VA Aid and Attendance is one of the few benefits that can put real money toward assisted living in Maryland, where the median cost runs about $7,083 a month. It's a monthly cash payment for wartime veterans and surviving spouses who need help with daily activities, and it can be used to pay an assisted living facility directly.

This guide explains what assisted living costs in Maryland, how much Aid and Attendance pays, how those care costs can actually help you qualify, and where to get free, accredited help filing the claim.

In This Guide

How Much Assisted Living Costs in Maryland

Assisted living is expensive in Maryland. Per the Genworth/CareScout 2024 Cost of Care Survey, the most recent state-level data, the median cost of assisted living in Maryland is about $84,990 per year, or roughly $7,083 per month.

That sits well above the national assisted living median of about $70,800 per year, and costs in the Washington, D.C., and Baltimore suburbs tend to run higher than in rural parts of the state. These are industry-survey medians, not government figures, so the price your family is quoted will vary by community and level of care.

At those numbers, families look hard for anything that helps cover the bill. For a veteran or a veteran's surviving spouse, Aid and Attendance is often the single largest source of help available.

How Aid and Attendance Helps Pay for It

Aid and Attendance is an increased monthly amount added to the VA pension for veterans or survivors who need help with daily activities or are housebound. It is paid in cash to the veteran. The VA does not operate the assisted living facility or pay it directly, but you can apply the monthly benefit toward your assisted living bill.

Here are the 2026 maximum monthly rates, in effect from December 1, 2025 through November 30, 2026:

Category Monthly Amount
Veteran alone Up to $2,424
Veteran with a spouse Up to $2,874
Surviving spouse Up to $1,558

Against a roughly $7,083 monthly assisted living cost in Maryland, a veteran receiving up to $2,424 covers a meaningful share of the bill, and a veteran with a spouse covers more still. Aid and Attendance rarely covers the full cost on its own, so most families combine it with savings, family contributions, or, where eligible, Medicaid.

Wondering how much Aid and Attendance could cover for your family? Chat with Brevy for a quick, personalized estimate.

How Assisted-Living Costs Lower Your Countable Income

This is the part most families miss. The VA pension, including its Aid and Attendance increase, is a needs-based benefit: the VA pays the difference between your countable income and a set pension limit. Because the payment is keyed to countable income, you can lower that income by deducting continuing, unreimbursed medical expenses, and assisted living costs can count.

There is one rule to understand. Only the portion of those medical expenses that exceeds 5% of the applicable pension rate is deductible. For 2026, that 5% threshold is $872 for a veteran with no dependents and $1,141 for a veteran with one dependent. Costs above that floor come off your countable income.

Assisted living costs count as a deductible medical expense when the facility provides health care or custodial care and the resident either qualifies for Aid and Attendance or housebound status, or a physician (or PA, nurse practitioner, or clinical nurse specialist) states in writing that the person needs that care or must live in a protected environment. In practice, this means a veteran whose income looks too high at first can still qualify once a large recurring bill, like Maryland's roughly $7,083-a-month assisted living cost, is deducted from countable income.

Who Qualifies

To be eligible for Aid and Attendance, the veteran must meet several requirements:

  • Wartime service: at least 90 days of active duty with at least one day during a wartime period (WWII, Korea, Vietnam, or the Gulf War/post-9/11 era). Gulf War service has its own duty-length rules.
  • Age or disability: be 65 or older, or be permanently and totally disabled.
  • Care need: need help with daily activities such as bathing, dressing, or feeding yourself; or be largely bedridden; or be in a nursing home due to incapacity; or have severely limited eyesight.
  • Net worth: have a net worth under $163,699, which counts assets and annual income but excludes the primary home, vehicles, and basic household items.

The VA also enforces a 3-year look-back on assets transferred for less than fair market value before filing, with a penalty period that can apply. A surviving spouse can qualify for the Survivors Pension version of Aid and Attendance under the same net worth limit.

How Aid and Attendance Works with Maryland Medicaid

For a Maryland senior who needs long-term care, the VA pension with Aid and Attendance and Maryland Medicaid are separate programs with different rules, and the two interact. Maryland Medicaid long-term services and supports, administered by the Maryland Department of Health's Medical Assistance program, has its own much stricter income and asset limits.

Under general federal rules, when a state Medicaid program counts income, the VA pension is treated as income except for the portion attributable to unreimbursed medical expenses and, where applicable, the Aid and Attendance amount, which is excluded. The precise treatment depends on the specific Medicaid category and how Maryland applies the rules to an individual's situation.

Because the programs use different income and asset tests, confirm the exact effect on benefits with the Maryland Medicaid program (Maryland Health Connection or a local Department of Social Services) or an accredited benefits counselor before relying on it.

Not sure how Aid and Attendance and Maryland Medicaid fit together? Chat with Brevy to sort through your options.

How to Apply and Get Free Help

You apply for Aid and Attendance with two VA forms:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), completed with a doctor's exam documenting the need for help.
  • VA Form 21P-527EZ (Application for Veterans Pension), if you are not already receiving a VA pension.

Forms can be submitted online at va.gov, mailed, or filed through an accredited representative. Processing often takes 3 to 6 months or longer, and you can apply while your loved one is already in assisted living.

Do not file alone. Maryland veterans and families can get free, accredited help filing VA claims, including the Aid and Attendance allowance, through the Maryland Department of Veterans and Military Families (MDVMF) Service Program. Its VA-accredited benefits specialists help develop, prepare, submit, and track compensation and pension claims at no cost. The department operates service offices across the state, generally by appointment, Monday through Friday, and you can reach the program through its Baltimore Regional Office at 410-230-4444 ext. 16453 or toll-free at 800-446-4926 ext. 6450. The department emphasizes that veterans should never have to pay to access the benefits they earned.

Frequently Asked Questions

No. The VA does not run or pay an assisted living facility directly. Aid and Attendance is a monthly cash benefit paid to the veteran or surviving spouse, who can then apply it toward an assisted living bill in Maryland.

In 2026, the maximum is up to $2,424 a month for a veteran alone, $2,874 with a spouse, and $1,558 for a surviving spouse. Against Maryland's median assisted living cost of about $7,083 a month, the benefit covers a meaningful share but rarely the full bill on its own.

Possibly. Because the pension is needs-based, the VA deducts continuing care costs, such as assisted living, that exceed 5% of the applicable pension rate ($872 for a veteran with no dependents, $1,141 with one dependent) from countable income. A large assisted living bill can lower countable income enough to qualify.

The two are separate programs with different rules, and they interact. Under general federal rules, the portion of the VA pension tied to unreimbursed medical expenses (and, where applicable, the Aid and Attendance amount) is excluded when Medicaid counts income, but the exact effect depends on the Medicaid category. Confirm with Maryland Medicaid or an accredited counselor.

Compare Care Settings in Maryland

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

Learn More

Find personalized help paying for assisted living with VA benefits in Maryland at brevy.com.

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.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.