VA Aid and Attendance for Memory Care in Maryland

VA Aid and Attendance can put thousands of dollars a month toward memory care in Maryland, and many veteran families never realize the money is there. It's a tax-free monthly cash benefit, paid directly to the veteran or surviving spouse, that you can spend on a memory care community for a loved one living with Alzheimer's or another dementia. For a family facing a secured-unit bill that climbs well above standard assisted living, that benefit often makes the difference between affording care and not.

This guide walks through what memory care costs in Maryland, what Aid and Attendance pays in 2026, why veterans with dementia so often qualify, how those care costs can actually help you qualify, how the benefit works alongside Maryland Medicaid, and how to apply with free help.

In This Guide

• Key Takeaways
• How Much Memory Care Costs in Maryland
• How VA Aid and Attendance Helps Pay for Memory Care in Maryland
• Why Veterans With Dementia Often Qualify
• How Memory Care Costs Lower Your Countable Income
• Who Qualifies
• How Aid and Attendance Works with Maryland Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much Memory Care Costs in Maryland

Standard assisted living in Maryland runs about $7,172 a month, based on the CareScout 2025 Cost of Care Survey.1 Memory care generally costs more than standard assisted living because of the secured environment, higher staffing ratios, and dementia-specific programming.1 That premium is exactly the gap Aid and Attendance is designed to help close.

Memory care is more expensive than standard assisted living almost everywhere, because a secured dementia unit means more staff, more training, and a physical environment built to keep residents safe. That higher bill is the reason families look hard for every benefit they can layer on, and Aid and Attendance is one of the most overlooked.

How VA Aid and Attendance Helps Pay for Memory Care in Maryland

Aid and Attendance is an increase to the VA pension paid to veterans, and surviving spouses, who need help with daily activities.2 It's tax-free cash that arrives every month, and there's no rule about where the veteran lives or that the money go to a specific facility. You can apply it straight to a memory care bill.

Here's what the 2026 rates look like, effective December 1, 2025 through November 30, 2026:2

VA publishes these as annual rates; a monthly amount is the yearly award divided by 12, so treat the monthly column as approximate.2 These figures are ceilings, not checks: the Maximum Annual Pension Rate is the maximum amount of pension payable, and VA pays the difference between the claimant's income for VA purposes and that limit.2

The benefit doesn't have to cover the whole memory care bill to be worth claiming. It stacks with Social Security, a private pension, or family contributions, though income the VA counts is the same income that reduces the award, so run the arithmetic on your own household rather than assuming the maximum.2 For a Maryland family awarded at or near the ceiling, that is a meaningful share of the monthly cost; for a family with more countable income, it is less.

One thing to be clear about: the VA does not run memory care facilities and does not pay a community directly. Aid and Attendance pays the veteran or surviving spouse, and the family uses that money toward care.

Why Veterans With Dementia Often Qualify

The Aid and Attendance clinical test is built around the very limitations dementia tends to cause, which is why so many veterans with Alzheimer's or a related dementia meet it.

To qualify on care need, a veteran must show one of several things: a need for help with daily activities such as bathing, dressing, or feeding yourself; being unable to protect yourself from the ordinary hazards of your daily environment; being bedridden; or living in a care facility because of physical or mental incapacity.3 As dementia progresses, a person commonly needs hands-on help with bathing and dressing and can no longer be left alone safely, which is exactly what a secured memory care unit exists to address.3

In other words, the same realities that lead a family to choose memory care, the wandering, the inability to manage medications, the around-the-clock supervision, are the realities the VA looks for. A medical examiner's exam documenting that need is what carries the claim. You do not need a service-connected disability for Aid and Attendance.3

How Memory Care Costs Lower Your Countable Income

This is the part most families miss, and it's where memory care and Aid and Attendance fit together in a way that surprises people.

The VA pension is needs-based: to be eligible, the veteran's yearly family income and net worth have to meet limits set by Congress.2 Because the benefit is keyed to income for VA purposes, lowering the income the VA counts is what brings a family inside those limits, and you lower it by deducting unreimbursed medical expenses.

