VA Aid and Attendance can help a wartime veteran or surviving spouse pay for a nursing home in New Hampshire, where nursing-home costs run well above the national median. It is an increase added to a monthly VA pension, not a nursing-home program. Unreimbursed nursing-home fees can lower the income VA counts against that pension. But 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. CareScout's 2025 Cost of Care Survey (released March 2, 2026) puts the New Hampshire median for a semi-private nursing home room at $146,913 per year ($12,243 a month) and for a private room at $161,330 per year ($13,444 a month). Both run well above the national medians of about $114,975 a year (roughly $315 a day) for a semi-private room and about $129,575 a year for a private room. These are industry-survey medians, not government numbers, and costs vary within the state and rise as care needs grow.

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

Aid and Attendance is a higher VA pension rate for a veteran who gets a VA pension and meets at least one need-based requirement, such as needing another person's help with daily activities like bathing, feeding and dressing, or being a patient in a nursing home due to the loss of mental or physical abilities related to a disability. VA publishes a separate Aid and Attendance rate for a surviving spouse on Survivors Pension.

Category Yearly maximum (MAPR)
Veteran with no dependents $29,093
Veteran with one dependent $34,488
Surviving spouse, no dependents $18,697

These are 2026 rates, effective December 1, 2025 through November 30, 2026. The VA publishes them as yearly Maximum Annual Pension Rates but pays pension monthly: under 38 CFR 3.273, the monthly rate is your MAPR less your countable income, 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 New Hampshire semi-private nursing-home median of $146,913 a year, a full award of $29,093 a year 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)). That nursing-home branch of the regulation sets no clinician-statement condition, unlike the separate branches for in-home attendants and for care facilities other than a nursing home, such as 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 New Hampshire's median of $146,913 a year for a semi-private room subtracts only the first $872, so nearly all of that bill, if unreimbursed, counts as a deductible medical expense, which can 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 also meets this test by having started on active duty after October 16, 1981 without having previously served on active duty for at least 24 months, with at least one day during wartime.
  • 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 meets this test without an adjudicated permanent-and-total rating.
  • Yearly family income and net worth within the limits Congress sets. The net worth limit is $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).

VA also looks back 36 months (3 years) from the date it receives the pension claim. If, during that period, you transferred an asset for less than fair market value that would otherwise have caused or partly caused your net worth to exceed the limit, VA assesses a penalty period of up to 5 years.

The $90/Month Nursing-Home Pension Cap

Under federal law, when a veteran who has neither a spouse nor a child is covered by Medicaid for nursing-facility care, the VA limits the pension, including the Aid and Attendance amount, to no more than $90 per month. The statute, 38 U.S.C. 5503(d)(2), starts the cap after the month of admission to the nursing facility, while VA's implementing regulation, 38 CFR 3.551(i), starts it after the month in which the Medicaid payments begin. If you were admitted as a private payer before Medicaid started, those can be different months, so confirm with VA which date it applied to your award.

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.

The cap does not reach every nursing home. The statute's definition of a nursing facility leaves out a State home for which VA makes per diem payments for nursing home care, so a beneficiary whose Medicaid-covered care is in such a home is outside the $90 cap. Whether a particular New Hampshire veterans home is one VA makes that payment for is something to confirm with an accredited Veterans Services Officer. In that setting federal Medicaid law applies its own rule for a veteran with no spouse or child, or a surviving spouse with no child, who receives a pension above $90 a month after being found eligible for Medicaid: any pension above $90 a month, including Aid and Attendance, is counted as income only for the purpose of applying it to the State home's cost of nursing home care.

Federal law does not decide whether the $90 comes in addition to a state's Medicaid personal needs allowance or instead of it; each state's own post-eligibility rules do, and states differ. New Hampshire's rule answers it. Its nursing-facility cost-of-care calculation subtracts either the $90 nursing facility pension or a $93 personal needs allowance, so a resident entitled to the $90 pension has that $90 protected instead of the $93, never the two added together.

