VA Aid and Attendance is a higher VA pension rate for wartime veterans and surviving spouses who qualify, for example by needing another person's help with daily activities., In Maryland, where assisted living has a median cost of about $7,172 a month, that bill can also help a veteran qualify, because VA can deduct qualifying care costs above a 5% floor from countable income when the resident gets care there and meets VA's conditions.,

In This Guide

How Much Assisted Living Costs in Maryland

Assisted living is expensive in Maryland. Per the CareScout 2025 Cost of Care Survey (released March 2, 2026, from rates gathered July through November 2025), the median cost of assisted living in Maryland is about $86,070 per year, or roughly $7,172 per month.

That sits above the national assisted living median of $74,400 per year and ranks 12th highest among the states. These are industry-survey medians, not government figures, and CareScout collects rates by metropolitan area, so the price your family is quoted will vary by community and level of care.

How VA Aid and Attendance Helps Pay for Assisted Living in Maryland

Aid and Attendance is the VA pension paid at a higher maximum rate for veterans or survivors who qualify, for example because they need another person's help with daily activities, so the Aid and Attendance rate is the ceiling on the whole pension, not an amount added over the basic rate., Housebound is a separate, lower allowance, and VA says you can't get Aid and Attendance and Housebound benefits at the same time.

Here are the 2026 maximum annual rates, in effect from December 1, 2025 through November 30, 2026. VA publishes these as annual amounts and pays pension monthly: under 38 CFR 3.273, the monthly payment is the annual rate minus your countable income, divided by 12.

Category Maximum Annual Amount
Veteran with no dependents Up to $29,093
Veteran with one dependent Up to $34,488
Surviving spouse with no dependents Up to $18,697
Surviving spouse with one dependent child Up to $22,304

Against Maryland's median assisted living cost of about $86,070 a year, the $29,093 ceiling for a veteran with no dependents and the $34,488 ceiling for a veteran with one dependent each fall well short of the median bill.,

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

The VA pension, including its Aid and Attendance increase, is a needs-based benefit: to be eligible, your yearly family income and net worth have to meet limits set by Congress. Because the benefit is keyed to your income for VA purposes, you can lower that income by deducting 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 spouse or child, and it rises for a veteran with dependents, though it never counts the Aid and Attendance increase. Costs above that floor come off your countable income.

VA treats assisted living under its own rule for care facilities other than nursing homes. The facility has to be licensed if Maryland requires that type of facility to be, and a residential facility has to be staffed with care providers 24 hours a day. Payments for help with daily activities count when the resident receives health care or custodial care there and either the resident needs Aid and Attendance or is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that, due to a physical, mental, developmental, or cognitive disorder, the resident needs to be in a protected environment. Meals and lodging count too when the facility provides or contracts for the resident's health care or custodial care. In practice, this means a veteran whose income looks too high at first may still qualify once the deductible part of a large recurring bill, like Maryland's roughly $7,172-a-month assisted living cost, comes off countable income.,

Who Qualifies

To be eligible for Aid and Attendance, the veteran must have a discharge that was not dishonorable and meet several requirements:

  • Wartime service: meet one of three service paths, each with at least 1 day during a wartime period VA recognizes, such as World War II, the Korean conflict, the Vietnam War era, or the Gulf War (which has no end date set yet). Started active duty before September 8, 1980 and served at least 90 days on active duty; or started active duty as an enlisted person after September 7, 1980 and served at least 24 months or the full period called or ordered to active duty (with some exceptions); or was an officer who started active duty after October 16, 1981 and had not previously served on active duty for at least 24 months.
  • Age, disability, or care status: meet at least one of four alternatives: 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. A permanent and total disability is only one of the four routes, so a wartime veteran under 65 who gets SSI meets this test through the SSI route.
  • Care need: meet at least one of these: need another person's help with daily activities like bathing, feeding, and dressing; have to stay in bed, or spend a large part of the day in bed, because of illness; be a patient in a nursing home because of the loss of mental or physical abilities related to a disability; or have limited eyesight (even with glasses or contact lenses, 5/200 or less in both eyes, or a visual field contracted to 5 degrees or less).
  • Net worth: have a net worth under $163,699. VA's net worth calculation counts your and your dependents' assets and annual income together, and excludes the primary home, a vehicle, and basic household items, so do not compare assets alone against that limit.,

VA also looks back 36 months (3 years) from the date it receives the pension claim for assets transferred for less than fair market value. Where a transferred asset would otherwise have caused or partly caused net worth to exceed the limit, VA assesses a penalty period of up to 5 years. Surviving spouses have their own Survivors Pension rates, including an Aid and Attendance rate, and the same $163,699 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 income and asset rules.

At the eligibility step, Maryland applies SSI income rules, under which the Aid and Attendance allowance is not counted as income at all, so only the basic pension counts toward the income limit. That exclusion governs eligibility only: once a person is eligible and living in a nursing facility or other medical institution, federal rules require income that was disregarded in determining eligibility to be considered in the post-eligibility calculation of what the resident's own income contributes (42 CFR 435.725), so an Aid and Attendance amount VA is still paying at the full rate can count at that stage. How Maryland treats that amount for a particular resident is something to confirm with the Maryland Department of Health's Medical Assistance program. Before any of it reaches the facility, 42 CFR 435.725(c) requires Maryland 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. They are not necessarily the only deductions: the same regulation lets a state also deduct, for no more than 6 months, an amount to maintain a single person's or couple's home, but only where a physician has certified that either of them is likely to return home within that period. Whether Maryland offers that deduction is something to ask the Medical Assistance program rather than assume either way. That section applies to people in medical institutions and intermediate care facilities, so these are the institutional rules; how the same income is treated for someone on a home and community-based services waiver is a separate question to put to Maryland Medicaid. 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.

