A wartime veteran in North Carolina who needs daily help with bathing, dressing, or eating can collect a VA pension of up to $2,874 a month in 2026. That benefit is VA Aid and Attendance, the same federal pension paid at a higher maximum rate when a veteran needs regular care, so the figure caps the whole pension rather than adding to a veteran's existing check: $34,488 a year for a veteran with a spouse. Because it isn't a separate program you apply to on its own, it's easy to overlook when you're comparing ways to pay for care.

This guide walks through who qualifies, how much you can receive, how to apply, and where to get free help filing in North Carolina, including from the NC Division of Veterans Affairs and its accredited Veteran Service Officers.

In This Guide

What Is Aid and Attendance?

Aid and Attendance (A&A) is an enhanced VA pension benefit for wartime veterans and their surviving spouses who need help with everyday activities. It isn't a separate program. It's the same VA pension paid at a higher maximum rate when you need regular care, so the Aid and Attendance rate caps the single pension you receive; it is not a figure to add to the basic rate.

You may qualify if you need help with daily activities such as:

  • Bathing or showering
  • Dressing and undressing
  • Eating
  • Using the toilet
  • Adjusting prosthetic devices
  • Protecting yourself from everyday hazards

You can also qualify if you have to stay in bed, or spend a large portion of the day in bed, because of illness, if you're a patient in a nursing home because of a loss of mental or physical abilities related to a disability, or if you have limited eyesight (5/200 or less in both eyes, or a visual field contracted to 5 degrees or less).

A&A arrives as part of the veteran's monthly VA pension payment rather than as a payment to a care provider, so it can help with in-home care, assisted living, or nursing home costs alike. That flexibility is part of what makes it useful for North Carolina families piecing together long-term care.

Not sure whether your parent qualifies for Aid and Attendance? Check with Brevy's care navigator at brevy.com.

Do You Qualify?

Aid and Attendance rests on a baseline condition and four requirements. The baseline is that the veteran did not receive a dishonorable discharge. From there, all four of these must be met.

1. Wartime service. How much active duty the veteran needs turns on when their service began, not on which war it fell in. VA lists three ways to satisfy this test, and meeting any one of them is enough. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty. A veteran who entered active duty as an enlisted person after September 7, 1980 needs at least 24 months of active duty "(with some exceptions)," in VA's own words, or the full period for which they were called or ordered to active duty. And a veteran who was an officer and started active duty after October 16, 1981 qualifies if they had not previously served on active duty for at least 24 months. In each case at least one day of that service must fall during a recognized wartime period; qualifying periods include World War II, the Korean War, the Vietnam War, and the Gulf War. Because the 24-month rule carries exceptions, a post-1980 veteran with a shorter record is not automatically ruled out. If you're not sure which rule applies to your service dates, a county veterans service officer can read your DD-214 and tell you.

2. Age, disability, or care status. VA gives four alternatives here, and the veteran needs to meet only one: be at least 65 years old; 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 branches stand on their own, so a wartime veteran under 65 who receives SSI meets this test with no adjudicated disability rating at all.

3. Need for assistance. The veteran or surviving spouse must need regular help with daily activities, be bedridden, be in a nursing home, or have severely limited eyesight as described above.

4. Net worth under $163,699. This is the 2026 limit. VA's net worth calculation counts your and your dependents' assets plus your annual income combined, so comparing savings alone against the limit gives you the wrong answer. Your primary residence, your car, and basic home items don't count.

Surviving spouses qualify too. If the veteran has passed away and the surviving spouse needs help with daily activities, they can apply for the Survivors Pension with Aid and Attendance, worth up to $1,558 a month in 2026.

2026 Aid and Attendance Rates

The VA calculates your payment as the difference between your countable income and the Maximum Annual Pension Rate (MAPR) for your category. If your income is low enough, you receive the full amount. These rates are federal, so they're the same in North Carolina as anywhere else. The VA publishes them as annual amounts; the monthly figures below are the yearly rate divided by 12, which is how the payment arrives. Each row in the table is an alternative ceiling on the whole pension, not an amount that stacks on the row beneath it: a veteran who qualifies for Aid and Attendance is paid against the $29,093 rate instead of the $17,441 basic rate, never both.

