VA Aid and Attendance for Assisted Living in New Hampshire

For a New Hampshire veteran facing a steep assisted-living bill, VA Aid and Attendance pays up to $2,874 a month toward the cost of care, and a surviving spouse can receive up to $1,558 a month. New Hampshire ranks among the most expensive states in the country for assisted living, which makes using every available benefit critical. Yet most families who qualify for Aid and Attendance never apply, because they do not know the program exists.1

This guide covers what assisted living costs in New Hampshire, how Aid and Attendance can help offset those costs, how the care expenses themselves can improve eligibility, and how to get free help applying.

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 Free Help
• Frequently Asked Questions
• Learn More

How Much Assisted Living Costs in New Hampshire

New Hampshire has long ranked among the most expensive states in the country for assisted living. The most recent national benchmark, CareScout's 2025 Cost of Care Survey (released in 2026), puts the median cost of assisted living at about $6,200 per month (roughly $74,400 per year) nationwide, and New Hampshire has consistently run well above that national line across recent surveys.2

Costs vary within the state and rise as care needs increase. The actual monthly bill depends on the facility, location, and level of care required, and in New Hampshire families should generally expect to pay more than the national median.

For New Hampshire veteran families, making assisted living affordable requires using every available benefit.

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

VA Aid and Attendance is a pension benefit for veterans and surviving spouses who need help with daily activities. The VA pays it as a monthly cash benefit that can be applied to any care-related expense, including assisted living. 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.1

2026 Aid and Attendance Rates

The VA publishes these ceilings as annual maximums; the monthly payment is that yearly amount divided by 12.1

At $2,874 a month for a veteran with a spouse, the benefit covers close to half of the national median assisted living cost of about $6,200 a month. Because New Hampshire's costs run above that national line, the benefit covers a smaller share of a typical New Hampshire bill, but in a state where care is this expensive, that monthly benefit can still be the difference between affording a good facility and not being able to.1,2

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

Many families do not realize that the cost of care can actually help them qualify for the benefit.

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, and so do care costs where there is a documented need for the care.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 expenses above that floor are deductible. But in New Hampshire, where families routinely pay more than the national median of about $6,200 a month for assisted living ($74,400 a year), a large share of that cost, above the 5-percent floor, can be deducted where the care qualifies as an unreimbursed medical expense. That can substantially reduce countable income and bring a veteran within qualifying limits.2

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. 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 in a nursing home due to mental or physical incapacity; or has severe vision loss
• 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 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 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.5

Under federal rules, a single veteran or surviving spouse on Medicaid-covered nursing home care generally has the VA pension reduced to a small personal-needs allowance for the duration of that institutional coverage. Aid and Attendance is treated differently at each of Medicaid's two steps. Deciding eligibility, DHHS applies 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. New Hampshire is one of only 8 states that elected the more restrictive 209(b) option, so its own eligibility rule governs at that step and may differ; confirm how it treats the Aid and Attendance amount with the Department of Health and Human Services before relying on it. After eligibility, for someone receiving care in a nursing facility or other medical institution, income that was disregarded at the eligibility step is counted in the share-of-cost calculation (42 CFR 435.725), so the Aid and Attendance amount does count toward what the resident owes the facility. Before that income reaches the facility, federal law requires the state to subtract five things from it, in this order: a personal needs allowance the resident keeps for clothing and other personal needs; an additional amount for the maintenance needs of a spouse still at home; an additional amount for the maintenance needs of other family members at home; amounts for incurred medical or remedial care expenses that Medicaid does not pay for; and the full amount of any SSI or state supplement payments the resident keeps receiving. Those are duties DHHS owes the resident, not options a family has to ask for. One New Hampshire wrinkle matters on the first of them: a nursing facility resident entitled to the VA nursing facility pension has that VA amount protected instead of the state's personal needs allowance, not on top of it, so the two are never added together. That share-of-cost rule is written for people in a nursing facility or other medical institution. Choices for Independence waiver services are governed by a separate federal post-eligibility rule, and the maintenance allowance a waiver participant keeps is set differently and is generally much larger, so ask DHHS which calculation applies to you before you budget for one. 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.5

How to Apply and Get Free Help

The steps below are the pension route, the one most assisted-living families use. The VA states the condition plainly: "You may be eligible for this benefit if you get a VA pension." 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.6

To apply through 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 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.6

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, generally by helping them file claims for compensation or pension benefits with the VA; as state employees, they represent the veteran throughout the claim process, and the Division's benefits guide says the service is provided free of charge. The main office is in Manchester (275 Chestnut Street, Room 517; (603) 624-9230 / NH toll-free 1-800-622-9230), which schedules all appointments, 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, the Readiness Center in Portsmouth, and the Veterans Home in Tilton.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. A Higher-Level Review or a Board Appeal has to be elected within one year of the date the VA issues notice of its decision for most VA benefits, and because certain benefits carry shorter time limits, the decision letter is where your actual deadline appears; a Supplemental Claim can be filed at any time after that notice, though the VA recommends filing within one year to keep your effective date. That recommendation carries real money: a Supplemental Claim the VA receives more than one year after the date on the decision notice takes an effective date no earlier than the date the VA receives it, so filing late can cost back pay that would otherwise reach to the original claim date.7 An accredited attorney, claims agent, or Veterans Service Organization representative, including a New Hampshire Veterans Services Officer, can help you request the review, and the VA's search tool will find one.7

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.