VA Aid and Attendance is one of the most overlooked ways Texas veterans pay for in-home care: in 2026 it raises the ceiling on a veteran's pension to as much as $29,093 a year, about $2,424 a month. That ceiling is a maximum rather than a payment, because the VA pays the difference between it and your income for VA purposes. It is paid as part of a veteran's or surviving spouse's monthly VA pension, and because it arrives as cash, the money can go straight toward an aide who comes to the house. For a family trying to keep a parent at home rather than move them to a facility, that monthly payment can be the deciding factor.

This guide explains exactly how Aid and Attendance works for in-home care, how much it pays in 2026, who qualifies, and how to get free help filing the claim.

In This Guide

How Much In-Home Care Costs in Texas

Non-medical home care in Texas runs a median of about $30 an hour in 2025, or roughly $68,640 a year (about $5,720 a month) for full-time care, according to the CareScout (formerly Genworth) 2025 Cost of Care Survey. That sits below the national median of about $35 an hour ($80,080 a year). Many families instead use a part-time schedule of about 20 hours a week, which runs roughly $2,600 a month at that rate.

Beginning with the 2025 survey, CareScout reports a single non-medical caregiver category rather than separate homemaker and home health aide rates. Skilled, medical home health care is often covered by Medicare or Texas Medicaid when it is medically necessary, so families usually pay out of pocket only for non-medical home care, which is why an extra monthly benefit matters.

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

Aid and Attendance is an increased monthly VA pension for a qualifying veteran or surviving spouse who needs help with daily activities. It raises the ceiling on the pension itself rather than paying a second benefit on top of the basic rate. It is paid as cash, so unlike a benefit that only covers care at a specific facility, the money can go toward an in-home aide, a homemaker, or other care costs at home.

Here are the 2026 ceilings (rates effective December 1, 2025 through November 30, 2026). The VA publishes these rates as annual maximums, so a monthly amount is the yearly award divided by 12:

Category Maximum Annual Amount Monthly Equivalent
Veteran alone $29,093 about $2,424
Veteran with one dependent $34,488 $2,874
Surviving spouse $18,697 about $1,558

Each additional dependent adds $2,984 a year to the ceiling, and two veterans married to each other who both qualify share a ceiling of $46,143 a year. No one is paid the figure in the table: it is the most the pension can reach, and the VA subtracts your income for VA purposes from it.

Against Texas's roughly $5,720-a-month cost for full-time non-medical home care, the maximum veteran rate covers a meaningful share. It rarely covers full-time care on its own, but combined with other income it can keep a loved one safely at home, and it can fully cover a part-time schedule.

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

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 set by Congress. Because the benefit is keyed to income for VA purposes, recurring out-of-pocket care costs can be subtracted from the income the VA counts, which can make a family that looked "over income" eligible after all.

The rule has a floor. Only the portion of your unreimbursed medical expenses above 5% of the applicable Maximum Annual Pension Rate (MAPR) is deductible. The VA states that floor as $872 per year for a veteran with no spouse or child, and it rises for a veteran with dependents. In-home attendant care counts as a deductible medical expense when the attendant is a health care provider, or when the veteran needs aid and attendance or is housebound, or when a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that a physical, mental, developmental, or cognitive disorder makes that care necessary.

For example, a veteran paying for an in-home aide might spend $20,000 over a year on that care. The first $872 does not count, but the remaining roughly $19,000 can be subtracted from countable income, often lowering it enough to qualify for the pension or increase the amount paid.

Who Qualifies

To qualify for Aid and Attendance, a veteran generally must meet all of the following:

  • Wartime service: at least 90 days of active duty with at least one day during a wartime period (such as World War II, Korea, Vietnam, or the Gulf War). Gulf War service has its own length-of-service rules.
  • Discharge, age, or disability: no dishonorable discharge, plus at least one of four situations: be at least 65 years old, 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 (SSDI) or Supplemental Security Income (SSI). Any one of the four satisfies this test, so a wartime veteran under 65 who gets SSI meets it without a permanent-and-total disability rating.
  • A need for aid and attendance: need help with daily activities such as bathing, dressing, or eating; have to stay in bed, or spend a large portion of the day in bed, because of illness; be a patient in a nursing home due to the loss of mental or physical abilities related to a disability; or have severely limited eyesight.
  • Net worth under $163,699 for 2026, which counts your and your dependents' assets and annual income for VA purposes but excludes the primary home, a vehicle, and basic household goods.

