VA Aid and Attendance is one of the most useful and most overlooked ways to help pay for in-home care in Texas. It is a monthly cash benefit added to a veteran's or surviving spouse's VA pension, and because it is paid 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 check 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 costs approximately $24 to $31 per hour in 2026, with a statewide average around $24 to $26 per hour, below the national average of about $27 per hour. Monthly costs for full-time care average roughly $4,576, and many families use part-time schedules of about 20 hours a week, costing roughly $1,950 to $2,500 a month.

Costs vary by city, with Dallas starting around $21 an hour and Houston ranging from about $19 to $28. Skilled home health care is often covered by Medicare or Medicaid when medically necessary, so families primarily pay out of pocket for non-medical home care, which is why an extra monthly benefit matters.

How Aid and Attendance Helps Pay for In-Home Care

Aid and Attendance is an increased monthly pension the VA pays on top of a qualifying veteran's or surviving spouse's basic VA pension when they need help with daily activities. 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 is what the benefit pays in 2026 (rates effective December 1, 2025 through November 30, 2026):

Category Maximum Monthly Amount
Veteran alone $2,424
Veteran with one dependent $2,874
Surviving spouse $1,558

Against Texas's roughly $4,576-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

VA Pension, including the Aid and Attendance increase, is a needs-based benefit: the VA pays the difference between your countable income and a set income ceiling called the Maximum Annual Pension Rate (MAPR). Because the benefit is keyed to income, recurring out-of-pocket care costs can be subtracted from your countable income, 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 that exceeds 5% of the applicable MAPR counts. For 2026, that floor is $872 per year for a veteran with no dependents and $1,141 per year for a veteran with one dependent. In-home attendant care for daily activities counts as a deductible medical expense when there is a documented care need.

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.
  • Age or disability: be 65 or older, or permanently and totally disabled.
  • A need for aid and attendance: need help with daily activities such as bathing, dressing, or eating, or be bedridden, in a nursing home due to incapacity, or have severely limited eyesight.
  • Net worth under $163,699 for 2026, which counts assets and annual income 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 as cash, a family can use it to help compensate a relative who provides care at home. There is no VA rule that forces you to hire an outside agency.

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 members 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

You apply for Aid and Attendance using two VA forms: Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), which a doctor completes to document the need for help, and Form 21P-527EZ (Application for Veterans Pension) if you are not already receiving a pension. You can file online at va.gov, by mail, or through an accredited representative. Processing often takes three to six months or longer.

Do not do this alone. The Texas Veterans Commission (TVC) is the designated state agency for veteran benefit assistance, and its claims counselors provide free help filing and appealing VA claims from offices in VA regional offices, medical facilities, and clinics across Texas. 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

Yes. Aid and Attendance is paid as cash added to a 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.

Up to $2,424 a month for a veteran alone, up to $2,874 for a veteran with one dependent, and up to $1,558 for a surviving spouse. These are maximums; the actual amount depends on your countable income.

Not necessarily. The VA subtracts unreimbursed care costs above a yearly floor of $872 (or $1,141 with one dependent) from countable income, so families that look over the limit often still qualify once in-home care costs are counted.

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:

Learn More

Find personalized help using VA benefits to pay for in-home care in Texas 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

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