VA Aid and Attendance for Assisted Living in Montana

VA Aid and Attendance can pay a veteran with a spouse up to $34,488 a year, or $2,874 a month, toward assisted living in Montana.1 Assisted living in Montana runs a median of about $72,900 a year ($6,075 a month), per the CareScout 2025 Cost of Care Survey.2 Even at the maximum, the benefit covers only part of that bill, so families generally pair it with Social Security and savings to close the gap. If you're already paying an assisted-living bill out of pocket, it's worth checking whether the veteran in your family qualifies.

This guide covers what assisted living costs in Montana, how Aid and Attendance can help offset that cost, how the care expenses themselves can improve eligibility, what to do if a claim is denied, and how to apply with free help from the state.

In This Guide

• Key Takeaways
• How Much Assisted Living Costs in Montana
• How VA Aid and Attendance Helps Pay for Assisted Living in Montana
• How Montana Assisted-Living Costs Lower Your Countable Income for Aid and Attendance
• Who Qualifies for Aid and Attendance in Montana
• How Aid and Attendance Works with Montana Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much Assisted Living Costs in Montana

According to the CareScout 2025 Cost of Care Survey (released March 2026, the most recent national data), the median cost of assisted living in Montana is about $72,900 a year, or $6,075 a month. That ranks Montana 29th among the states CareScout reports and puts it a little below the national median of about $74,400 a year. These are industry-survey medians, not government figures.2

Costs vary by region and level of care within the state and rise as care needs increase.2 The actual monthly bill depends on the facility, location, and the level of care required.

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

VA Aid and Attendance is a pension benefit for veterans and surviving spouses who need help with daily activities. The VA pays it as cash that can be applied to any care-related expense, including assisted living. The figures below are ceilings, not payments: the VA pays the difference between a household's income for VA purposes and the limit Congress sets, so a claimant with countable income receives less than the maximum.1

2026 Aid and Attendance Maximum Rates

The VA publishes these rates as annual maximums. Pension is paid monthly: under 38 CFR 3.273, the VA takes the annual rate, subtracts the claimant's countable income, and divides what is left by 12, rounding down to the whole dollar.1

Even at the $34,488 annual maximum for a veteran with one dependent, the benefit covers less than half of Montana's $72,900 median assisted-living bill.1,2 Combined with Social Security or other income, many families can make assisted living affordable.

How Montana Assisted-Living Costs Lower Your Countable Income for Aid and Attendance

Many families are surprised to learn that the cost of assisted living can help them qualify for a higher benefit.

The VA calculates pension by comparing your countable income to the Maximum Annual Pension Rate (MAPR). Before making that comparison, it lets you subtract unreimbursed medical expenses (UMEs) that exceed 5 percent of your MAPR. Health insurance premiums, including Medicare Part A, B, and D premiums, count as UMEs.1

An assisted-living bill counts under its own rule for a care facility other than a nursing home (38 CFR 3.278(d)(3)), and the facility must be licensed where Montana requires a license and, if residential, staffed 24 hours a day with care providers. Payments for help with daily activities are medical expenses when the resident is receiving health or custodial care in the facility and either needs Aid and Attendance or is housebound, or has a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist state in writing that they need to be in a protected environment. The meals-and-lodging part of the bill counts when the facility provides or contracts for the resident's health or custodial care, or when one of those clinicians states in writing that the resident must live in the facility, or a similar one, to receive care from a separately hired provider or from family or friends.1

For 2026, the VA puts the 5-percent floor at $872 for a veteran with no spouse or child. The floor is higher for a veteran with dependents, because it tracks the pension rate that applies to your household, but it never rises with the Aid and Attendance or housebound increase.1

Only the portion of qualifying expenses above that floor is deductible. Against a Montana median assisted-living bill of about $72,900 a year, the floor is small.2 Where the bill qualifies under the conditions above, the deduction can reduce countable income enough to qualify a veteran whose income first appeared too high.1

Who Qualifies for Aid and Attendance in Montana

To qualify for VA Aid and Attendance, a veteran must have a discharge that is not dishonorable and meet all of the requirements below:3

• Wartime service: for a veteran who started active duty before September 8, 1980, at least 90 days of active duty with at least one day during a recognized wartime period (WWII, Korea, Vietnam, or the Gulf War, which began August 2, 1990 and covers post-9/11 service); for someone who started as an enlisted person after September 7, 1980, generally at least 24 months, or the full period for which they were called or ordered to active duty, again with at least one day during wartime; and for an officer who started on active duty after October 16, 1981, that officer must not have previously served on active duty for at least 24 months
• Age, disability, or care status: any one of these four is enough, and they are independent of each other: age 65 or older; a permanent and total disability; a patient in a nursing home for long-term care because of a disability; or getting Social Security Disability Insurance or Supplemental Security Income
• Need for care: requires regular help with daily activities, such as bathing, dressing, or eating; or is in a nursing home due to mental or physical incapacity; or has severe vision loss; or has to stay in bed, or spend a large portion of the day in bed, because of illness
• Net worth under $163,699: VA counts the veteran's and their dependents' assets plus annual income, and excludes the primary home, a vehicle, and basic home items3,1

