VA Aid and Attendance can help a wartime veteran or surviving spouse pay for a nursing home in New Hampshire, where the cost of care is among the highest in the country. It is a monthly pension benefit, not a nursing-home program, so the money goes to the veteran and can be applied to the bill. This guide explains how much the benefit pays, how nursing-home costs can actually lower your countable income, who qualifies, and the one rule that catches most families off guard: once Medicaid is covering nursing-facility care for a veteran with neither a spouse nor a child, federal law caps the VA pension at $90 a month.

In This Guide

How Much a Nursing Home Costs in New Hampshire

Nursing-home care in New Hampshire is expensive. Per CareScout's 2025 Cost of Care Survey, the most recent data (released in 2026), the national median for a semi-private nursing home room is about $114,975 per year (roughly $315 a day) and about $129,575 per year for a private room. New Hampshire is consistently one of the most expensive states in the country for senior care, so families here should generally expect to pay well above the national figure. These are industry-survey medians, not government numbers, and costs vary within the state and rise as care needs grow.

Those costs are why so many New Hampshire families look at every benefit a veteran has earned. Aid and Attendance will not cover the full bill, but it can close a meaningful part of the gap and, in combination with Medicaid, change what a family can afford.

How VA Aid and Attendance Helps Pay for a Nursing Home in New Hampshire

Aid and Attendance is a higher VA pension rate for veterans (and surviving spouses) who need help with daily activities or are a patient in a nursing home because of a loss of mental or physical abilities related to a disability. The money is paid to the veteran, who can use it toward nursing-home charges.

Category Yearly maximum (MAPR) Per month (yearly divided by 12)
Veteran with no dependents $29,093 About $2,424
Veteran with one dependent $34,488 About $2,874
Surviving spouse, no dependents $18,697 About $1,558

These are 2026 rates, effective December 1, 2025 through November 30, 2026. The VA publishes them as yearly Maximum Annual Pension Rates, and the monthly payment is the yearly award divided by 12. Those figures cap the whole pension; they are not the size of the check. The VA sets the payment at the difference between your income for VA purposes and the MAPR, so a veteran with other income receives less than the maximum. Even so, against a semi-private nursing-home bill that runs about $9,580 a month at the national median and higher in New Hampshire, a full award at about $2,424 covers a real slice of the cost, and a household awarded less than the ceiling covers a correspondingly smaller share., The benefit is more powerful once you understand how the care bill itself lowers your income for VA purposes.

How Nursing Home Costs Lower Your Countable Income

VA pension, including the Aid and Attendance increase, is needs-based: to be eligible, your yearly family income and net worth have to meet limits Congress sets. You can lower your income for VA purposes by deducting unreimbursed medical expenses, and nursing-home fees count. VA's regulation is unusually direct about this setting: payments to hospitals, nursing homes, medical foster homes, and inpatient treatment centers, "including the cost of meals and lodging charged by such facilities, are medical expenses" (38 CFR 3.278(d)(1)). There is no clinician-certification step for a nursing home, unlike the separate rules VA applies to in-home attendants and to assisted living. The payments must be unreimbursed to be deductible.

There is a floor. Only the portion of those expenses that exceeds 5% of your applicable MAPR is deductible, counting the MAPR before any Aid and Attendance or housebound increase. For 2026 that threshold is $872 per year for a veteran with no spouse or child, and it rises for a veteran with dependents.

A nursing-home bill dwarfs that floor. For example, a veteran paying the national median of about $114,975 a year for a semi-private room (New Hampshire families typically pay more) subtracts the first $872, leaving roughly $114,103 in deductible medical expense, far more than enough to bring a veteran who first looked too "high income" within the limit.,

Who Qualifies

To qualify for Aid and Attendance, a veteran must meet these tests:

