VA Aid and Attendance for Assisted Living in Texas

VA Aid and Attendance raises a wartime veteran's VA pension to as much as $29,093 a year in 2026 if they have no dependents, money a Texas family can put toward an assisted living bill.1 Pension is paid monthly to the veteran or surviving spouse, and against a median Texas assisted living cost of $67,992 a year, it can be the difference between affording care and not.2

This guide walks through what Aid and Attendance pays in 2026, how assisted living costs can actually help you qualify, who's eligible, how it works alongside Texas Medicaid, and how to apply with free help.

In This Guide

• Key Takeaways
• How Much Assisted Living Costs in Texas
• How VA Aid and Attendance Pays for Assisted Living in Texas
• How Assisted-Living Costs Lower Your Countable Income
• Who Qualifies
• How VA Aid and Attendance Works with Texas Medicaid for Assisted Living
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

How Much Assisted Living Costs in Texas

According to the CareScout 2025 Cost of Care Survey, published in March 2026, the median cost of assisted living in Texas is $67,992 a year, about $5,666 a month, for a private one-bedroom unit.2 That runs below the national median of $74,400 a year ($6,200 a month), and ranks Texas 34th highest among the states. CareScout collects rates metro by metro, so a single state median hides real variation between Texas cities, and it is a provider-reported survey figure, not a quote for any particular resident.2

Ask every community you tour for its level-of-care fee schedule, because the bill a family actually pays depends on the care the resident needs, and the median can't tell you that.2 The gap between that bill and the family's income is what Aid and Attendance can help close. It's rarely the only benefit worth claiming: if the family still owns a homestead, the Texas disabled veteran property tax exemption can cut or erase the property tax on it for a veteran with a service-connected disability rating.

How VA Aid and Attendance Pays for Assisted Living in Texas

Aid and Attendance is an increase to the VA pension paid to veterans, and surviving spouses, who need the aid and attendance of another person.3 Pension is paid monthly to the beneficiary, so the family can put it toward an assisted living bill.1

Here's what the 2026 rates look like, effective December 1, 2025 through November 30, 2026:1

The VA publishes these caps as annual amounts. Under 38 CFR 3.273, your monthly payment is figured by subtracting your countable income from the annual rate and dividing what's left by 12, so the only way to know your monthly amount is to start from your own income.1

The word "cap" is doing real work there. The VA sets the payment amount at the difference between your income for VA purposes and the limit Congress sets, so a veteran with countable income receives the maximum less that income, and a veteran whose countable income reaches the limit receives nothing.1 Most veterans draw some income, so most receive less than the headline number.

Set the rates against the cost of care, and be honest about which number is yours. Even a veteran with no countable income, at the full $29,093 a year,1 covers less than half of the $67,992 Texas median, and a veteran with countable income covers less still.2 The benefit doesn't have to cover the whole cost to be worth claiming. Just remember that it doesn't sit on top of the income the VA counts: that income comes off the ceiling when the VA sets your rate.1 Build the budget from your award letter, not from the table above.

One thing to be clear about: the pension is payable to the veteran or surviving spouse, not to the community, and the family decides how to put it toward care.1

How Assisted-Living Costs Lower Your Countable Income

This is the part most families miss, and it's where assisted living and Aid and Attendance fit together in a way that surprises people.

The VA pension is needs-based: to be eligible, the veteran's yearly family income and net worth have to come in under limits set by Congress.1 Because the benefit is keyed to the income the VA counts, lowering that income is what can put it within reach, and you lower it by deducting unreimbursed medical expenses.

Assisted living fees can count as those medical expenses, under the VA's rule for a care facility other than a nursing home, but only on that rule's own conditions, not just because the resident lives there.1 The resident has to be receiving health care or custodial care in the facility, and either need aid and attendance or be housebound, or have a physician, PA, certified nurse practitioner, or clinical nurse specialist state in writing that, because of a physical, mental, developmental, or cognitive disorder, the person needs to be in a protected environment.1 Room and board has its own test: it counts if the facility provides or contracts for the resident's health or custodial care, or if one of those clinicians states in writing that the person must live in the facility to receive that care. The community itself must be licensed if Texas requires that type of facility to be, and a residential facility must have care staff on duty 24 hours a day.1 You report these costs on VA Form 21P-8416 (Medical Expense Report), for expenses you weren't and don't expect to be reimbursed for.5

One more rule: only the portion of those expenses above 5% of the applicable MAPR is deductible.1 For 2026, that 5% floor is $872 for a veteran with no spouse or child, and higher for a veteran with dependents, since the floor is figured from a MAPR that includes the increase for family members but never the aid-and-attendance or housebound increase.1 A Texas assisted living bill near the $67,992 median2 runs far above that floor, so when the facility branch's conditions are met, a veteran whose income looks too high on paper may still qualify once the qualifying care costs are deducted from the income the VA counts.1

