VA Aid & Attendance for In-Home Care in New York

VA Aid and Attendance is one of the most overlooked ways to pay for in-home care in New York. It is a monthly cash benefit paid as part of a VA pension for veterans and surviving spouses who need help with everyday activities, and the money can go straight toward a home health aide, a homemaker, or a family member who provides the care. For a New York family trying to keep a parent at home, that steady payment can change what is affordable.

This guide explains what in-home care costs here, how much Aid and Attendance pays, how your care costs can actually help you qualify, and where to get free help applying.

In This Guide

• Key Takeaways
• How Much In-Home Care Costs in New York
• How VA Aid and Attendance Helps Pay for In-Home Care in New York
• How In-Home Care Costs Lower Your Countable Income for Aid and Attendance in New York
• Who Qualifies
• Using Aid and Attendance to Pay a Family Caregiver
• How Aid and Attendance Works with New York Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much In-Home Care Costs in New York

In-home care in New York is a major expense. According to the CareScout 2025 Cost of Care Survey, released March 2, 2026, a non-medical caregiver at home runs about $80,080 a year, based on 44 hours of care a week for 52 weeks, which is exactly the national median of $80,080.2 Worth noting if you are comparing against older figures: the 2025 survey merged homemaker services and home health aide work into that single non-medical caregiver category, so there is no longer a separate survey median for each.2

These are survey medians, not government figures, and costs vary widely across the state, with New York City and downstate generally higher than upstate. The real number for your family depends on how many hours of care your loved one needs. Either way, a steady monthly benefit takes pressure off the budget.

Care isn't the only line worth attacking. Because the veteran is staying in their own home, a second New York benefit can trim the housing side of the same budget: if the veteran has a service-connected disability rating, the state reduces the assessed value the home is taxed on, claimed at the municipal assessor. Our guide to the New York disabled veteran property tax exemption walks through the rules and the deadline.

How VA Aid and Attendance Helps Pay for In-Home Care in New York

Aid and Attendance is a higher pension rate for veterans and surviving spouses who need another person's help with daily activities such as bathing, feeding, and dressing, who are bedridden because of illness, who are in a nursing home because of a disability, or whose eyesight is severely limited.1 The award is paid monthly as part of your VA pension, and you arrange the care yourself. Many New York families put it directly toward a home health aide, a homemaker, or a family caregiver.

Read those figures as ceilings, not as checks. The VA sets the payment on the difference between your income for VA purposes and the rate that applies to you, so a household with countable income receives less than the number above; the VA publishes the rates annually, and a monthly payment is the yearly award divided by 12, rounded down to the whole dollar.1 That is also why the deduction in the next section matters so much: lowering the income the VA counts raises the check.

The VA does not run or provide the care itself, and it does not pick your aide or agency. It pays the benefit, and you arrange the care. A New York veteran with one dependent and little countable income could receive close to the full $34,488 a year, paid monthly, enough to cover a meaningful share of a part-time aide or homemaker.1

How In-Home Care Costs Lower Your Countable Income for Aid and Attendance in New York

Here is the part many families miss. VA pension, including the Aid and Attendance increase, is a needs-based benefit: to be eligible, your yearly family income and net worth have to meet limits set by Congress. Because eligibility is keyed to income for VA purposes, the lower your countable income, the better your position.1

What you pay an in-home attendant for help with daily activities and household tasks is a deductible medical expense, on conditions the VA spells out for in-home care specifically. The attendant has to provide health care or custodial care, and the payments have to be commensurate with the number of hours the attendant actually attends to the person. The attendant also has to be a health care provider, unless the person needs aid and attendance or is housebound, or unless a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that, because of a physical, mental, developmental, or cognitive disorder, the person requires the health care or custodial care the attendant provides. Those two exceptions are what let a family hire a non-clinical aide and still deduct the bill. Payments only count if they are unreimbursed, so whatever insurance or another program pays back does not count.1

Only the portion of those costs above 5% of your annual MAPR, counted without the aid-and-attendance or housebound increase, is deductible. For 2026 the VA puts that floor at $872 a year for a veteran with no spouse or child, and $1,141 for a veteran with one dependent.1

Say a veteran with no spouse or child pays $32,000 a year for an aide. Subtract the $872 floor, and about $31,128 can be deducted from countable income. That deduction can take a veteran who looked "over income" and bring them within the limit. So if your income looks too high on paper, apply anyway once care costs are in the picture.1

Who Qualifies

To qualify for Aid and Attendance, the veteran must not have received a dishonorable discharge, and must also:5

• Meet the wartime service requirement, which turns on when service began. VA lists three paths. For active duty that started before September 8, 1980: at least 90 days of active duty with at least one day during a wartime period. For enlisted service that started after September 7, 1980: at least 24 months (with some exceptions), or the full period for which the veteran was called or ordered to active duty, with at least one day during wartime. For a veteran who started on active duty as an officer after October 16, 1981: not having previously served on active duty for at least 24 months, with at least one day during wartime.5,1
• Meet at least one of four tests, any one of which is enough: be 65 or older; have a permanent and total disability; 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. The nursing-home and SSDI/SSI routes stand on their own, so a wartime veteran under 65 who receives SSI meets this test without any disability rating.5
• Need aid and attendance under the criteria at 38 CFR 3.352(a), such as being unable to dress or undress, keep clean and presentable, feed oneself, or attend to the wants of nature, or needing regular care to stay safe from the hazards of daily life. Being bedridden qualifies, as does being a patient in a nursing home because of a loss of mental or physical abilities related to a disability, as does eyesight of 5/200 or less in both eyes or a visual field contracted to 5 degrees or less.5
• Have a net worth within the $163,699 limit. VA's net-worth calculation is the sum of the claimant's and their dependents' assets and annual income, so comparing assets alone against that limit gives the wrong answer.5 Assets exclude the primary residence, the veteran's car, and basic home items such as appliances.1

