VA Aid and Attendance for Assisted Living in New Hampshire

VA Aid and Attendance raises a New Hampshire veteran's pension ceiling to $34,488 a year with one dependent, such as a spouse. A veteran alone has a $29,093 ceiling and a surviving spouse $18,697, and VA subtracts countable income before dividing the rest into monthly payments.1 In New Hampshire, where a typical assisted-living community runs about $96,300 a year, that money matters.2

In This Guide

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

How Much Assisted Living Costs in New Hampshire

CareScout's 2025 Cost of Care Survey (released March 2, 2026) puts the median cost of an assisted living community in New Hampshire at $96,300 a year ($8,025 a month). The national median is about $6,200 a month, roughly $74,400 a year, so New Hampshire families pay well above the national line.2

These are industry-survey medians, not government figures. Costs vary widely within the state and rise as care needs grow, so the actual bill depends on the facility, its location, and the level of care required.2

How Aid and Attendance Helps Pay for Assisted Living in New Hampshire

VA Aid and Attendance is an increase to a VA pension for a veteran or surviving spouse who gets the pension and meets at least one care-need requirement, such as needing another person's help with daily activities.3 It is the same VA pension paid at a higher maximum rate, so the Aid and Attendance figure below is the ceiling on the whole pension, not an amount paid in addition to the basic rate.5,1

2026 Aid and Attendance Rates

The VA publishes these ceilings as annual maximums. It pays pension monthly: under 38 CFR 3.273, it subtracts your countable income from the applicable annual rate and divides what remains by 12.1

Set against New Hampshire's $96,300 median for assisted living, even the $34,488 ceiling for a veteran with one dependent covers a little over a third of a typical year's bill, and less once countable income is subtracted.1,2

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

VA pension is needs-based: to be eligible, your yearly family income and net worth have to fall within limits set by Congress, and the benefit is keyed to your income for VA purposes. You can lower that income by subtracting unreimbursed medical expenses (UMEs), but only the portion above 5 percent of your applicable Maximum Annual Pension Rate (MAPR), counting any increase for family members but not the increase for aid and attendance or being housebound.1 Health, medical, hospitalization, and long-term care insurance premiums count as medical expenses.1 An assisted-living bill falls under VA's rule for a care facility other than a nursing home. The facility must be licensed where the state requires it and, if residential, staffed with care providers 24 hours a day. Payments for assistance with daily activities count when the resident receives health or custodial care there and either needs Aid and Attendance or is housebound, or a physician, physician assistant, nurse practitioner, or clinical nurse specialist states in writing that the resident needs to be in a protected environment. Meals and lodging count when the facility provides or contracts for that care, or when one of those clinicians states in writing that the resident must live in the facility to receive it.1

For 2026, the VA states the floor this way: "If you have medical expenses, you may deduct only the amount that's above 5% of your MAPR amount ($872 for a Veteran with no spouse or child)."1 The floor is higher for a veteran with dependents, because it tracks the MAPR that includes increases for family members.

Only the amount above that floor is deductible. Where a New Hampshire stay meets those conditions, the qualifying fees above the floor come off income for VA purposes, and set against the state's $96,300 median for assisted living, the floor itself is a small slice. Lower income for VA purposes is what VA tests against its limits, and what it subtracts from the MAPR to set the payment.2,1

Who Qualifies

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

• Wartime service: any one of three service tests. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty with at least one day during a wartime period. A veteran who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months, or the full period for which they were called or ordered to active duty, with at least one day during wartime. An officer who started active duty after October 16, 1981 qualifies on that branch if they had not previously served on active duty for at least 24 months, again with at least one day during wartime. Recognized wartime periods include World War II, the Korean conflict, the Vietnam War era, and the Gulf War.
• Age, disability, or care status: any one of four alternatives satisfies this test. The veteran is at least 65 years old; or has a permanent and total disability; or is a patient in a nursing home for long-term care because of a disability; or is getting Social Security Disability Insurance or Supplemental Security Income. A permanent-and-total rating is not the only disability route: the nursing-home and SSDI/SSI branches stand on their own, so a wartime veteran under 65 who receives SSI meets this test with no adjudicated rating at all.
• Need for care: requires regular help with daily activities, such as bathing, dressing, or eating; or has to stay in bed, or spend a large portion of the day in bed, because of illness; or is a patient in a nursing home due to the loss of mental or physical abilities related to a disability; or has limited eyesight (5/200 or less in both eyes even with glasses or contacts, or a visual field contracted to 5 degrees or less)
• Net worth under $163,699: the VA's net-worth calculation counts the claimant's and their dependents' assets plus annual income, and excludes the primary home, a vehicle, and basic household items3

The VA also applies a 36-month (three-year) look-back on asset transfers, counted back from the date it receives the pension claim. If, in that window, the claimant transferred an asset for less than fair market value that would otherwise have caused or partly caused their net worth to exceed the limit, VA assesses a penalty period of up to 5 years.3

How Aid and Attendance Works with New Hampshire Medicaid

VA Aid and Attendance and New Hampshire Medicaid long-term care are separate programs administered by different agencies. The NH Department of Health and Human Services (DHHS) administers the state's Medicaid long-term care benefits, including nursing facility care and the Choices for Independence (CFI) home- and community-based waiver. It has its own income and asset limits.6