Memory care costs count as those medical expenses.2 When the resident genuinely needs the care the community provides, the cost of that care can be deducted from the income the VA counts, so put a written statement from a physician, PA, nurse practitioner, or clinical nurse specialist describing that need in the claim file.2 With dementia, that need is rarely in doubt.

There's one rule to know: only the portion of those expenses above 5% of the applicable Maximum Annual Pension Rate (MAPR) is deductible.2 For 2026, that 5% floor is $872 a year for a veteran with no spouse or child, and it rises with dependents, though it never counts the Aid and Attendance increase.2 Memory care in Maryland runs far above that annual floor, so the practical upshot is powerful: a veteran whose income looks too high to qualify can often qualify once a year's worth of memory care costs is deducted, because those costs can dramatically reduce, or zero out, countable income.2

Who Qualifies

To be eligible for Aid and Attendance, the veteran must:3

• Have wartime service and a discharge that is not dishonorable: 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 longer duty requirements, and separate rules apply to enlisted members who started active duty after September 7, 1980 and to officers who started after October 16, 1981 without 24 months of prior active duty).
• Meet at least one of four age or disability tests: be at least 65 years old; 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. Any one of the four satisfies this test on its own, so a wartime veteran under 65 who receives SSI qualifies without an adjudicated disability rating.
• Need help with daily activities: such as bathing, dressing, or feeding yourself, being unable to protect yourself from everyday hazards, being bedridden, or living in a care facility because of physical or mental incapacity, a bar dementia commonly meets.
• Have a net worth under $163,699 for 2026. VA's net-worth calculation is not assets alone: it combines the claimant's and their dependents' assets and annual income, while excluding the primary home, a vehicle, and basic household items.3

Note that you do not need a service-connected disability to qualify.3 The VA also applies a 3-year look-back on assets transferred for less than fair market value before you file, with a penalty period that can run up to five years, so don't give away or move assets to qualify without getting advice first.3

How Aid and Attendance Works with Maryland Medicaid

Aid and Attendance and Medicaid can work together, and for a family paying for memory care that combination matters.

In Maryland, the VA pension with Aid and Attendance and Maryland Medicaid are separate programs with different rules. 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.4

Because the interaction between VA pension and Maryland Medicaid is complex and fact-specific, work with a Veterans Service Officer or an elder law attorney before relying on the combination.4 The right order and timing of applications can change the outcome.

How to Apply and Get Free Help

The steps below are the pension route, which is what most Maryland memory care families are using. VA's own condition for it is that you may be eligible for this benefit if you get a VA pension. A veteran who already receives VA disability compensation instead is on a different track: VA Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation, and 21P-527EZ below is not the form for that situation.5

Two VA forms carry a pension-route claim:5

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination section a medical examiner must fill out to document the need for help, which for dementia means documenting the supervision and hands-on care the person requires.
• VA Form 21P-527EZ (Application for Veterans Pension), for a wartime veteran pursuing the pension route who isn't already receiving a VA pension. This is the wartime, means-tested pension application, so it's the wrong form for a veteran whose monthly VA money is disability compensation rather than pension.

If you're still gathering paperwork, you can submit VA Form 21-0966 (Intent to File) 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.5

You can file 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.5 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.5 You can apply while your loved one is already living in memory care.

Don't do this alone. The Maryland Department of Veterans and Military Families (MDVMF) Service and Benefits Program has VA-accredited benefits specialists who assist with preparing and submitting VA pension and Aid and Attendance claims, at no cost. One condition worth knowing before the appointment: a claim can be submitted at that appointment if the veteran's discharge paperwork supports the claim, so bring the DD-214. MDVMF asks veterans to find the DVMF Service Office nearest them and call that office directly to make an appointment. Its Baltimore regional office is at 31 Hopkins Plaza, Room 3020, and can be reached at 410-230-4444 ext. 16453 or 800-446-4926 ext. 6450; those are that one office's details, not a statewide line.6 Their help can improve your chances of approval and reduce errors that cause delays.

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 In-Home 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.