VA Aid and Attendance can add up to $2,424 a month toward nursing home care in Montana for eligible wartime veterans. Montana nursing home costs run slightly below the national median -- and most families paying those bills have never heard of this benefit. This guide explains what Aid and Attendance pays, who qualifies, how it interacts with Montana Medicaid, and how to get free help applying through the Montana Veterans Affairs Division.

In This Guide

How Much a Nursing Home Costs in Montana

A semi-private nursing home room in Montana costs about $108,770 per year (roughly $9,064 per month), and a private room runs about $113,150 per year, according to the Genworth/CareScout 2024 Cost of Care Survey. Both figures sit slightly below the national medians of approximately $111,325 and $127,750. These are industry-survey medians, not government figures, and costs vary within the state and rise as care needs increase.

At roughly $9,000 a month for a semi-private room, nursing home care in Montana is still a major expense. VA Aid and Attendance -- up to $2,424 a month -- can cover a meaningful share of that cost.

How Aid and Attendance Helps Pay for It

VA Aid and Attendance is an increased monthly payment added to a veteran's basic VA pension for those who need help with daily activities -- such as bathing, dressing, eating, or adjusting prosthetic devices -- or who live in a nursing home due to physical or mental incapacity.

For 2026, the Aid and Attendance rates are:

  • Veteran with no dependents: $2,424 per month ($29,093 per year)
  • Veteran with one dependent (such as a spouse): $2,874 per month ($34,488 per year)
  • Surviving spouse with no dependents: $1,558 per month ($18,697 per year)

These are VA pension payments sent to the veteran or surviving spouse -- not direct payments to the nursing home. The money can be applied toward facility costs or other care expenses.

The VA does not run or pay for private nursing homes. Aid and Attendance is a monthly cash benefit.

How Nursing Home Costs Lower Your Countable Income

VA pension, including Aid and Attendance, is needs-based. The VA pays the difference between your Maximum Annual Pension Rate (MAPR) and your countable income for VA purposes. Lower countable income means a larger payment.

The VA lets you subtract unreimbursed medical expenses -- including out-of-pocket nursing home costs -- from your countable income, but only the portion that exceeds 5% of your applicable MAPR.

For 2026, that threshold is:

  • $872 per year for a veteran with no dependents (5% of the $17,441 basic MAPR)
  • $1,141 per year for a veteran with one dependent (5% of the $22,839 basic MAPR)

Only the amount above those annual floors is deductible. Montana nursing home costs will typically exceed this threshold by a wide margin, substantially reducing or eliminating countable income.

Example (annual): A single veteran has $22,000 in annual income and $95,000 in annual out-of-pocket nursing home costs. Subtracting $872 leaves $94,128 deductible -- far more than $22,000. Countable income is $0, and the veteran qualifies for the full $29,093/year ($2,424/month) Aid and Attendance rate.

Who Qualifies

To qualify for VA pension with Aid and Attendance, a veteran must meet all of the following:

Wartime service. At least 90 days of active duty with at least one day during a recognized wartime period: World War II, the Korean War, the Vietnam War, or the Gulf War/post-9/11 era. Gulf War service requires 24 months of continuous active duty or the full period called to active duty.

Age or disability. Age 65 or older, OR permanently and totally disabled.

Net worth under $163,699. This combines assets and annual income, excluding the primary home, vehicles, and basic household items. A 3-year look-back applies to asset transfers for less than fair market value on or after October 18, 2018; penalties can extend up to 5 years.

Need for aid and attendance. The veteran must require help with daily activities, be largely confined to bed, be a nursing home patient due to mental or physical incapacity, or have severe vision impairment (5/200 or less in both eyes, or visual field contracted to 5 degrees).

Surviving spouses of wartime veterans may qualify for the Survivors Pension with Aid and Attendance under similar rules.

The $90/Month Nursing-Home Pension Cap

A critical federal rule applies when a single veteran with no spouse or dependent children is covered by Medicaid for nursing facility care: the VA reduces that veteran's pension to no more than $90 per month for any period after the month of admission to the nursing facility.

This rule comes from 38 U.S.C. 5503(d)(2) and its implementing regulation at 38 CFR 3.551. The $90/month is a personal allowance -- not a payment toward care -- while Montana Medicaid covers the facility. This cap applies only to a single veteran with no dependents in a Medicaid-funded nursing facility. It does not apply to veterans paying privately or to veterans with a spouse or dependent child.

How Aid and Attendance Works with Montana Medicaid

VA Aid and Attendance and Montana Medicaid (administered by the Montana Department of Public Health and Human Services Senior and Long Term Care Division) are separate programs that a senior needing long-term care may use together, but they interact through income rules.

Under the general federal rule, the base VA pension counts as income for Medicaid; however, the portion of a VA pension attributable to the Aid and Attendance allowance -- money paid specifically because the veteran needs help with daily activities and pays unreimbursed medical or care expenses -- is generally not counted against Medicaid income limits, because it offsets recurring medical costs. 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 DPHHS or an accredited Veteran Service Officer before relying on it.

How to Apply and Get Free Help

To apply for Aid and Attendance, you will need two VA forms:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) -- completed by a physician documenting the need for assistance.
  • VA Form 21P-527EZ (Application for Veterans Pension) -- required if the veteran is not already receiving a VA pension.

Forms can be submitted online at va.gov, mailed, or filed through an accredited representative. Processing often takes three to six months.

Free help in Montana: The Montana Veterans Affairs Division (MVAD) staffs nationally accredited Veteran Service Officers at nine offices statewide -- in Belgrade, Billings, Butte, Great Falls, Havre, Helena, Kalispell, Miles City, and Missoula -- who prepare and file VA pension and Aid and Attendance claims at no cost. Visit veterans.mt.gov to contact your nearest office.

Frequently Asked Questions

Does being in a Montana nursing home automatically qualify a veteran for Aid and Attendance?

Being in a nursing home due to mental or physical incapacity is one qualifying condition. But the veteran must also meet wartime service, age or disability, and net worth requirements. Placement alone does not create eligibility.

Can a Montana veteran receive both Aid and Attendance and Montana Medicaid at the same time?

Possibly. For a single veteran with no dependents whose nursing home stay is Medicaid-funded, the VA pension is capped at $90/month under federal law. How the programs interact depends on the individual's income, assets, and situation; confirm with MVAD and DPHHS before applying.

How does the VA look-back period work for nursing home residents?

If a veteran transferred assets for less than fair market value within three years before filing, the VA may impose a penalty period during which no pension is paid -- potentially up to five years. An MVAD accredited VSO can help assess whether this applies before you file.

How long does Aid and Attendance take?

Processing typically takes three to six months or longer. An MVAD Veteran Service Officer can help ensure the file is complete, which reduces delays.

Compare Care Settings in Montana

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

Learn More

Find personalized help using VA benefits to pay for a nursing home in Montana 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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