Category Annual Rate Monthly Rate
Veteran, no dependents $29,093 $2,424
Veteran with spouse $34,488 $2,874
Two veterans married to each other (both A&A) $46,143 $3,845
Surviving spouse $18,697 $1,558
Veteran, no dependents (Housebound) $21,313 $1,776
Veteran, no dependents (basic pension) $17,441 $1,453
Each additional dependent +$2,984 +$248

Here's how the math works. If a veteran with a spouse has $12,000 in annual countable income and qualifies for A&A, the VA pays the difference: $34,488 minus $12,000 leaves $22,488 a year, or about $1,874 a month. Unreimbursed medical expenses can lower the income the VA counts, but only the portion above 5% of your MAPR, figured without the Aid and Attendance increase; the VA puts that threshold at $872 for a veteran with no spouse or child.

The Net Worth Limit and 3-Year Lookback

The 2026 net worth limit is $163,699. VA's calculation combines your and your dependents' assets (savings, investments, and property other than your home) with your annual income; it is not an assets-only test.

What counts: bank accounts, stocks, bonds, investment property, IRAs, and other financial assets, plus your annual income.

What doesn't count: your primary residence, your car, and basic home items. The house you live in doesn't push you over the limit, which matters for the many North Carolina veterans who own their homes outright but live on a modest fixed income.

The 3-Year Lookback Rule

The VA reviews any assets you transferred for less than fair market value in the three years before you file your claim. If you gave away or sold assets below market value to get under the net worth limit, the VA may impose a penalty period of up to five years during which you won't receive pension benefits.

This rule exists to stop people from simply giving away savings to qualify. If you're thinking about transferring assets, talk to a VA-accredited attorney or an elder law attorney first. The penalty can be steep, so it's worth getting advice before you move money.

How to Apply for VA Aid and Attendance in North Carolina

One form does double duty here, so it's worth knowing which route you're on. VA Form 21-2680 is used to apply for Aid and Attendance benefits "that will be added to your monthly compensation or pension benefits," so a veteran already receiving VA disability compensation uses the same exam form on the compensation side. The steps below are the pension route, the one this guide covers, where VA's condition is: "You may be eligible for this benefit if you get a VA pension."

1
Step 1

File an intent to file, if you're still gathering information

Submitting VA Form 21-0966 (Intent to File) starts the clock while you assemble the rest. VA says "submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive," and the form covers disability, Veterans pension, survivors pension, and DIC claims.

2
Step 2

Get a medical examination

A medical examiner fills out the examination information section of VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), documenting which daily activities you need help with and why. Be thorough. The more detail about specific limitations, the stronger the claim.

3
Step 3

Complete the pension application

A wartime veteran on this pension route who isn't already receiving a VA pension also files VA Form 21P-527EZ (Application for Veterans Pension), which covers service history, income, net worth, and medical conditions. A veteran adding Aid and Attendance to existing compensation doesn't use this form.

4
Step 4

Add the nursing home form if the claim involves one

For a claimant 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. Ask the facility or your county veterans service officer who completes it in your case, since VA's pages describe this differently.

5
Step 5

Submit everything

You can file online at va.gov, mail the forms to the VA Pension Intake Center, or file in person at a VA regional office; an accredited attorney, claims agent, or Veterans Service Organization representative such as your county veterans service officer can also file for you. Filing online lets you save your progress and track the claim.

6
Step 6

Wait for a decision

Asked how long a decision takes, VA answers: "It depends." It processes claims in the order it receives them, unless a claim requires priority processing. A complete application with strong medical documentation spares you a round of back-and-forth.

Documents to Gather First

  • DD-214 (discharge papers) showing wartime service dates
  • Medical records documenting the need for daily help
  • Income documentation (Social Security and pension statements)
  • Asset information (bank and investment statements)
  • Marriage certificate, if claiming as a veteran with a spouse
  • Death certificate, if applying as a surviving spouse

Free Help in North Carolina: NC DMVA and County Veterans Service Offices

You don't have to file this claim alone. Free, accredited help is available across North Carolina, and DMVA's answer to whether veterans have to pay for it is blunt: "Never. All services are 100% free."

