VA Aid and Attendance in North Dakota (2026)

A wartime veteran with a spouse in North Dakota who needs daily help with bathing, dressing, or eating can draw a VA pension of up to $34,488 a year in 2026.1 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. The pension itself is paid monthly.1 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 Dakota, including from the North Dakota Department of Veterans Affairs and your county or tribal veterans service officer.

In This Guide

• Key Takeaways
• What Is Aid and Attendance?
• Do You Qualify?
• 2026 Aid and Attendance Rates
• The Net Worth Limit and 3-Year Lookback
• How to Apply for VA Aid and Attendance in North Dakota
• Free Help in North Dakota: NDDVA and County Veterans Service Officers
• How VA Aid and Attendance Works with North Dakota Medicaid
• Frequently Asked Questions

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 is where the pension maximum lands once the allowance is built in, not a second figure stacked on the basic rate.1

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're bedridden, are a patient in a nursing home because of a loss of mental or physical abilities related to a disability, or have limited eyesight (5/200 or less in both eyes, or a visual field contracted to 5 degrees or less).2

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.1 That flexibility is part of what makes it useful for North Dakota families piecing together long-term care.

Do You Qualify?

The veteran must not have received a dishonorable discharge, and these four requirements all have to be met.2

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 paths, and meeting any one of them satisfies the test. 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), or the full period for which they were called or ordered to active duty. A veteran who started on active duty as an officer after October 16, 1981 and had not previously served on active duty for at least 24 months falls under the third path. In every 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. A post-1980 veteran with fewer than 24 months isn't automatically out, so if you're not sure which rule applies to your service dates, your county or tribal veterans service officer can read your DD-214 and tell you.1

2. Age or disability, any one of four. VA lists four alternatives here, and the veteran needs only one of them: being at least 65 years old; having a permanent and total disability; being a patient in a nursing home for long-term care because of a disability; or 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.2

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 combines the claimant's and their dependents' assets with their annual income, so comparing savings alone against the limit gives the wrong answer. Your primary residence, your car, and basic home items are excluded.2

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, capped at $18,697 a year in 2026.1

2026 Aid and Attendance Rates

The MAPR is the maximum amount of pension payable, and the VA pays the difference between your income for VA purposes and that limit. If your income is low enough, the payment reaches that maximum. These rates are federal, so they're the same in North Dakota as anywhere else. VA publishes these rates as annual amounts. Your monthly payment is worked out from them by a rule in federal regulation: your rate minus your countable income, divided by 12, and rounded down to the whole dollar.1 Each rate below is an alternative ceiling on the whole pension, not an amount that stacks: a veteran who qualifies for Aid and Attendance is paid against the $29,093 rate instead of the $17,441 basic rate, never both.1

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, which VA divides by 12, rounding down to the whole dollar, to set the monthly payment.1 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.1

The Net Worth Limit and 3-Year Lookback

The 2026 net worth limit is $163,699. VA's calculation combines your assets and your dependents' assets (savings, investments, and property other than your home) with annual income for VA purposes, not gross income: VA may first subtract deductible expenses, such as medical costs you aren't reimbursed for.2

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

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 Dakota 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 36 months (three years) before it receives your claim.2 If you gave away or sold assets below market value and keeping them would have put you over the net worth limit, the VA will assess a penalty period of up to five years during which you won't receive pension benefits.2 Putting money into an annuity, a trust, or another investment that lowers your net worth also counts as a transfer for less than fair market value, unless you can cash out the whole balance for your own use, in which case VA counts it as net worth.2

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 Dakota

The steps below are the pension route: VA states you may be eligible for this benefit if you get a VA pension. VA Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation benefits, so a veteran who receives VA disability compensation rather than pension uses that form and skips the pension application in step 3.3

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 Dakota: NDDVA and County Veterans Service Officers

You don't have to file this claim alone. Free help is available across North Dakota, and NDDVA states that all services are provided at no cost to veterans and their dependents.4

The North Dakota Department of Veterans Affairs (NDDVA)

The North Dakota Department of Veterans Affairs, known as NDDVA, is the state agency that connects veterans and their families to the federal, state, and local benefits they earned, including federal VA pension benefits like Aid and Attendance. NDDVA doesn't decide your VA claim itself (the federal VA does that), but it provides personalized assistance with claims, healthcare, education, employment, and financial support, delivered directly or through the dedicated County and Tribal Veterans Service Officers it trains and supports. Its stated mission is to make sure North Dakota veterans and their families receive all the benefits they're entitled to, and all services are provided at no cost to veterans and their dependents.4

North Dakota law also requires the state to maintain a veterans' home in Lisbon: the North Dakota Veterans Home, on a 90-acre wooded campus bordering the Sheyenne River. The Home provides two levels of long-term care: a Basic Care unit designed for residents who care for their own personal needs independently (bathing, dressing, eating, walking, toileting, and transferring), with medical and nursing supervision available; and a Skilled Care unit, a licensed Medicare/Medicaid provider, for residents who need ongoing nursing supervision or help with activities of daily living. The Home's own site lists 98 basic care beds and 52 skilled nursing beds, while NDDVA's page for the Home gives 111 and 38, so ask the Home what is open when you apply. Since 1893 the Home has served honorably discharged veterans and their spouses. Admission rules come from state law and administrative rules, including North Dakota residency (which can be waived for an applicant who served in a North Dakota regiment or was accredited to the state), and the Home's board of admissions must approve each application.5 For a veteran weighing a move into long-term care, an A&A award can help cover costs whether they stay at home or move into the Home.

