VA Aid and Attendance for In-Home Care in Texas

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.1 That ceiling is a maximum rather than a payment, because the VA pays the difference between it and your income for VA purposes.1 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

• Key Takeaways
• How Much In-Home Care Costs in Texas
• How Aid and Attendance Helps Pay for In-Home Care in Texas
• How In-Home Care Costs Lower Your Countable Income for Aid and Attendance in Texas
• Who Qualifies
• Using Aid and Attendance to Pay a Family Caregiver
• How Aid and Attendance Works with Texas Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Learn More

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).3 A part-time schedule costs proportionally less at the same $30 hourly median.3

Beginning with the 2025 survey, CareScout reports a single non-medical caregiver category rather than separate homemaker and home health aide rates.3 Medicare covers home health care only when a person is homebound and needs intermittent skilled care, and it does not cover 24-hour care at home or custodial personal care when that is the only care needed.5 That leaves much of the non-medical help families hire outside Medicare, 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.1 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 amounts. Pension is paid monthly: under 38 CFR 3.273, the VA subtracts your countable income from the annual rate and divides what is left by 12.1

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.1 The figure in the table is the most the pension can reach, not what you are paid: the VA subtracts your income for VA purposes from it.1

Against Texas's roughly $5,720-a-month cost for full-time non-medical home care, the maximum veteran rate covers a meaningful share.3 It won't cover full-time care at the median rate on its own, but combined with other income it can help keep a loved one at home.1

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.1 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), figured without the Aid and Attendance increase, 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.1 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.1

For example, a veteran with no spouse or child who pays 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, which can lower it enough to qualify for the pension or increase the amount paid.1

Who Qualifies

To qualify for Aid and Attendance, a veteran generally must meet all of the following:2

• Wartime service: at least one day of active duty during a wartime period (such as World War II, Korea, Vietnam, or the Gulf War), plus a minimum length of service: 90 days if you started active duty before September 8, 1980, or generally 24 months or the full period you were called to duty if you started later.
• 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.1

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.2 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 comes as monthly payments added to the veteran's pension, a family can put it toward care a relative provides at home. Under 38 CFR 3.352(c), care given by a relative or another member of the household does not prevent the VA from granting the allowance.2

If you want a more structured way to pay a family caregiver, ask your VA medical center about Veteran-Directed Care (VDC). VDC is a VA Geriatrics and Extended Care program that gives an enrolled veteran a flexible budget, managed by the veteran or a representative, to hire and supervise their own workers, and the veteran may also hire family, friends, and/or neighbors.6 VA medical centers deliver VDC through aging and disability network agencies, such as area agencies on aging, which arrange fiscal management services and provide counseling and support.6 An enrolled veteran is eligible if they are eligible for community care, meet the clinical criteria for the service, and it is available.6

How Aid and Attendance Works with Texas Medicaid

Aid and Attendance and Texas Medicaid are separate programs, run by different agencies under different applications and rules, and a veteran can qualify for and receive both at the same time.7 The two count income differently: the VA subtracts unreimbursed medical expenses above 5% of the MAPR from income for VA purposes, while Medicaid applies its own income and asset tests, which vary by state.7

How a VA pension counts for a particular Texas Medicaid long-term care program is the state Medicaid agency's call under its own rules, so a veteran receiving Aid and Attendance who also needs Texas Medicaid long-term care should have the income treatment reviewed for their situation rather than assume either way. A Texas Veterans Commission Benefits Advisor or a county Veteran Service Officer can help with the VA side of the claim at no fee.4

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.8

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.8

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."8 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.8

Do not do this alone. The Texas Veterans Commission (TVC) is the designated state agency for veteran benefit assistance, and its VA-accredited Benefits Advisors help with filing pension and other VA claims and with appeals, free of charge, from forty-nine offices across the state, many of them inside VA facilities. You can reach TVC at 1-800-252-8387 or through tvc.texas.gov/claims.4 Many of Texas's 249 counties also have a Veteran County Service Officer, who works with TVC under a memorandum of understanding and provides services at no fee.4

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 Assisted Living in Texas
• How Aid and Attendance Pays for a Nursing Home 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.