NC Division of Veterans Affairs

The NC Division of Veterans Affairs, part of the North Carolina Department of Military and Veterans Affairs (NC DMVA), is the state office that connects North Carolina veterans and their families with the benefits and support they've earned. Its accredited Veteran Service Officers are trained professionals who give personalized, one-on-one support: a VSO helps you determine eligibility, gather evidence, and choose the right claim type, DMVA files the claim electronically through the VA system, and the VSO then monitors and tracks it and communicates with the VA. The help spans disability compensation, education, health care, and state veteran benefits, and it's open to any veteran, active-duty service member, National Guard member, reservist, or family member living in North Carolina.

The NC DMVA also operates the State Veterans Homes program, a network of skilled nursing facilities for eligible veterans. DMVA runs four full-service homes: Salisbury, Black Mountain, Kinston, and Kernersville, which held its ribbon-cutting on October 31, 2023. The long-running Fayetteville home is closed; DMVA shut it after identifying significant repair needs and structural deficiencies, helped its 85 residents relocate, and says a new facility is under consideration. Each active home provides 24/7 registered-nurse coverage, physical, occupational, and speech therapy, wound care, and hospice, and is approved for Medicare and Medicaid. Each state sets the eligibility and admission criteria for its own veterans homes, so ask the home's admissions office or the NC DMVA what North Carolina requires; each home also has a DMVA Veterans Service Officer who helps veterans and families apply for VA benefits. For a veteran weighing nursing care, an A&A award can help cover costs whether they stay at home or move into one of these homes.

County Veterans Service Officers

This is where most North Carolina veterans get hands-on help. Veteran Service Officers work out of the division's 12 State Veteran Centers; appointments are recommended but not required, and many counties accept walk-ins. A VSO can prepare and submit your claim, develop the evidence the VA needs, and guide you through a higher-level review, a supplemental claim, or a board appeal if the VA says no. You can find your nearest officer through DMVA's "Find your VSO" and State Veterans Service Officer pages, or call DMVA's toll-free line at 844-624-8387.

North Carolina's Veteran Population

North Carolina has one of the largest veteran populations of any state, with 682,184 veterans living here in FY 2024, according to the VA's National Center for Veterans Analysis and Statistics North Carolina state summary. That ranks the state 4th in the country, holding 3.8 percent of the nation's veterans, and 293,234 of those North Carolina veterans were 65 or older. With that many veterans, demand on county offices is real, so it's worth contacting yours early rather than waiting until a care crisis forces the issue.

A word of caution: be wary of companies that charge fees to help with VA claims. Asked whether veterans have to pay for VSO services, NC DMVA answers: "Never. All services are 100% free."

How VA Aid and Attendance Works with North Carolina Medicaid

Aid and Attendance is a veteran's or surviving spouse's VA pension paid at a higher maximum rate, and that higher maximum is the ceiling on the entire pension rather than a second amount paid alongside the basic rate, while North Carolina Medicaid is a separate program run under different rules. A veteran can receive both, but the two count money differently, so a few points are worth understanding.