  • Wartime service. The length-of-service test turns on when the veteran entered active duty, not on which war. A veteran who started on 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 on 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, again with at least one day during wartime. An officer who started on active duty after October 16, 1981 and had not previously served on active duty for at least 24 months falls under that same 24-month requirement.
  • No dishonorable discharge, plus any one of four conditions. The veteran must be at least 65 years old, or have a permanent and total disability, or be a patient in a nursing home for long-term care because of a disability, or be getting Social Security Disability Insurance or Supplemental Security Income. Meeting any single one of the four satisfies this test, so a wartime veteran under 65 who receives SSI qualifies without an adjudicated permanent-and-total rating.
  • Net worth under $163,699 for 2026. The calculation includes the claimant's and dependents' assets and income for VA purposes; assets exclude the primary residence, the car, and basic home items like appliances you would not take with you if you moved.
  • A need for aid and attendance. VA's criteria include being unable to dress or undress yourself or keep yourself ordinarily clean and presentable, being unable to feed yourself, being unable to attend to the wants of nature, needing frequent adjustment of a special prosthetic or orthopedic appliance, or a physical or mental incapacity that requires care or assistance on a regular basis to protect you from hazards in your daily environment. Being bedridden qualifies, so does being a patient in a nursing home because of a loss of mental or physical abilities related to a disability, and so does limited eyesight (5/200 or less in both eyes even with glasses or contact lenses, or concentric contraction of the visual field to 5 degrees or less).

The VA applies a 3-year look-back on assets transferred for less than fair market value before filing.

The $90/Month Nursing-Home Pension Cap

Here is the rule families miss most often. Under federal law, when a single veteran with no spouse or dependent children is covered by Medicaid for nursing-facility care, the VA reduces the pension, including the Aid and Attendance amount, to no more than $90 per month for any period after the month of admission. This is set by 38 U.S.C. 5503(d)(2) and carried out at 38 CFR 3.551.

The same rule applies to a surviving spouse who has no child. Federal law also protects the $90 from the facility: the payment a nursing facility receives under a Medicaid plan may not be reduced by any amount of pension the veteran is permitted to keep.

One thing families are often told incorrectly: whether that $90 comes in addition to the state's Medicaid personal needs allowance or instead of it is not settled by federal law. The federal statute caps the pension and bars the offset; the personal needs allowance is a deduction set in each state's own post-eligibility rules, and states differ (Rhode Island, for one, provides the $90 instead of its own monthly allowance rather than on top of it). Do not add the two together before asking New Hampshire DHHS how it treats the $90.

In plain terms: once Medicaid is footing the nursing-home bill, you do not also keep the full Aid and Attendance payment. The benefit matters most while you are private-paying or before Medicaid kicks in.

How Aid and Attendance Works with New Hampshire Medicaid

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

A veteran may qualify for both, but under federal rules a veteran with neither a spouse nor a child who is receiving Medicaid-funded nursing-home care generally has the VA pension reduced to a small monthly amount for the duration of that coverage: no more than $90 a month, as described above. That $90 is capped pension, and calling it New Hampshire's Medicaid personal needs allowance is a common mistake: the two are set by different bodies of law, and whether the $90 comes on top of the state allowance or in place of it depends on New Hampshire's own post-eligibility rules. The eligibility step and the share-of-cost step treat the money differently. For eligibility, states apply SSI income rules to the aged, blind, and disabled Medicaid groups, and under those rules VA aid and attendance and housebound allowances are not counted as income. 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. Once a person is eligible and receiving nursing-facility or Choices for Independence waiver services, a share-of-cost calculation applies. Where 42 CFR 435.725 governs, meaning individuals in medical institutions and intermediate care facilities in SSI states, income that was disregarded at the eligibility step becomes part of the income from which the required deductions are made, and it can raise the amount the resident owes. Those deductions are not open-ended: the agency deducts "Amounts for incurred expenses for medical or remedial care that are not subject to payment by a third party", and the category covering care that is recognized under State law but not covered under the State plan is "subject to reasonable limits the agency may establish". That federal rule does not settle New Hampshire, which is a 209(b) state rather than an SSI state, and on its face it does not reach home- and community-based waiver services such as Choices for Independence, so ask NH DHHS which post-eligibility rule applies to you instead of assuming the federal result. Because the treatment depends on your household, confirm with a NH DHHS caseworker and an accredited Veterans Services Officer before relying on both.