The VA applies a 3-year look-back on assets transferred for less than fair market value before you file.5 Surviving spouses can also receive Aid and Attendance through Survivors Pension, which uses the same $163,699 net worth limit.1

Using Aid and Attendance to Pay a Family Caregiver

Many New York families want a son, daughter, or other relative to provide the care. The pension arrives as cash, so it can go toward paying that person, and what you pay an in-home attendant counts as a deductible medical expense on the conditions set out above, as long as the payments track the hours the attendant actually works.1 VA's rules also say that a relative or another household member providing the care does not stop VA from granting the Aid and Attendance allowance.5

There is also a VA program built for this. Veteran-Directed Care (VDC) is a VA Geriatrics and Extended Care program that gives enrolled veterans of any age a flexible budget, managed by the veteran or a representative, to hire and supervise their own workers, including family, friends, and neighbors.3 Enrolled veterans are eligible if they are eligible for community care, meet the clinical criteria for the service, and it is available. VA medical centers deliver VDC through aging and disability network agencies, such as area agencies on aging, where an options counselor helps assess needs and plan care, arranges fiscal management services, and offers ongoing support.3

How Aid and Attendance Works with New York Medicaid

Aid and Attendance is a federal VA pension benefit, administered by the U.S. Department of Veterans Affairs and separate from New York Medicaid, which is run by the New York State Department of Health. A veteran or surviving spouse can receive both at the same time, but each program counts income and assets under its own rules.6

Keep the two rulebooks apart. The unreimbursed-medical-expense deduction described earlier is a VA rule that lowers the income the VA counts; it is not how Medicaid treats your income. For Medicaid, federal rules handle VA pension income in two separate steps. At the eligibility determination, the state applies SSI income methodologies to aged, blind, and disabled applicants (42 CFR 435.601), and under SSI methodology the Aid and Attendance allowance is not income, so only the basic pension amount counts toward the income limit. Confirm the treatment for your own case with the New York State Department of Health. At the post-eligibility step (the share-of-cost calculation for someone already found eligible and living in a medical institution), the federal rule says income disregarded at eligibility must be considered. New York's own budgeting rule, in the Department of Health's Medicaid Reference Guide, sets the result for a nursing-home resident in permanent absence status: starting the month after permanent absence is established, Aid and Attendance is not applied toward the cost of care. A resident who is not in permanent absence status is not covered by that rule, so confirm how the allowance is budgeted in your case with your local department of social services. For a resident those rules do cover, deducting incurred medical expenses is a duty the state owes rather than a favor it does, and it is not the only deduction in the calculation, so do not assume medical expenses are the only thing that comes off before the share is set. If your care comes at home through a home and community-based waiver or a Managed Long Term Care plan, none of the rules just described settles your post-eligibility calculation, so ask the New York State Department of Health which rule applies to your setting. Ask your local department of social services for the full list of deductions and the amounts New York applies to your case, including any allowance for a spouse still living at home. New York also lets some people divert excess income into a pooled trust run by a nonprofit, but only a person certified as disabled can use one, and if you are married and budgeted under spousal impoverishment rules, as in a Managed Long Term Care plan, income you place in the trust still counts.6 Because the two programs interact, a veteran weighing both should talk with a benefits counselor familiar with New York Medicaid, and can get free help with the VA side from DVS's Veterans Benefits Advisors.6

How to Apply and Get Free Help

The steps here are the pension route: VA frames Aid and Attendance as a benefit you may be eligible for if you get a VA pension. The examination form, VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination section a medical examiner fills out, also covers Aid and Attendance that will be added to monthly compensation benefits, so a veteran receiving VA disability compensation rather than a pension still uses it. VA Form 21P-527EZ (Application for Veterans Pension) is the wartime, means-tested pension application, filed by a wartime veteran pursuing the pension route who is not already receiving a VA pension. If you are still gathering information, you can submit VA Form 21-0966 (Intent to File) first, because submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive.7 You can file 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 answer is "It depends." It processes claims in the order received, unless a claim requires priority processing.7

Do not do this alone, and you do not have to pay anyone to file. The New York State Department of Veterans' Services (DVS) connects veterans and families to local, state, and federal benefits. Its Veterans Benefits Advisors, all veterans themselves, prepare and file VA claims free of charge, help gather supporting documents, and can file claims or appeals on your behalf.4 Reach an advisor at 1-888-838-7697, book a phone or video consultation online, or use DVS's search to find a services office near you.4

Compare Care Settings in New York

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

• How Aid and Attendance Pays for Assisted Living in New York
• How Aid and Attendance Pays for a Nursing Home in New York
• How Aid and Attendance Pays for Memory Care in New York

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.