The VA reviews asset transfers made for less than fair market value during the three years before you file, so it is worth planning ahead. A surviving spouse can qualify under the Survivors Pension version of the benefit.

Using Aid and Attendance to Pay a Family Caregiver

Because Aid and Attendance is paid to the beneficiary as part of the monthly pension, families commonly use it to help compensate a relative who provides care at home.

If you want a more structured way to pay a family caregiver, ask your VA medical center about Veteran-Directed Care (VDC). VDC gives a veteran a flexible, clinically set budget to hire their own caregivers, including family, friends and/or neighbors and even a spouse, with a financial management service handling payroll. In Texas, VDC is available through organizations such as REACH, Inc. and the North Central Texas Council of Governments in the Dallas-Fort Worth area. Eligibility requires VA enrollment, a clinical need for personal care, and risk of needing institutional care. VDC is separate from the Aid and Attendance pension, but the two can both support care at home.

How Aid and Attendance Works with Texas Medicaid

Aid and Attendance and Texas Medicaid are separate programs that can interact, so coordination matters for a veteran who needs both. The reason it matters comes from how the VA pension is built: it is needs-based, and the VA reduces a pensioner's countable income by unreimbursed care costs that exceed 5% of the MAPR, so much of the Aid and Attendance amount is effectively attributable to medical expenses. That medical-expense framing is also what shapes how Medicaid treats the money.

Because the exact treatment depends on the specific Texas Medicaid pathway and is determined case by case, a veteran receiving Aid and Attendance who also needs Texas Medicaid long-term care should have the income and unreimbursed-medical-expense treatment reviewed for their situation. Work this through with a Texas Veterans Commission claims counselor or a county Veterans Service Officer, who provide this help free of charge.

How to Apply and Get Free Help

Every claim starts with 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 to document the need for help. The VA uses that one form for Aid and Attendance benefits "that will be added to your monthly compensation or pension benefits," so the paperwork that goes with it depends on which of those two routes you are on.

The steps here describe the pension route, the one this guide covers: the VA says 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 also files a pension claim on Form 21P-527EZ (Application for Veterans Pension), which is the wartime pension application. If your Aid and Attendance would instead be added to monthly VA disability compensation, that is the other route, so confirm which one applies to you before filing a pension application.

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 representative can file for you. If you are still gathering information, you can submit VA Form 21-0966 (Intent to File) first: the VA says submitting an intent to file "can secure the earliest possible effective date for any retroactive payments you may be eligible to receive." Asked how long a decision takes, the VA answers "It depends." It works through claims in the order it receives them unless a claim requires priority processing.

Do not do this alone. The Texas Veterans Commission (TVC) is the designated state agency for veteran benefit assistance, and its VA-accredited claims counselors provide free help filing and appealing VA claims from roughly 49 offices in VA regional offices, medical facilities, and clinics across Texas. You can reach TVC at 1-800-252-8387 or through tvc.texas.gov/claims. County Veterans Service Officers provide additional free services, including pension and survivor claims, and you can visit a county office during business hours with no appointment necessary.

Frequently Asked Questions

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

Yes. Aid and Attendance is paid in cash as part of a monthly VA pension, so the money can go directly toward an in-home aide, a homemaker, or other care at home. It is not tied to a specific facility, which makes it well suited to families keeping a loved one at home.

How much does Aid and Attendance pay in 2026?

The 2026 ceiling is $29,093 a year (about $2,424 a month) for a veteran alone, $34,488 a year ($2,874 a month) for a veteran with one dependent, and $18,697 a year (about $1,558 a month) for a surviving spouse. The VA publishes these rates as annual maximums, so a monthly amount is the yearly award divided by 12. Nobody receives the full figure: the VA pays the difference between the ceiling and your countable income.

Does my parent's income disqualify them if it looks too high?

Not necessarily. The VA subtracts unreimbursed care costs above a yearly floor from countable income, $872 for a veteran with no spouse or child and higher for a veteran with dependents, so families that look over the limit often still qualify once in-home care costs are counted.

Where can I get free help applying in Texas?

The Texas Veterans Commission and county Veterans Service Officers provide free help filing and appealing VA claims, including Aid and Attendance. They never charge for this assistance.

Compare Care Settings in Texas

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

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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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