VA Aid and Attendance for Memory Care in South Dakota

When Alzheimer's or another dementia makes living alone unsafe, VA Aid and Attendance can help a wartime veteran or surviving spouse pay for memory care in South Dakota.1

If you are arranging dementia care for a veteran parent, this benefit can add hundreds of dollars a month to what the family already has, and the way the VA counts care costs often makes a parent eligible even when their income looks too high at first glance. This guide walks through what it pays, why dementia usually qualifies, and how to apply.1

In This Guide

• Key Takeaways
• How Much Memory Care Costs in South Dakota
• How Aid and Attendance Helps Pay for Memory Care in South Dakota
• Why Veterans With Dementia Often Qualify
• How Memory Care Costs Lower Your Countable Income for Aid and Attendance in South Dakota
• Who Qualifies
• How Aid and Attendance Works with South Dakota Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much Memory Care Costs in South Dakota

South Dakota does not issue a separate memory-care license. Instead, dementia care is built into the licensing of assisted living centers and nursing facilities overseen by the South Dakota Department of Health, where a "memory care unit" is a defined, regulated part of a facility: a secured environment designed to maximize residents' functioning, promote safety, and encourage independence, staffed by people trained to meet the needs of the residents admitted to it.2 Because memory care is a unit within a larger license rather than its own license, it is worth confirming that a facility operates a recognized memory care unit, asking how its staff are trained for dementia, and reviewing how it secures the environment and plans for wandering before you choose it.2

South Dakota's facility care is among the most affordable in the country. Per the CareScout 2025 Cost of Care Survey, assisted living runs about $4,900 a month, roughly $58,800 a year, one of the lowest figures in the nation and well below the national median of about $74,400 a year ($6,200 a month).3 Nursing home care is also below the national line, at about $9,444 a month ($113,333 a year) for a semi-private room and about $10,190 a month ($122,275 a year) for a private room.3 These are industry-survey medians, not government figures, and costs vary within the state. Memory care adds a secured setting and specialized staffing, so use the assisted-living figure as a starting point, not the final price, and ask each facility for its actual memory-care monthly rate.3

How Aid and Attendance Helps Pay for Memory Care in South Dakota

Aid and Attendance is the VA pension paid at a higher maximum rate for veterans and surviving spouses who need help with daily activities, so the figures below are the maximum for the whole pension, not an extra amount on top of the basic rate. It is paid monthly, in cash, and can go toward the memory-care bill.1 The amount depends on who is receiving it:

These are 2026 maximums, effective December 1, 2025 through November 30, 2026. VA publishes annual rates; a monthly amount is the yearly award divided by 12, so treat the monthly column as approximate.1 The pension is needs-based: to be eligible, the veteran's yearly family income and net worth have to meet limits set by Congress.1 Each figure above is a ceiling, the maximum amount of pension payable, and the VA pays the difference between the claimant's income for VA purposes and that limit rather than the full figure.1 Against South Dakota's memory-care costs, a benefit paid at the ceiling can cover a meaningful share of the bill, and it stacks with Social Security, a private pension, or family contributions toward the rent.3 Read that share as the top of the range: income the VA counts is the same income that reduces the award, so a household with other income is awarded less than the table shows and covers less of the bill.1

Why Veterans With Dementia Often Qualify

One of the ways the VA recognizes a need for aid and attendance is needing help with daily activities such as bathing, dressing, feeding yourself, or protecting yourself from the ordinary hazards of daily living.5 A veteran with moderate or advanced dementia usually meets this standard: the condition is exactly why families turn to a secured memory-care unit, where staff manage wandering, supervise medications, and step in with the everyday tasks a parent can no longer manage safely alone.5 Being a patient in a nursing home due to mental or physical incapacity is another way the VA recognizes the need, so a veteran whose dementia has progressed to nursing-facility care can qualify on that basis as well.5 The need is documented on VA Form 21-2680, part of the application, where a medical examiner fills out the examination information section.6

How Memory Care Costs Lower Your Countable Income for Aid and Attendance in South Dakota

This is the part families most often miss. Because the pension is keyed to the income the VA counts, you can subtract unreimbursed medical expenses, including the cost of memory care, from that income.1 The care has to be genuinely needed: someone who qualifies for Aid and Attendance or is housebound meets that test, and otherwise a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist can state in writing that a cognitive disorder makes the health or custodial care necessary, which fits a memory-care resident.1

Only the portion of those expenses above 5% of the applicable maximum annual pension rate is deductible. For 2026 that floor is $872 a year for a veteran with no spouse or child, an annual figure, not a monthly one, and it rises with dependents, though never with the Aid and Attendance increase itself.1

Here is how it works in practice. Suppose a veteran's memory-care unit charges in the range of South Dakota's care costs: the standard assisted-living rate alone is about $58,800 a year, and a secured memory-care unit's actual rate is set by each facility.3 Subtract the first $872, and roughly $57,900 or more remains as a deductible medical expense.1 That deduction can wipe out most or all of a parent's countable income, which is why a veteran whose income looked too high to qualify often does qualify once the memory-care bill is counted.1

