VA Aid and Attendance for assisted living in North Dakota gives qualifying veterans and surviving spouses a monthly benefit that can be used to help pay for care. North Dakota assisted living costs are below the national median, which means Aid and Attendance covers a meaningful share of actual bills. Most families who qualify never apply because they do not know the program exists or assume they earn too much.

This guide explains what assisted living costs in North Dakota, how Aid and Attendance can help offset those costs, how care expenses can improve eligibility, and how to apply with free help from the state.

In This Guide

How Much Assisted Living Costs in North Dakota

North Dakota assisted living costs are below the national median. According to the 2024 CareScout/Genworth Cost of Care Survey, the median cost of assisted living in North Dakota is about $5,335 per month (roughly $64,020 per year), compared with a national median of approximately $70,800 per year.

Costs vary within the state and rise as care needs increase. Fargo, Bismarck, and Grand Forks tend to run higher than rural areas. The actual monthly bill depends on the facility, location, and level of care required.

How Aid and Attendance Helps Pay for It

VA Aid and Attendance is a pension benefit for veterans and surviving spouses who need help with daily activities. The VA pays it as a monthly cash benefit that can be applied to any care-related expense, including assisted living.

2026 Aid and Attendance Monthly Rates

Category Monthly Amount
Veteran alone Up to $2,424
Veteran with spouse Up to $2,874
Surviving spouse Up to $1,558

At $2,874 a month for a veteran with a spouse, the benefit covers roughly 54 percent of the North Dakota median assisted living cost. Combined with Social Security or other income, many North Dakota families can make assisted living work.

Not sure whether your family qualifies for Aid and Attendance? Chat with Brevy for a quick eligibility check.

How Assisted-Living Costs Lower Your Countable Income

A feature of Aid and Attendance that surprises many families: the cost of assisted living can help you qualify for the benefit.

The VA calculates pension by comparing your countable income to the Maximum Annual Pension Rate (MAPR). Before making that comparison, it lets you subtract unreimbursed medical expenses (UMEs) that exceed 5 percent of your MAPR. Assisted-living costs, in-home care costs, and health insurance premiums all count as UMEs when the facility provides health or custodial care.

The 5-percent floors for 2026 are:

  • $872 for a veteran with no dependents (5% of the $17,441 MAPR)
  • $1,141 for a veteran with one dependent (5% of the $22,839 MAPR)

Only the portion of expenses above those floors is deductible. But if your loved one is paying $5,335 a month for assisted living, that is $64,020 a year. After subtracting the floor, the deductible amount is large and can reduce countable income enough to qualify a veteran who initially appeared to earn too much.

Who Qualifies

To qualify for VA Aid and Attendance, a veteran must meet all four requirements:

  • Wartime service: at least 90 days of active duty with at least one day during a recognized wartime period (WWII, Korea, Vietnam, or the Gulf War/post-9/11 era)
  • Age or disability: age 65 or older, or permanently and totally disabled
  • Need for care: requires help with at least two Activities of Daily Living, such as bathing, dressing, or eating; or is in a nursing home due to mental or physical incapacity; or has severe vision loss
  • Net worth under $163,699: includes assets and annual income, but excludes the primary home, one vehicle, and basic household items

The VA also enforces a three-year look-back on asset transfers. If assets were moved for less than fair market value in the three years before filing, a penalty period may apply.

How Aid and Attendance Works with North Dakota Medicaid

VA Aid and Attendance and North Dakota Medicaid long-term care are separate programs administered by different agencies. North Dakota Health and Human Services administers the state's Medicaid long-term care program, covering nursing facility services for eligible low-income residents who meet the state's income and asset limits.

Under general federal rules, when an unmarried veteran or surviving spouse with no dependents is receiving Medicaid-covered nursing home care, the VA pension is generally reduced to no more than $90 per month as a personal needs allowance. Because the rules interact in complex ways depending on marital status, dependents, and unreimbursed medical expenses, families should confirm their specific situation with a VA-accredited service officer and North Dakota HHS before relying on both benefits.

How to Apply and Get Free Help

To apply for Aid and Attendance, you need two forms:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance): a physician completes this to document the need for assistance
  • VA Form 21P-527EZ (Application for Veterans Pension): submit this if the veteran is not already receiving a VA pension

Forms can be submitted online at va.gov, mailed, or filed through an accredited representative. Processing typically takes three to six months.

Do not do this alone. The North Dakota Department of Veterans Affairs (NDDVA) and its network of County and Tribal Veterans Service Officers provide free, accredited claims help for pension and Aid and Attendance applications across the state. Veterans are not required to join any organization to receive assistance. Find a local service officer at veterans.nd.gov.

Ready to start the application? Chat with Brevy to get a step-by-step plan for your family's situation.

Frequently Asked Questions

No. The VA pays Aid and Attendance as a monthly benefit to the veteran or surviving spouse. The recipient uses those funds to pay their care bills, including assisted living costs. The VA does not operate or directly fund assisted living facilities.

Possibly. The VA subtracts unreimbursed medical expenses that exceed 5 percent of the applicable MAPR from countable income before comparing it to the pension rate. For a veteran with no dependents, only expenses above $872 a year are deductible; for a veteran with one dependent, the floor is $1,141. Ongoing assisted-living and in-home care costs can reduce countable income enough to bring a higher-income applicant within limits.

Processing typically takes three to six months from the date the VA receives a complete application. Working with a NDDVA service officer or accredited County/Tribal Veterans Service Officer reduces the risk of errors that cause delays.

The net worth limit is $163,699 for 2026. This includes both assets and annual income, but excludes the primary home, one vehicle, and basic household items. The VA also enforces a three-year look-back on asset transfers made for less than fair market value.

Compare Care Settings in North Dakota

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

Learn More

Find personalized help paying for assisted living with VA benefits in North Dakota 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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.