Under federal rules (38 CFR 3.551(i)), a veteran with no spouse or child, or a surviving spouse with no child, who is receiving Medicaid-covered nursing home care has the VA pension capped at $90 a month for any period after the month Medicaid payments begin. That cap does not reach care in a State veterans home that VA makes per diem payments for, so check the stay with an accredited Veterans Services Officer rather than assume the cap applies. Aid and Attendance is treated differently at each of Medicaid's two steps. Deciding eligibility, states apply SSI income rules to the aged, blind, and disabled groups (42 CFR 435.601), and under SSA POMS SI 00830.308 the Aid and Attendance allowance is not income for SSI purposes. But SSA lists New Hampshire among the 8 states that use at least one eligibility criterion more restrictive than the SSI program, so New Hampshire's own eligibility rule governs at that step and may differ; confirm how it treats the Aid and Attendance amount with DHHS before relying on it. After eligibility, New Hampshire figures a nursing facility resident's cost of care under 42 CFR 435.733, which says income disregarded in determining eligibility must be considered. Its manual runs the calculation in a fixed order: start from earned income less an employment expense disregard, plus all unearned income; subtract either the $90 VA nursing facility pension or a $93 personal needs allowance, never both added together; subtract income allocated to family members; subtract the resident's own health insurance premiums (including Medicare Part B), coinsurance and deductibles, needed care Medicaid does not cover, and unpaid prior medical debt; subtract continuing SSI benefits; where a physician has verified the stay will be 3 months or less and the resident is expected to return home, subtract an allowance to keep up the home; and only then add the Aid and Attendance allowance. The result is the amount the resident must apply toward the cost of care. That add-back can reach only a resident whose VA pension has not been cut to the $90 cap, such as a veteran with a spouse or a child. It does not reach a capped pension, because the $90 nursing facility pension is subtracted before anything is added back. For Choices for Independence and other home- and community-based services, New Hampshire's rule (He-W 854.12(b)) says the Aid and Attendance allowance shall be applied to the cost of care, so ask DHHS how the rest of that calculation works for you before you budget. The exact treatment depends on the household and the specific benefits involved, so families should confirm with a NH DHHS caseworker and an accredited Veterans Services Officer before relying on both.6

How to Apply and Get Help Filing

The steps below are the pension route. The VA states the condition plainly: "You may be eligible for this benefit if you get a VA pension and you meet at least 1 of these requirements." A veteran who receives VA disability compensation rather than a pension takes a different path, because VA Form 21-2680 also covers Aid and Attendance "that will be added to your monthly compensation or pension benefits." The wartime pension application below is not their route.5

To apply through the pension route, you need two forms:5

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance): a medical examiner must fill out its examination information section to document the need for assistance
• VA Form 21P-527EZ (Application for Veterans Pension): this is the wartime, means-tested pension application, so a wartime veteran pursuing the pension route who is not already receiving a VA pension files it along with Form 21-2680

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 attorney, accredited claims agent, or accredited Veterans Service Organization representative can help you file. Asked how long a decision takes, the VA's answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.5

Do not do this alone. The New Hampshire Division of Veterans Services employs Veterans Services Officers who assist New Hampshire residents and their dependents in securing the benefits they may be entitled to under state or federal law, and state law (RSA 110-B:85) charges the Division's director with a statewide structure that helps veterans and family members identify eligibility, file claims, and review claims decisions for appeals. The main office is in Manchester (275 Chestnut Street, Room 517; (603) 624-9230 / NH toll-free 1-800-622-9230); the Division says all locations are booked through that number and are by appointment only, and officers also meet veterans at visitation sites including the Manchester VA Medical Center, the Readiness Center in Nashua, the Gibson Center in North Conway, and the Readiness Center in Portsmouth. The Division lists its Tilton site as starting back up in January 2027.4

If Your Claim Is Denied

A denial is not the end of the road. After the VA issues its initial decision on a claim, you have three review options: file a Supplemental Claim with new and relevant evidence the VA did not have when it reviewed the case before, request a Higher-Level Review by a higher-level reviewer with no new evidence submitted, or file a Board Appeal for review by a Veterans Law Judge. Choose one. These are an election, not a menu you can work in parallel: under 38 CFR 3.2500(b), once you have filed under one of these options you may not file under a different one on the same claim or issue while that review is pending final adjudication, and none of them is open while the benefit is on appeal before a federal court. So pick the route that fits the reason you were denied rather than filing two to hedge.7 A Higher-Level Review or a Board Appeal generally has to be elected within one year of the date the VA issues notice of its decision, though the regulation carves out exceptions; in a contested claim, where several people claim a benefit only one can receive, the only route is a Board Appeal filed within 60 days. A Supplemental Claim can otherwise be filed at any time after that notice, but timing matters: one the VA receives more than one year after the decision notice takes an effective date no earlier than the date the VA receives it.7 An accredited attorney, claims agent, or Veterans Service Organization representative can help you request the review, and the VA's search tool will find one.7 New Hampshire law also charges the Division of Veterans Services with helping veterans review claims decisions for appeals.4

Compare Care Settings in New Hampshire

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 New Hampshire
• How Aid and Attendance Pays for In-Home Care in New Hampshire
• How Aid and Attendance Pays for Memory Care in New Hampshire

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.