VA Aid and Attendance for In-Home Care in Montana

VA Aid and Attendance can help pay for in-home care in Montana, 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 Montana, 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 Montana
• 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 Montana Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much In-Home Care Costs in Montana

In-home care is often the most affordable way to get help, but the bills still add up. In its 2025 Cost of Care Survey, CareScout combined the old homemaker and home-health-aide categories into a single non-medical caregiver service, with a national median of about $35 an hour, or roughly $80,080 a year at 44 hours of care a week. Montana's in-home care costs run at or above that national line.2 These are industry-survey medians, not government figures, and costs vary across the state and rise as care needs grow.

For many Montana families, that is well beyond what 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 Montana, 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. With in-home care running about $80,080 a year at the national median, and Montana at or above that line, 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.1,2

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 Montana Medicaid

VA Aid and Attendance and Montana Medicaid are separate programs that a senior needing long-term care may use together, but they interact through income rules.5 Montana Medicaid for long-term care is administered by the Montana Department of Public Health and Human Services Senior and Long Term Care Division. Under the general federal rule, the base VA pension counts as income for Medicaid; however, the portion attributable to the Aid and Attendance allowance, paid specifically because the veteran needs help with daily activities and pays unreimbursed care expenses, is generally not counted against Medicaid income limits because it offsets recurring medical costs.5

Because these rules are technical and turn on a household's exact circumstances, a Montana family should confirm the treatment of any VA pension income with the Department of Public Health and Human Services or an accredited Veteran Service Officer 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 several months or longer.6

Do not do this alone. The Montana Veterans Affairs Division staffs nationally accredited Veteran Service Officers who prepare and submit VA pension and Aid and Attendance claims at no charge, operating statewide through nine Veteran Service Offices in Belgrade, Billings, Butte, Great Falls, Havre, Helena, Kalispell, Miles City, and Missoula.7 You can find your nearest office and its phone number through the Division's Veteran Services Program page at veterans.mt.gov.7 Only VA-accredited representatives may lawfully prepare a VA claim.

If Your Claim Is Denied

A denial is not the end of the road. If the VA denies the claim or grants less than expected, the veteran or surviving spouse has three decision-review options: file a Supplemental Claim with new and relevant evidence, request a Higher-Level Review by a more senior reviewer, or appeal to the Board of Veterans' Appeals for review by a Veterans Law Judge.8 The request is generally due within one year of the date on the decision letter.8 The same accredited Montana Veterans Affairs Division officers who file the original claim can prepare and submit a decision review at no charge, and the VA's main information line (MyVA411) is 800-698-2411.8

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 Assisted Living in Montana
• How Aid and Attendance Pays for a Nursing Home 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.