  • NC Medicaid long-term care is income- and asset-tested. For Nursing Facility Medicaid or a Home and Community Based Services waiver, eligibility depends on your income and assets, and a beneficiary in a nursing home generally must contribute most of their income toward the cost of care, keeping only a small personal-needs allowance.
  • Aid and Attendance is not counted against you at the eligibility step. North Carolina applies SSI income methodologies to aged, blind, and disabled applicants (42 CFR 435.601) because it is not one of the eight states that elected the more restrictive 209(b) option, and under SSI methodology the VA aid and attendance and housebound allowances are not income (SSA POMS SI 00830.308), so only the basic pension counts toward the income limit. Eligibility is only the first step, though: once you are eligible and living in a nursing facility, income that was disregarded at eligibility must be counted in the share-of-cost calculation (42 CFR 435.725), so the Aid and Attendance amount does count toward the patient monthly liability you owe the facility. Before any of that income reaches the facility, 42 CFR 435.725(c) requires the state to deduct five amounts in order: a personal needs allowance for you, an amount for the maintenance needs of a spouse still at home, an amount for the maintenance needs of other family members at home, incurred medical or remedial care expenses Medicaid does not cover, and any SSI and state supplement payments you keep receiving. Those five are deductions the agency must make, not benefits you apply for. That section covers people in medical institutions and intermediate care facilities; a Home and Community Based Services waiver participant has a share of cost as well, but it is figured under a separate federal rule, so ask NC Medicaid how yours is set.
  • A nursing-home pension cap can apply. By federal statute, a veteran with neither a spouse nor a child who is covered by Medicaid for nursing facility services has the VA pension capped at no more than $90 a month for any period after admission.
  • Confirm your case before you rely on it. Because income-counting rules vary by Medicaid category and are applied case by case, confirm the exact treatment with a county veterans service officer, an accredited attorney, or NC Medicaid before you file.

For the bigger picture of how to protect assets while qualifying for long-term care coverage, start with our guide to Medicaid planning strategies.

Frequently Asked Questions

How much does VA Aid and Attendance pay in North Carolina in 2026?

The maximum depends on your situation. At the Aid and Attendance rate the whole pension is capped at $2,424 a month for a veteran alone, $2,874 a month for a veteran with a spouse, and $1,558 a month for a surviving spouse. These are federal rates, identical in North Carolina. Your actual payment is reduced by your countable income, and unreimbursed medical expenses above 5% of your MAPR can lower that countable income.

Where can I get free help applying in North Carolina?

Contact the NC Division of Veterans Affairs, part of the NC Department of Military and Veterans Affairs, through its "Find your VSO" pages or its toll-free line at 844-624-8387. Its accredited Veteran Service Officers prepare and submit VA claims, and DMVA says its services are 100% free.

Can I receive Aid and Attendance and North Carolina Medicaid at the same time?

Yes. A veteran can receive both, but they count money differently. NC Medicaid long-term care is income- and asset-tested, and because North Carolina uses SSI income methodology rather than the 209(b) option, the Aid and Attendance allowance is not counted as income at the eligibility step; only the basic pension is. It does count later, in the share-of-cost calculation of what a nursing-facility resident owes. And a veteran with neither a spouse nor a child who is covered by Medicaid for nursing facility services has the VA pension capped at no more than $90 a month after admission. Because the rules are applied case by case, confirm your situation with a county veterans service officer, an accredited attorney, or NC Medicaid before applying.

How long does it take to get approved?

VA's own answer is "It depends." It works claims in the order it receives them, unless a claim requires priority processing. Incomplete applications draw follow-up requests that stall a claim, so have the medical examiner be detailed on VA Form 21-2680 and submit all supporting documents at once.

Learn More

VA BenefitsNorth Carolina Disabled Veteran Property Tax ExemptionNorth Carolina's disabled veteran property tax exemption excludes $45,000 of a qualifying home's value. Here's who qualifies and how to file Form NCDVA-9. VA BenefitsHow to Get VA Aid and Attendance in TexasLearn about VA Aid and Attendance benefits in Texas for 2026. Covers eligibility, monthly rates up to $2,874, how to apply, and free help from Texas VSOs. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. Care TypesNursing Homes in North CarolinaNursing homes in North Carolina in 2026: what a skilled nursing facility costs, how to check a facility's quality, and how Medicaid pays for nursing-home care. Care TypesAssisted Living in North CarolinaAssisted living in North Carolina costs about $6,496/month. What an adult care home is, how Special Assistance helps low-income seniors, and how to vet one. Care TypesThe Cost of Senior Care in North CarolinaWhat senior care costs in North Carolina in 2026: assisted living about $6,496 a month, a nursing home about $116,800 a year. See every setting and how to pay.
Your next step Find personalized help applying for VA Aid and Attendance in North Carolina at brevy.com.

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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