How to Apply and Get Free Help

These steps follow the pension route, the path VA describes when it says you may be eligible for this benefit if you get a VA pension and meet at least 1 of its requirements. That route uses two 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 help. VA describes this form as applying for Aid and Attendance benefits added to monthly compensation or pension benefits, so it serves both routes.
  • VA Form 21P-527EZ (Application for Veterans Pension), for a wartime veteran pursuing the pension route who is not already receiving a VA pension.

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. If you are still gathering documents, filing VA Form 21-0966 (Intent to File) first can secure the earliest possible effective date for any retroactive payments you may be eligible to receive. On how long a decision takes, VA's own answer is "It depends"; it processes claims in the order it receives them unless a claim requires priority processing.

You don't have to file alone. Maryland veterans and families can get free help from VA-accredited Benefits Specialists filing VA claims, including pension claims, through the Maryland Department of Veterans and Military Families (DVMF) Service Program. Its specialists help veterans, dependents, and survivors apply for benefits and work through claims, with one condition worth knowing before the appointment: DVMF submits a disability compensation or pension claim if the veteran's discharge paperwork supports it, so bring that paperwork. DVMF lists 16 Veteran Benefits Office locations, and its page is not consistent about access: it recommends appointments and mentions walk-ins at MVA branch locations, but also lists office hours of Monday through Friday, 8:00am to 4:00pm, by appointment only, and it lists its Rosedale office as staffed only Wednesday, 9am to 1pm, excluding federal holidays. Call the specific office before you visit. Its Baltimore regional office, one of those 16 rather than a statewide line, is at 31 Hopkins Plaza, Room 3020, and can be reached at 410-230-4444 ext. 16450 or 800-446-4926 ext. 6450. DVMF says veterans never pay for its services, which are 100% free, and it warns families to be cautious of unaccredited organizations that charge fees for claims assistance.

Frequently Asked Questions

Does the VA pay an assisted living facility directly in Maryland?

Aid and Attendance is a higher maximum rate of the veteran's or surviving spouse's VA pension, not a separate payment, and under 38 CFR 3.273 VA computes the monthly rate of pension payable to the beneficiary from that annual rate, less countable income, divided by 12. The assisted living bill matters in a different way: when the resident gets care there and meets VA's conditions for care facilities, its deductible part can lower countable income.

How much will Aid and Attendance cover toward assisted living costs?

In 2026, the maximum annual rate is $29,093 for a veteran with no dependents, $34,488 for a veteran with one dependent, and $18,697 for a surviving spouse with no dependents. Those are ceilings on the pension rather than fixed awards: VA subtracts countable income from the annual rate and pays the rest in monthly installments. Against Maryland's median assisted living cost of about $86,070 a year, each of those ceilings falls well short of the median bill.,

Can my parent qualify if their income seems too high?

Possibly. Because the pension is needs-based, VA deducts unreimbursed medical expenses above 5% of the applicable pension rate ($872 for a veteran with no spouse or child, higher with dependents) from countable income, and assisted living fees can count when the resident receives care there and meets VA's conditions for care facilities. So a large assisted living bill can bring countable income down.

Can a veteran get both Aid and Attendance and Maryland Medicaid?

The two are separate programs with different rules, and they interact. At the eligibility step, Maryland applies SSI income rules, under which the Aid and Attendance allowance is not counted as income at all, so only the basic pension counts toward the income limit. Once someone is eligible and living in a nursing facility or other medical institution, federal rules require that disregarded income be considered in the post-eligibility calculation, so a full-rate Aid and Attendance amount can count there; how Maryland treats it for a particular resident is something to confirm with its Medical Assistance program. Before the facility is paid, Maryland must deduct five amounts from the resident's income, in this order: a personal needs allowance the resident keeps, a maintenance allowance for a spouse still at home, one for other family at home, incurred medical or remedial expenses no third party pays, and any SSI or state supplementary payments the resident still receives. Those five are not necessarily the only deductions: a state may also deduct, for up to 6 months, an amount to maintain the home when a physician certifies the resident is likely to return within that period, so ask whether Maryland offers it. These are the institutional rules; ask separately how the same income is treated on a home and community-based services waiver. 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

VA BenefitsVA Aid and Attendance in MarylandVA Aid and Attendance in Maryland for 2026: who qualifies, annual rates up to $34,488, how to apply, and free claims help from the MDVMF Service Program. VA BenefitsVA Benefits for Senior Care in MarylandSix VA programs cover senior care in Maryland, from home care to Charlotte Hall Veterans Home and up to $29,093 a year in Aid and Attendance. How each works. Care TypesAssisted Living in MarylandAssisted living in Maryland runs about $7,172/month. What an Assisted Living Program is, who licenses it, what it costs, and how Medicaid and SOAR can help. 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.
Your next step 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.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

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