County and Tribal Veterans Service Officers

This is where the day-to-day help happens. North Dakota's county and tribal veterans service officers are trained and supported by NDDVA, and their help is free.4 NDDVA says county service officers provide free, professional assistance with health care, compensation, pensions, long-term care, and burial benefits, and describes tribal service officers the same way, with all services provided free of charge to veterans and their dependents. NDDVA says every North Dakota county is legally required to appoint and fund a service officer under NDCC 37-14-18 and 37-14-19, though state law lets one officer serve more than one county, so the office covering you may sit in a neighboring county.4

You can find your local service officer through the NDDVA "Find a Service Officer" directory. Because North Dakota is a rural state with offices spread across many counties, it's worth contacting yours early rather than waiting until a care crisis forces the issue.4

North Dakota's Veteran Population

North Dakota has a small veteran population in absolute terms: 46,477 veterans in fiscal year 2025, down from 47,474 in FY 2024, according to the FY2025 North Dakota state summary from the VA's National Center for Veterans Analysis and Statistics. These are modelled estimates rather than a headcount.6 Of the FY 2025 figure, 18,429 (39.7 percent) are 65 or older, below the national share of 45.8 percent.6 Contact your service officer early to get your claim moving.

A word of caution: be wary of companies that charge fees to help with VA claims. NDDVA and your county or tribal veterans service officer provide their assistance at no cost to veterans and their dependents.4

How VA Aid and Attendance Works with North Dakota Medicaid

Aid and Attendance and North Dakota Medicaid long-term care are run separately, by different agencies and under different rules. The VA administers A&A, and North Dakota Health and Human Services administers Medicaid. A veteran or surviving spouse can be eligible for both, but the two count money differently, so a few points are worth understanding.7

• A&A income doesn't automatically disqualify you from North Dakota Medicaid. Where a VA pension including Aid and Attendance keeps being paid alongside Medicaid, because you have a spouse or dependents, say, eligibility is only the first step: income that was disregarded in determining eligibility must be counted in the share-of-cost calculation, so the Aid and Attendance amount counts toward what you owe toward the cost of care in a nursing facility.7 Before any of that income goes to the facility, though, North Dakota's own post-eligibility rule allows six deductions, in this order: the nursing care income level; amounts for the maintenance needs of a spouse or family member; health insurance premiums; long-term care insurance premiums for you or your spouse; documented medical or remedial care expenses that no third party, Medicaid and Medicare included, will pay; and the cost of a guardian or conservator, up to 5% of countable gross monthly income.7 What you owe the facility is what remains after all six, and those are deductions the state applies, not benefits you apply for.7 Home- and community-based waiver services are a different case: the federal and North Dakota post-eligibility rules described here cover nursing facilities and other institutions, not waiver services at home, so ask North Dakota HHS how Aid and Attendance is treated if you get waiver services.7
• North Dakota Medicaid long-term care has its own income and asset limits. North Dakota Medicaid covers nursing facility services for Medicaid-eligible residents who need regular or daily services of a licensed nurse, and eligibility is decided under North Dakota's own rules, so qualifying for A&A tells you nothing about whether you qualify for Medicaid.7
• VA pension can be capped for Medicaid nursing home residents. As a general federal rule, when an unmarried veteran or surviving spouse with no dependents is receiving Medicaid-covered nursing home care, the VA pension (including Aid and Attendance) is reduced to no more than $90 a month, which the resident keeps.7 The cap does not reach a beneficiary with a spouse or dependents, or one receiving home- and community-based waiver services instead of Medicaid-covered nursing home care.7 Nor does it reach a veteran in a State veterans home for which VA pays a per diem for nursing home care, so if you're weighing the skilled care unit at the North Dakota Veterans Home, ask your service officer whether the cap applies there.8 North Dakota's post-eligibility rule lists that $90 of VA improved pension as income that may be disregarded for a veteran or surviving spouse with neither spouse nor child in a Medicaid-approved nursing facility, but how it combines with the state's other deductions is set by that same rule, so ask North Dakota HHS rather than assuming the amounts add up.7
• Confirm your case before you rely on it. Because the rules interact in complex ways and depend on marital status, dependents, and unreimbursed medical expenses, confirm your specific situation with a VA-accredited service officer and North Dakota HHS before relying on both benefits.7

For the bigger picture of how to protect assets while qualifying for long-term care, see our guide to Medicaid Planning Strategies.

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.