Who Qualifies

To receive Aid and Attendance, a veteran generally must meet four conditions:5

• Wartime service and a discharge that is not dishonorable: at least 90 days of active duty with at least one day during a recognized wartime period (World War II, Korea, Vietnam, or the Gulf War / post-9/11 era). Gulf War service has a longer active-duty requirement.5
• Age, disability, or care status: the veteran has to meet at least one of four alternatives, and any one of them satisfies the test. They are 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.5
• Net worth under $163,699 for 2026, counting the claimant's and their dependents' assets and annual income together but excluding the primary home, the car, and basic household items.5
• A documented need for aid and attendance, such as needing help with daily activities, which dementia commonly meets.5

The VA also applies a 3-year (36-month) look-back: it reviews assets transferred for less than fair market value in the three years before you file, and a disqualifying transfer can create a penalty period.5 A surviving spouse can qualify under the Survivors Pension with the same net worth limit.1

How Aid and Attendance Works with South Dakota Medicaid

Aid and Attendance and South Dakota Medicaid are separate programs that can interact when a veteran needs long-term care. Aid and Attendance is administered federally by the VA, while Medicaid long-term care in South Dakota is run by the South Dakota Department of Social Services and has its own income and asset rules.7 Under general federal rules a veteran or surviving spouse may qualify for both, but the programs coordinate: once Medicaid is paying for nursing home care, the VA typically reduces a single beneficiary's pension (the Aid and Attendance portion included) to a small monthly personal-needs amount.7

At the eligibility step, South Dakota 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. Once a person is eligible for South Dakota Medicaid and living in a nursing facility, income that was disregarded in determining eligibility must be counted in the share-of-cost calculation, so the Aid and Attendance amount does count toward what the resident owes the facility. Not all of it reaches the facility: before the bill is set, the agency is required to deduct incurred expenses for medical or remedial care that no third party pays, and that is a duty the state owes rather than a deduction a family has to ask for.7 A parent receiving Medicaid home- and community-based waiver services rather than nursing-facility care also has a share of cost, but it is not the facility calculation described here, so ask the South Dakota Department of Social Services which rule applies to a waiver participant and what it leaves the household each month.

Because the exact treatment of Aid and Attendance income and assets in a Medicaid eligibility determination depends on program rules and individual circumstances, confirm how the two will interact with the South Dakota Department of Social Services and an accredited Veterans Service Officer before relying on it.7 For privately paid memory care, this coordination does not apply; it comes into play once Medicaid is covering the cost of care.7

How to Apply and Get Free Help

The need itself is always documented on VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), on which a medical examiner fills out the examination information section. That form covers Aid and Attendance that will be added to monthly compensation as well as Aid and Attendance added to a pension.6 The steps below are the pension route, which is the one most memory-care families are on: the VA's condition for it is that you may be eligible for this benefit if you get a VA pension. On that route, a wartime veteran who is not already receiving a VA pension files VA Form 21P-527EZ (Application for Veterans Pension) along with the 21-2680.6 You can apply online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office, and an accredited attorney, accredited claims agent, or accredited Veterans Service Organization representative can file the claim for you.6 On how long a decision takes, the VA's own answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing, so it is worth filing as soon as the need is clear.6

You do not have to do this alone. South Dakota veterans and their dependents can get help preparing and filing VA claims, including pension benefits for certain wartime veterans, through the South Dakota Department of Veterans Affairs and the state's county and tribal service officers.4

What If the Claim Is Denied

If the VA denies the claim or grants less than you expected, an initial decision opens three decision review options. You can file a Supplemental Claim with new and relevant evidence the VA did not have when it reviewed the case before, request a Higher-Level Review by a higher-level reviewer (no new evidence is submitted), or appeal to the Board of Veterans' Appeals for review by a Veterans Law Judge.8 The menu narrows after that: following a Higher-Level Review decision the choices are a Supplemental Claim or a Board Appeal, and following a Board decision they are a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, which has to be filed within 120 days of the date on the Board's decision letter.8 For most VA benefits, a Higher-Level Review or a Board Appeal has to be elected within one year of the date the VA issues notice of its decision, while a Supplemental Claim can be filed at any time after that notice. Certain VA benefits carry time limits shorter than a year, and your decision letter tells you the deadline for yours.8 File it inside the year anyway: a Supplemental Claim the VA receives 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 all the way to the original claim date, unless the VA grants an extension of the one-year period for good cause.8 An accredited attorney, claims agent, or Veterans Service Organization representative can help you request the review, and the VA's search tool will find one near you.8

Compare Care Settings in South Dakota

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 South Dakota
• How Aid and Attendance Pays for a Nursing Home in South Dakota
• How Aid and Attendance Pays for In-Home Care in South Dakota

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.