Who Qualifies

To be eligible for Aid and Attendance, the veteran must:3

• Have wartime service, with the length keyed to when active duty started: a veteran who started before September 8, 1980 needs at least 90 days of active duty with at least one day during a wartime period VA recognizes (such as World War II, Korea, the Vietnam era, or the Gulf War); a veteran who started as an enlisted person after September 7, 1980 generally needs at least 24 months, or the full period for which they were called or ordered to active duty, again with at least one day during wartime; and an officer who started active duty after October 16, 1981 and hadn't previously served at least 24 months on active duty meets the test with at least one day during wartime.3
• Not have received a dishonorable discharge.
• Meet at least one of four conditions: be 65 or older; 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. Any one of the four satisfies this test on its own, so a wartime veteran under 65 who receives SSI qualifies here without any adjudicated permanent-and-total rating.
• Need aid and attendance: needing another person's help with daily activities like bathing, feeding, and dressing; having to stay in bed (or spend a large part of the day in bed) because of illness; being a patient in a nursing home because of a loss of mental or physical abilities related to a disability; or having limited eyesight (5/200 or less in both eyes even with glasses or contacts, or a visual field contracted to 5 degrees or less).
• Have a net worth under $163,699 for 2026. VA's net-worth calculation counts the claimant's and their dependents' assets and annual income, not assets alone, and excludes the primary residence, a vehicle, and basic home items like appliances.3

None of these tests asks for a service-connected disability.3 The VA also applies a 3-year look-back on assets transferred for less than fair market value before you file, with a penalty period that can run up to five years, so don't give away or move assets to qualify without getting advice first.3

How VA Aid and Attendance Works with Texas Medicaid for Assisted Living

Aid and Attendance and Medicaid can work together, and for assisted living in Texas that combination matters.

Texas Medicaid covers assisted living services through the STAR+PLUS HCBS waiver, with an important catch: Medicaid pays for the personal care and support services delivered in a licensed assisted living facility contracted with the member's managed care organization, but it does not pay for room and board.6 Room and board is the resident's responsibility, set based on the Supplemental Security Income (SSI) federal benefit rate minus an $85 personal needs allowance. It is a set rate that changes only when the federal benefit rate changes, generally each January 1, and it cannot be waived, although a facility may choose to accept a member for a lower amount. A copayment is a separate charge from room and board, not required of SSI recipients but required from members whose financial eligibility was determined under the special institutional criteria.6 The waiver also covers nursing, therapy, adaptive aids, medical supplies, and minor home modifications for members in an assisted living facility, as separate services authorized on the individual service plan rather than as part of the assisted living daily rate, but it has an interest list, or waitlist.6

That's where a VA pension can matter. Because the STAR+PLUS waiver leaves room and board to the resident,6 the pension is one source a family can look to for that part of the bill. How a VA pension and Texas Medicaid interact for one person turns on the income and eligibility rules of both programs, so have a Veterans Service Officer or elder law attorney check the plan before you count on both.

How to Apply and Get Free Help

The steps below are the pension route: VA's condition for Aid and Attendance here is "you may be eligible for this benefit if you get a VA pension." Form 21-2680 covers both routes, since it applies for Aid and Attendance that will be added to your monthly compensation or pension benefits, so a veteran who receives VA disability compensation rather than a pension is on the compensation route, which the pension steps below don't describe.5

On the pension route, you apply with these VA forms:

• VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination information section a medical examiner must fill out, documenting the need for help.
• VA Form 21P-527EZ (Application for Veterans Pension), for a wartime veteran pursuing the pension route who isn't already receiving a VA pension. This is the form a wartime veteran uses to file that pension claim.
• VA Form 21-0966 (Intent to File), if you're still gathering information and don't want to wait to start. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive, which matters while you wait on the medical examiner's section.

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 help you file.5 Asked 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.5

Don't do this alone. The Texas Veterans Commission (TVC) is designated by the state to represent Texas veterans before the VA, and its VA-accredited Benefits Advisors help file pension and survivor claims, free of charge, from forty-nine offices statewide. You can reach TVC at 1-800-252-8387.4 Many, though not all, of Texas's 249 counties also have a Veteran County Service Officer who works with TVC and helps at no fee; to find yours, call the TVC line above or contact your county government. TVC can prioritize claims and may refer some to another source of help, so if it can't take yours, ask where to go next.4

If your claim is denied, that isn't the end of the road. TVC's Benefits Advisors represent veterans during the VA appeals process, free of charge.4 Act promptly once the decision letter arrives, and bring that letter to your advisor so they can pinpoint exactly what the VA still needs.

Compare Care Settings in Texas

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

• How Aid and Attendance Pays for a Nursing Home in Texas
• How Aid and Attendance Pays for In-Home Care in Texas
• How Aid and Attendance Pays for Memory Care in Texas

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.