The VA also enforces a three-year look-back on asset transfers. If assets were moved for less than fair market value in the three years before filing, a penalty period may apply.3

How Aid and Attendance Works with Montana Medicaid

VA Aid and Attendance and Montana Medicaid long-term care are separate programs that a senior may use together, and they interact through income rules. On the Medicaid side, the Montana Department of Public Health and Human Services (DPHHS) Senior and Long-Term Care Division points seniors to Medicaid support options, administered by its Community Services Bureau.5

Federal Medicaid rules treat VA pension income in two steps. At the eligibility step, an aged, blind, or disabled applicant is generally judged by SSI's income rules, and under those rules the Aid and Attendance allowance is not income, while the basic VA pension is not covered by that exclusion. A state using more restrictive rules than SSI can apply different ones, so confirm Montana's treatment with DPHHS.5

The second step applies once Medicaid is paying for care in a nursing facility or other medical institution. Montana's rule (DPHHS manual section ABD 805-2) applies the resident's gross monthly income, less allowable deductions, to the cost of care. Those deductions include a $50 personal needs allowance, and veterans keep up to $90 a month of VA pension income on top of it; VA pension income above $90 a month is countable. Because VA pays Aid and Attendance as part of the monthly pension, an Aid and Attendance amount still paid at the full rate is part of that countable pension income. Federal rules (42 CFR 435.725(c)) also require deductions for a spouse or family still at home and for medical costs no third party will pay, and Montana's maintenance figures for a spouse at home should come from DPHHS.5

One federal rule can change that math completely. When Medicaid covers nursing-facility care for a veteran with no spouse or child, or a surviving spouse with no child, VA pension after the month of admission is capped at $90 a month, and that $90 may not reduce Medicaid's payment to the facility. The cap does not reach a State Veterans Home for which VA pays a per diem for nursing home care, so check a State Veterans Home stay with an accredited Veteran Service Officer.5

The share-of-cost rule above is written for residents of medical institutions. It does not set the math for someone receiving home- and community-based waiver services, so a family planning around a Montana waiver should ask DPHHS which post-eligibility rule applies to them. Because these rules turn on a household's exact circumstances, confirm the treatment of VA pension income with DPHHS or an accredited Veteran Service Officer before relying on both programs together.5

How to Apply and Get Free Help

Aid and Attendance is an increase added to an existing VA benefit, so how you apply depends on which benefit you receive. The steps below are the pension route, which is the one most assisted-living families use: the VA's condition is that "You may be eligible for this benefit if you get a VA pension." A veteran who receives VA disability compensation rather than pension uses Form 21-2680 to ask for Aid and Attendance to be added to that monthly compensation.6

For the pension route, you need two forms:6

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance): a medical examiner fills out the examination information section to document the need for assistance. This is the same form used to request Aid and Attendance added to monthly compensation or pension benefits
• VA Form 21P-527EZ (Application for Veterans Pension): the wartime, means-tested pension application, filed by a wartime veteran pursuing the pension route who is not already receiving a VA pension

If you are still gathering information, you can file VA Form 21-0966 (Intent to File) first. The VA says "Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive."6

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 file for you. Asked how long a decision takes, the VA's answer is "It depends." It works through claims in the order it receives them, unless a claim requires priority processing.6

Do not do this alone. The Montana Veteran Affairs Division (MVAD) staffs nationally accredited Veteran Service Officers who prepare and submit VA pension and Aid and Attendance claims at no cost to the veteran. MVAD operates nine Veteran Service Offices statewide, located in Belgrade, Billings, Butte, Great Falls, Havre, Helena, Kalispell, Miles City, and Missoula. You can reach MVAD and find your nearest office at veterans.mt.gov.4

If Your Claim Is Denied

If the VA denies your Aid and Attendance claim, or grants less than you expected, you are not out of options. You have three decision review paths: file a Supplemental Claim with new and relevant evidence, request a Higher-Level Review by a higher-level reviewer, who looks for an error or a difference of opinion and cannot take new evidence, or appeal to the Board of Veterans' Appeals for review by a Veterans Law Judge.7 You generally have one year from the date on your decision letter to request a Higher-Level Review or a Board appeal, and a Supplemental Claim can be filed at any time, though the VA recommends filing within a year to keep your effective date. The same Montana VSO can prepare the review at no cost, and an accredited VSO representative's services on a VA benefit claim are always free. Only accredited attorneys and claims agents may charge you at all, and only for representation provided after the VA has issued notice of its initial decision on the claim, so no one should charge you to prepare and file the initial pension application. For questions about a pension claim or its status, the VA benefits hotline is 800-827-1000 (TTY: 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.8

Compare Care Settings in Montana

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

• How Aid and Attendance Pays for a Nursing Home in Montana
• How Aid and Attendance Pays for In-Home Care in Montana
• How Aid and Attendance Pays for Memory Care in Montana

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.