How to Apply and Get Free Help

The steps below are the pension route, the one VA describes with the condition "You may be eligible for this benefit if you get a VA pension." Apply using VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination information section a medical examiner must fill out to document the need for care. That same form also covers Aid and Attendance "that will be added to your monthly compensation or pension benefits," so a veteran receiving VA disability compensation rather than pension uses it too. A wartime veteran pursuing the pension route who is not already receiving VA pension also files VA Form 21P-527EZ (Application for Veterans Pension), which is the means-tested wartime pension application and is not the right form for a compensation claim. For a veteran who is a patient in a nursing home, VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance) will also need to be filled out. Forms can be submitted online at VA.gov, by mail to the VA Pension Intake Center, in person at a VA regional office, or through an accredited representative. On how long a decision takes, VA's own answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.

Do not do this alone. New Hampshire's Division of Veterans Services employs Veterans Services Officers who help resident veterans and their dependents file pension and compensation claims with the VA and represent them through the process; the Division's own benefits guide says the service is free of charge. The main office is in Manchester at (603) 624-9230 or NH toll-free 1-800-622-9230, and it schedules every appointment, including the ones held at the Manchester VA Medical Center and in Nashua, North Conway, Portsmouth, and at the New Hampshire Veterans Home in Tilton.

Frequently Asked Questions

Does the VA pay for a nursing home in New Hampshire?

Not directly through Aid and Attendance. Aid and Attendance is a cash pension benefit paid to the veteran, who applies it toward the nursing-home bill. The pension is income you direct, not a facility the VA operates.

How much will Aid and Attendance pay toward a New Hampshire nursing home?

The 2026 maximum pension including the Aid and Attendance increase is $29,093 a year, about $2,424 a month, for a veteran with no dependents; $34,488 (about $2,874 a month) with one dependent; and $18,697 (about $1,558 a month) for a surviving spouse. Those are ceilings: the VA pays the difference between your income for VA purposes and the limit, so a household with other income is awarded less. Against a semi-private nursing-home cost of about $114,975 a year at the national median (and typically higher in New Hampshire), even a full award covers part of the bill, not all of it, and a smaller award covers less.,

What happens to Aid and Attendance once Medicaid pays for the nursing home?

For a veteran with neither a spouse nor a child on Medicaid-covered nursing-facility care, federal law caps the VA pension at $90 a month after the month of admission, and the same rule reaches a surviving spouse with no child. The facility's Medicaid payment cannot be reduced because the veteran keeps that $90. Whether the $90 is on top of, or instead of, New Hampshire's Medicaid personal needs allowance is set by state post-eligibility rules and varies by state, so ask NH DHHS rather than assuming the two stack.

Can a nursing-home bill help a "high income" veteran qualify?

Yes. The VA lets you deduct unreimbursed medical expenses, including nursing-home fees, above a small floor ($872 a year for a veteran with no spouse or child). A large care bill can reduce countable income enough to qualify someone who first appeared over the limit.

Compare Care Settings in New Hampshire

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

Learn More

VA BenefitsVA Aid and Attendance in New HampshireVA Aid and Attendance in New Hampshire for 2026: who qualifies, rates up to $2,874 a month, how to apply, and free help filing your claim in NH. VA BenefitsVA Benefits for Senior Care in New HampshireA guide to VA senior care benefits in New Hampshire: home care, nursing homes, Aid and Attendance, the state veterans home, and how to access them in 2026. Care TypesNursing Homes in New HampshireNursing homes in New Hampshire in 2026: costs run well above the national median. What a stay costs, who pays, and how to vet a facility before you choose. VA BenefitsHow VA Aid and Attendance Pays for Assisted LivingHow VA Aid and Attendance helps pay for assisted living: the 2026 monthly amounts, the medical-expense rule, who qualifies, and how to apply for the benefit. VA BenefitsVA Benefits for Senior Care: A Complete GuideA complete guide to VA benefits for senior care: long-term care, Aid and Attendance, pensions, DIC, and home grants for older veterans and surviving spouses.
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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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