VA Aid and Attendance is one of the most overlooked ways to pay for in-home care in Oregon. It is a monthly payment the VA adds to a VA pension, or to monthly compensation, for veterans and surviving spouses who need another person's help with everyday activities.,, What you pay an in-home aide can also count as a medical expense that lowers your income for VA purposes, which raises the payment. With Oregon's long-term care costs among the highest in the country, 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

How Much In-Home Care Costs in Oregon

Oregon's long-term care costs are among the highest in the nation. According to the CareScout 2025 Cost of Care Survey (released March 2026), non-medical in-home care in Oregon runs about $91,520 a year, based on roughly 44 hours of care a week. CareScout now reports this as a single "non-medical caregiver" rate, merging the former homemaker and home health aide categories.

These are survey medians, not government figures. CareScout collects its rates by metropolitan area, so a single statewide median averages markets that differ from one another and is not the price any one Oregon community charges. CareScout's annual figure assumes 44 hours a week at about $40 an hour, so 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.

How Aid and Attendance Helps Pay for In-Home Care in Oregon

Aid and Attendance is an increased monthly pension for veterans and surviving spouses who need another person's help with daily activities., It comes as a monthly payment added to your pension, not as care the VA arranges, so the in-home care itself is yours to set up.

Who Maximum Annual Pension Rate
Veteran alone Up to $29,093
Veteran with one dependent Up to $34,488
Surviving spouse Up to $18,697

The VA publishes these as Maximum Annual Pension Rates, effective December 1, 2025 through November 30, 2026, and they are yearly amounts. Pension is paid monthly, and the regulation sets the math: VA subtracts your countable income from the applicable rate, divides what is left by 12, and rounds down to the whole dollar. The MAPR is a ceiling, not a payment: the VA bases what it pays on the difference between your income for VA purposes and that limit, so a veteran with other income receives less than the maximum.

The top rate in the table is $34,488 a year, for a veteran with one dependent. CareScout puts about 44 hours a week of non-medical care in Oregon at $91,520 a year, so plan on the benefit covering part of the bill, not all of it.

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

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 Congress sets. Because the benefit is keyed to your income for VA purposes, lowering that income is what opens the door.

In-home care has its own rule in the regulation, at 38 CFR 3.278(d)(2). What you pay an in-home attendant for help with the activities of daily living and the instrumental activities of daily living counts as a medical expense as long as the attendant provides 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 must be a health care provider unless one of two things is true: the veteran needs Aid and Attendance or is housebound, or 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. The expense also has to be unreimbursed to be deductible.

Only the portion of those costs above 5% of your applicable Maximum Annual Pension Rate (MAPR) is deductible. For a veteran with no spouse or child, that floor is $872 a year. It rises if you have dependents, but it is figured on the MAPR excluding the Aid and Attendance or housebound increase, so it never rises because of that increase.

Say a veteran with no dependents pays $35,000 a year for an aide. Subtract the $872 floor, and about $34,128 can be deducted from countable income. That deduction can take a veteran who looked "over income" and bring them within the limit, and because VA pays the difference between your income for VA purposes and the MAPR, a lower countable income also means a larger pension. So if your income looks too high on paper, apply anyway once care costs are in the picture.

Who Qualifies

To qualify for Aid and Attendance, the veteran must:

  • Not have received a dishonorable discharge. This is VA's baseline condition for the pension that Aid and Attendance increases.
  • Meet the wartime service requirement. VA lists three paths, keyed to when active duty began: active duty that began before September 8, 1980, with at least 90 days of active duty and at least one day during a wartime period; enlisted service that began after September 7, 1980, with at least 24 months (VA writes it "with some exceptions") or the full period for which the veteran was called or ordered to active duty, again with at least one day during wartime; or active duty that began as an officer after October 16, 1981, where the veteran had not previously served on active duty for at least 24 months, again with at least one day during wartime.
  • Meet at least one of four age-or-disability conditions. Any single one is enough: being 65 or older; 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. A wartime veteran under 65 who receives SSI meets this test without any adjudicated disability rating.
  • Meet one of the need-for-care tests. Any one of these is enough: needing another person's help on a regular basis with daily activities (the 38 CFR 3.352(a) list, which covers being unable to dress or undress or keep yourself ordinarily clean and presentable, frequent adjustment of a prosthetic or orthopedic appliance, being unable to feed yourself, being unable to attend to the wants of nature, or needing care on a regular basis to protect you from the hazards of your daily environment); or being bedridden; or being a patient in a nursing home because of a loss of mental or physical abilities related to a disability; or having eyesight of 5/200 or less in both eyes, or a visual field contracted to 5 degrees or less.
  • Have a net worth below $163,699. VA's net worth calculation combines the claimant's and their dependents' assets and annual income, excluding the primary home and a vehicle, so comparing savings alone against the limit gives the wrong answer.

