VA Aid and Attendance for In-Home Care in Maryland

VA Aid and Attendance can help pay for in-home care in Maryland, turning a monthly VA pension into real money toward an aide, a homemaker, or a family caregiver. If your loved one is a wartime veteran who needs help with daily activities, this benefit can cover a meaningful share of the cost of staying at home. The hard part is usually knowing it exists and how to claim it.

This guide walks through what in-home care costs in Maryland, how much Aid and Attendance pays, how your care costs can actually help you qualify, and where to get free help applying.

In This Guide

• Key Takeaways
• How Much In-Home Care Costs in Maryland
• How Aid and Attendance Helps Pay for In-Home Care
• How In-Home Care Costs Lower Your Countable Income
• Who Qualifies
• Using Aid and Attendance to Pay a Family Caregiver
• How Aid and Attendance Works with Maryland Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much In-Home Care Costs in Maryland

In-home care is often the most affordable way to get help, but the bills add up fast. In Maryland, in-home care from a non-medical caregiver (the category that covers both personal-care aides and homemaker help) runs about $80,080 a year, based on roughly 44 hours of care a week, per the CareScout 2025 Cost of Care Survey.2 Beginning with its 2025 survey, CareScout merged its former separate home health aide and homemaker categories into this single figure. These are industry-survey medians, not government figures, and costs vary across the state, with the Washington-DC and Baltimore suburbs running higher than rural Maryland.

For many Maryland families, that is more than a fixed retirement income can absorb on its own. This is where Aid and Attendance comes in.

How Aid and Attendance Helps Pay for In-Home Care

Aid and Attendance is an increased monthly VA pension for wartime veterans and surviving spouses who need help with everyday activities.4 It is paid as tax-free cash, which means the family decides how to spend it, including on a home health aide, a homemaker, or a family caregiver.

At up to $2,424 a month for a veteran, the benefit can cover a meaningful share of in-home care in Maryland, and more when combined with the veteran's other income.1

How In-Home Care Costs Lower Your Countable Income

VA Pension, including the Aid and Attendance increase, is needs-based: the VA pays the difference between your countable income and a yearly limit set by Congress called the Maximum Annual Pension Rate (MAPR).1 The lower your countable income, the more the VA pays.

Here is the part families miss: continuing, unreimbursed medical expenses, including in-home care, lower your countable income when there is a documented care need. You can only deduct the portion of those expenses that exceeds 5% of your applicable MAPR. For 2026 that floor is $872 a year for a veteran with no dependents and $1,141 a year for a veteran with one dependent.1

Think of it in annual terms. If a veteran with no dependents pays for in-home care, only the first $872 of that yearly cost is not deductible. Everything above that floor reduces countable income.1 With in-home care running about $80,080 a year in Maryland, those costs can wipe out most or all of a veteran's countable income, which is exactly how someone whose income looked too high ends up qualifying.2

Who Qualifies

To be eligible for Aid and Attendance, the veteran must:4

• Have served at least 90 days of active duty with at least one day during a wartime period
• Be 65 or older, or permanently and totally disabled
• Need help with daily activities such as bathing, dressing, or feeding, or be largely confined to bed
• Have a net worth below $163,699 for 2026 (assets plus annual income, not counting the primary home)4

The VA also applies a 3-year look-back on assets transferred for less than fair market value.4 Surviving spouses of wartime veterans can qualify under the survivor pension.

Using Aid and Attendance to Pay a Family Caregiver

Many families want a son, daughter, or spouse to provide the care. Aid and Attendance is paid as cash, so it can be used to compensate a family caregiver directly.

There is also a separate VA program built for this. Veteran-Directed Care gives a veteran a flexible budget to hire their own caregivers, including family members, with help from an Aging and Disability Network agency and a financial management service that handles payroll.3 Unlike some Medicaid programs, Veteran-Directed Care has no blanket ban on hiring a spouse.3 Ask your VA medical center's social work team whether it is available in your area.

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.5 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.5

Because the programs use different income and asset tests, a household should confirm the exact effect on benefits with the Maryland Medicaid program or an accredited benefits counselor before relying on it.5

How to Apply and Get Free Help

Apply using VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), which includes a doctor's exam documenting the care need.6 If the veteran is not already receiving a VA pension, also file VA Form 21P-527EZ (Application for Veterans Pension).6 You can file online at va.gov, by mail, or through an accredited representative. Processing often takes 3 to 6 months.6

Do not do this alone. The Maryland Department of Veterans & Military Families Service Program provides free, accredited help filing VA pension and Aid and Attendance claims through benefits specialists in service offices across the state; you can reach the Baltimore Regional Office at 410-230-4444 ext. 16453 or toll-free at 800-446-4926 ext. 6450.7 Their help is free, and only VA-accredited representatives may lawfully prepare a VA claim.

Compare Care Settings in Maryland

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 Maryland
• How Aid and Attendance Pays for a Nursing Home in Maryland
• How Aid and Attendance Pays for Memory Care in Maryland

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.