In plain terms: once Medicaid is paying for a New Hampshire nursing-facility stay, the Aid and Attendance money does not stay fully in your pocket. A pension capped at $90 keeps only the $90, and for a resident whose pension is not capped, the Aid and Attendance allowance is added back into what the resident must pay toward the cost of care, as the next section explains.

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 a veteran without a spouse or child, or a surviving spouse without a child, who is receiving Medicaid-covered nursing home care has the VA pension capped at no more than $90 a month, as described above. That $90 is capped pension, set by federal law, while New Hampshire's $93 personal needs allowance is set by the state's own post-eligibility rules; in New Hampshire a resident gets one or the other, and the two do not add together. 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 resident is eligible, New Hampshire's own rule sets the share of cost. For nursing facility care, its administrative rule (He-W 854.17) and the DHHS cost-of-care instructions start from the resident's income, subtract either the $90 nursing facility pension or the $93 personal needs allowance, then subtract income allocated to family members, the resident's own health insurance premiums (including Medicare Part B), coinsurance and deductibles, necessary care that Medicaid does not cover, and a few other set items. Only after all of those deductions is the VA Aid and Attendance allowance added back, and the result is the amount the resident must pay toward the cost of care. That add-back reaches only a resident whose VA pension has not been reduced to the federal $90 cap, such as a veteran who has a spouse or a child. A capped $90 pension is subtracted in the earlier step, not added back, and federal law bars reducing the nursing facility's Medicaid payment by any amount of pension paid under the cap. New Hampshire bases that step on 42 CFR 435.733(c), the federal post-eligibility rule for states using more restrictive requirements than SSI, which says income disregarded at eligibility "must be considered in this process." 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 is applied to the cost of care; ask a NH DHHS caseworker how the rest of that calculation works for you. 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 and you meet at least 1 of these requirements." 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), the pension claim itself. 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) is also needed; a nursing home official uses it to verify the veteran is a patient in a qualifying extended care facility. 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 assist resident veterans and their dependents in securing the state and federal benefits they may be entitled to, and state law (RSA 110-B:85) charges the Division with a statewide structure that helps veterans and families identify eligibility, file claims and review claims decisions for appeals. Filing itself should cost you nothing: VA says no one can charge a claimant for preparing or filing an application for VA benefits without violating the law, and VA-accredited attorneys and agents may not charge for services on an initial claim. The Division's main office is in Manchester at (603) 624-9230 or NH toll-free 1-800-622-9230. Officers also meet veterans in person at visitation sites around the state, including the Manchester VA Medical Center, the armories in Nashua and Portsmouth, and the Gibson Center for Senior Services in North Conway; the Division lists its Tilton site as starting back up in January 2027. It says all locations are by appointment only, booked through (603) 624-9230, and also invites veterans to contact the site most convenient to them.

Frequently Asked Questions

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

Not directly through Aid and Attendance. Aid and Attendance is an increase added to a monthly VA pension, not a nursing-home program. Its amount depends on your income for VA purposes: VA pays the difference between that income and the Maximum Annual Pension Rate.

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

The 2026 maximum annual pension rate including the Aid and Attendance increase is $29,093 for a veteran with no dependents, $34,488 with one dependent and $18,697 for a surviving spouse with no dependents; VA pays it monthly, dividing the annual amount left after countable income by 12. 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 New Hampshire semi-private nursing-home median of $146,913 a year, 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, and the same rule reaches a surviving spouse with no child. The statute starts the cap after the month of admission and VA's regulation after the month Medicaid payments begin, so confirm the date with VA. The facility's Medicaid payment cannot be reduced because the veteran keeps that $90. In New Hampshire, the $90 is protected instead of the state's $93 personal needs allowance, not on top of it, and a State home that VA makes per diem payments to for nursing home care is outside the cap.

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 unreimbursed care bill can reduce countable income enough to bring someone who first appeared over the limit within it.

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, up to $2,874 a month for a veteran with a spouse, how to apply, and where to get help 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 annual pension limits, the medical-expense rule, who qualifies, and how to apply. 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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