Because those need-for-care tests are alternatives, a veteran who lives at home is not shut out: needing the regular help is itself the qualifying test, and the nursing-home route is only one of several.

For the net worth calculation, assets exclude your primary residence, your car, and basic home items like appliances that you would not take with you if you moved., The home's exclusion covers a residential lot of up to 2 acres; marketable land beyond that counts as an asset. The VA applies a 3-year look-back on assets transferred for less than fair market value before you file, and a transfer that would have pushed net worth over the limit can trigger a penalty period of up to 5 years. A surviving spouse can qualify for Aid and Attendance as part of Survivors Pension, under the same $163,699 net worth limit.

Using Aid and Attendance to Pay a Family Caregiver

If you want a son, daughter, or other relative to provide the care, that does not stand in the way of the benefit: under 38 CFR 3.352(c), a relative or another member of the household providing the aid and attendance will not prevent VA from granting the allowance. VA's in-home care rule also does not require the attendant to be a health care provider when the person cared for needs Aid and Attendance, and what you pay an in-home attendant for help with daily activities counts as a medical expense when the attendant provides health care or custodial care and the payments match the hours of care actually provided. Before you plan around paying a relative, and especially a spouse, ask an accredited representative how VA will treat those payments in your case.

There is also a separate VA program built around hiring your own caregivers. Veteran-Directed Care (VDC) is a VA Geriatrics and Extended Care program that gives an enrolled veteran a flexible budget, managed by the veteran or their representative, to hire and supervise their own workers so they can live at home or in their community. Through that budget, veterans may also hire family, friends, or neighbors to provide services. VA medical centers deliver VDC through aging and disability network agencies, such as Area Agencies on Aging and aging and disability resource centers, where an options counselor helps with assessment and care planning, arranges fiscal management services, and provides ongoing counseling and support. All enrolled veterans are eligible for VDC if they are eligible for community care, meet the clinical criteria for the service, and it is available, so ask your VA social worker whether it is offered in your area.

How Aid and Attendance Works with Oregon Medicaid

An Oregon senior can potentially receive both VA pension with Aid and Attendance and Oregon Health Plan (OHP) Medicaid long-term-care benefits, but the two programs count income differently. For VA purposes, your countable income is reduced by unreimbursed medical expenses that exceed 5% of the applicable pension limit, which is how the cost of care can bring a higher-income applicant within VA limits.

For OHP Medicaid eligibility, Oregon applies SSI income rules, under which the Aid and Attendance allowance is not counted as income at all, so only the basic pension counts toward the income limit. Oregon's own rule, OAR 461-145-0580, says the same thing for its OSIP and OSIPM clients: aid-and-attendance and housebound payments are excluded when determining eligibility. Eligibility is only the first step, though. For residents of medical institutions and intermediate care facilities, federal rules require income that was disregarded in determining eligibility to be considered in the post-eligibility calculation (42 CFR 435.725). Oregon's rule then counts the entire aid-and-attendance payment as unearned income when it calculates monthly service benefits or patient liability for an OSIP or OSIPM client receiving long-term care or home and community-based care. So an Aid and Attendance amount VA is still paying at the full rate, for example to a veteran who has a spouse or a child, or for the month of admission, counts toward a nursing-facility resident's patient liability, subject to the federal VA limits below. Not all of the income that counts reaches the facility. The state must deduct a personal-needs allowance for clothing and other personal needs (federal law sets a floor of $30 a month for an individual, and a state may protect more), amounts for a spouse or family at home, and incurred medical expenses that no third party pays. Those are amounts the agency has to take off, not benefits you apply for. We could not confirm Oregon's own personal-needs allowance, or whether Oregon raises it for a resident who receives a VA pension based on unreimbursed medical expenses, so ask OHA about both. One federal rule can shrink the pension itself. If Medicaid covers nursing-facility care for a veteran with no spouse or child, or for a surviving spouse with no child, VA pension is capped at $90 a month after the month of admission, and that reduced amount is treated as an Aid and Attendance allowance, not income. Federal law also bars that $90 from reducing what Medicaid pays the nursing facility. With the pension capped, there is no full-rate Aid and Attendance amount left for Oregon's patient-liability rule to count. The cap does not reach a State home for which VA pays a per diem for nursing home care, and a separate federal rule governs pension in such a home, so check an Oregon Veterans' Home stay with an accredited veteran service officer and confirm with OHP/OHA how the federal and Oregon rules apply together. If you receive home and community-based services at home instead of living in a facility, 42 CFR 435.725 does not state your share of cost. Oregon's rule above does count the full Aid and Attendance payment for OSIP and OSIPM clients receiving home and community-based care, but it is not the whole of Oregon's waiver liability rule, so confirm your own case with OHP/OHA. One more Oregon rule matters when a VA award arrives late: if you are an OSIP or OSIPM client and a payment covers a past period of eligibility, you must turn over the full amount, up to the cost of the institutional and home and community-based care you received in those months, and failing to do so is an overpayment of public assistance. Because the two programs use different income tests and the interaction is fact-specific, confirm your own situation with an accredited veteran service officer and OHP/OHA before relying on dual eligibility.

