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 $7,172 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 CareScout 2025 Cost of Care Survey (released March 2026), the most recent state-level data, the median cost of assisted living in Maryland is about $86,070 per year, or roughly $7,172 per month.

That sits well above the national assisted living median of about $74,400 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 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 need help with daily activities or are housebound, so the Aid and Attendance rate is the ceiling on the whole pension, not an amount added over the basic rate. 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 rates, in effect from December 1, 2025 through November 30, 2026. VA publishes annual maximum amounts; a monthly figure is the yearly maximum divided by 12, so treat the monthly column as approximate.

Category Maximum Annual Amount Monthly Equivalent
Veteran alone Up to $29,093 About $2,424
Veteran with a spouse Up to $34,488 $2,874
Surviving spouse Up to $18,697 About $1,558

Against a roughly $7,172 monthly assisted living cost in Maryland, a ceiling of $29,093 a year (about $2,424 a month) covers a meaningful share of the bill, and the higher ceiling for 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: 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.

Assisted living costs count toward those unreimbursed medical expenses when the resident genuinely needs the care the facility provides, so put a written statement from a physician (or PA, nurse practitioner, or clinical nurse specialist) describing that need in the claim file. 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 $7,172-a-month assisted living cost, is deducted from 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: 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, 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 rating is only one of the four routes, so a wartime veteran under 65 who receives SSI meets this test without any adjudicated rating.
  • 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. 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.,

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.

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, income that was 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 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. 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. 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

Most families paying for assisted living reach Aid and Attendance through the pension route, which is the path VA describes when it says you may be eligible for this benefit if you get a VA pension. 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. This same form covers Aid and Attendance that would be added to monthly compensation benefits, not just pension, so a veteran already drawing VA disability compensation still starts here.
  • VA Form 21P-527EZ (Application for Veterans Pension), for a wartime veteran pursuing the pension route who is not already receiving a VA pension. This is the means-tested wartime pension application, so it is not the form for a veteran seeking Aid and Attendance added to disability compensation.

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 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 and Benefits Program. Its VA-accredited benefits specialists help develop, prepare, submit, and track compensation and pension claims at no cost, with one condition worth knowing before the appointment: submitting a disability compensation or pension claim depends on the veteran's discharge paperwork supporting the claim, so bring the DD-214. MDVMF tells veterans to find the DVMF Service Office nearest them and call that office directly to make an appointment, Monday through Friday, 8:00am to 4:00pm, by appointment only. Its Baltimore regional office, one office among several rather than a statewide line, can be reached at 410-230-4444 ext. 16453 or 800-446-4926 ext. 6450. The department emphasizes that the assistance is at no cost and that veterans should never have to pay to access the benefits they earned, and it warns families to be cautious of individuals or organizations that charge fees or are not VA-accredited.

Frequently Asked Questions

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

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.

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

In 2026, the maximum is $29,093 a year (about $2,424 a month) for a veteran alone, $34,488 a year ($2,874 a month) with a spouse, and $18,697 a year (about $1,558 a month) for a surviving spouse. Those are ceilings on the pension rather than fixed awards. Against Maryland's median assisted living cost of about $7,172 a month, the benefit covers a meaningful share but rarely the full bill on its own.,

Can my parent qualify if their income seems too high?

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

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. That disregarded income is counted again in the post-eligibility share-of-cost calculation once someone is eligible and living in a nursing facility or other medical institution, and Maryland must take five deductions from it first, 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. Only what is left goes to the facility. Home and community-based waiver services are governed by separate post-eligibility rules. 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, monthly rates up to $2,874, how to apply, and free help from the MDVMF Service and Benefits 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, its care levels, 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 monthly amounts, the medical-expense rule, who qualifies, and how to apply for the benefit. 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.

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