet them by being unable to dress or undress or keep clean and presentable, by frequently needing a special prosthetic or orthopedic appliance adjusted, by being unable to feed themselves, by being unable to attend to the wants of nature, or by needing care or assistance on a regular basis to stay safe from the hazards of daily life, or by being bedridden, by being a patient in a nursing home due to a loss of mental or physical abilities related to a disability, or by limited eyesight (5/200 or less in both eyes, or a visual field contracted to 5 degrees or less).5

Surviving spouses of wartime veterans may qualify for the Survivors Pension with Aid and Attendance under similar rules.1

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, 2033.3,6

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.3

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. Ask the Maine DHHS Office for Family Independence how the $90 is treated in your case before you budget around it.3

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.3

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.7

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 Medicaid long-term-care eligibility. That exclusion applies at the eligibility step only, and what happens after eligibility depends on the state and the setting. 42 CFR 435.725 is titled "Post-eligibility treatment of income of institutionalized individuals in SSI States," and it applies to "individuals in medical institutions and intermediate care facilities." It therefore does not settle the share-of-cost calculation in a 209(b) state (Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota and Virginia, a list that does not include Maine) or for home and community-based waiver services; in those situations, check your own state's post-eligibility rule rather than assuming the federal result. Where 435.725 does apply, "income that was disregarded in determining eligibility must be considered" in the calculation, so an Aid and Attendance amount disregarded at eligibility becomes part of the income from which the required deductions are made, and it can raise the amount the resident owes the facility. Those deductions 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 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.7

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.8

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."8

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.8

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.4

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 In-Home Care 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.