How to Apply and Get Free Help

These steps are the pension route, the one this guide covers: VA's condition is that you may be eligible if you get a VA pension. Everyone uses VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination section a medical examiner fills out; that form covers Aid and Attendance that will be added to your monthly compensation or pension benefits. A wartime veteran pursuing the pension route who is not already receiving a VA pension also files VA Form 21P-527EZ (Application for Veterans Pension). Form 21P-527EZ is the wartime, means-tested pension application, so it is not the form for a veteran whose Aid and Attendance would be added to VA disability compensation. If you are still gathering information, you can file 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. You can file online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office, and an accredited attorney, claims agent, or Veterans Service Organization representative can help you file. On how long a decision takes, the VA's answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.

Do not do this alone. The Oregon Department of Veterans' Affairs (ODVA) notes on its VA pension page that individuals and organizations are available to help you file a VA pension claim free of charge. ODVA's county services page gives you a drop-down and an interactive map for reaching veteran services and resources in your county, and ODVA's general inquiries line is 800-692-9666 or 503-373-2085.

If the VA denies your claim or pays less than you expected, an initial decision opens three review options: a Supplemental Claim (file new and relevant evidence the VA did not have before), a Higher-Level Review (a higher-level reviewer looks at the case, with no new evidence submitted), or a Board Appeal to the Board of Veterans' Appeals, where a Veterans Law Judge reviews the case. Choose one. These are an election, not a menu you can work in parallel: under 38 CFR 3.2500(b), once you have filed under one of these options you may not file under a different one on the same claim or issue while that review is pending final adjudication, and none of them is open while the benefit is on appeal before a federal court. So pick the route that fits the reason you were denied rather than filing two to hedge. A Higher-Level Review must be requested within one year of the date on the decision letter for an initial claim or Supplemental Claim, and a Board Appeal within one year of the date on the decision letter for an initial claim, a Supplemental Claim, or a Higher-Level Review. One exception runs shorter: if you are one of several people claiming a benefit that only one of you can receive, your only route is a Board Appeal, filed within 60 days of the date VA issues notice of the decision. A Supplemental Claim can still be filed after that year, but filing within one year protects your effective date: a Supplemental Claim received more than one year after the date on the decision notice takes an effective date no earlier than the date the VA receives it, which can cost back pay reaching to your original claim date. The menu also changes as the case moves. After a Higher-Level Review decision, the options are a Supplemental Claim or a Board Appeal (there is no second Higher-Level Review), and after a Board decision, a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, filed within 120 days of the date on the Board's decision letter. Address that one to the Court, not to the VA. A notice of appeal that is properly addressed and mailed is deemed received on the date of the legible U.S. Postal Service postmark on the envelope, so a notice postmarked within the 120 days is on time even if it arrives at the Court afterward. An accredited attorney, claims agent, or Veterans Service Organization representative can help you request the review.

Frequently Asked Questions

Can Aid and Attendance be used to pay for in-home care in Oregon?

It can help, in two ways. Aid and Attendance is a monthly payment added to a VA pension, and the higher Aid and Attendance rate raises the ceiling on what VA can pay., What you pay an in-home attendant for help with daily activities can also count as an unreimbursed medical expense, which lowers your countable income and so raises the payment.

How much does Aid and Attendance pay toward home care?

The 2026 maximum annual pension rate with Aid and Attendance is $29,093 for a veteran, $34,488 with one dependent, and $18,697 for a surviving spouse. VA pays it monthly: it subtracts your countable income from that rate, divides the rest by 12, and rounds down to the whole dollar. That maximum is a ceiling, not the payment: the VA pays the difference between your income for VA purposes and the limit, so a veteran with other income receives less.

My income seems too high. Should I still apply?

Often, yes. Your ongoing in-home care costs count as unreimbursed medical expenses and can be deducted from your countable income, but only the portion above 5% of your applicable annual pension limit ($872 a year for a veteran with no spouse or child, and more if you have dependents). Large care bills can bring an "over income" veteran within the limit.

Can I pay my daughter to care for me with this benefit?

A relative can provide the care without costing you the benefit: a relative doing the caregiving does not stop VA from granting the allowance. The Veteran-Directed Care program is another route: it gives an enrolled veteran a flexible budget to hire their own workers, who may include family, friends, or neighbors. Ask your VA medical center social worker whether it is available locally, and ask an accredited representative before counting on paying a spouse.

Compare Care Settings in Oregon

See how Aid and Attendance applies in other care settings in Oregon:

Learn More

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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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