VA Aid and Attendance for Memory Care in Texas

Memory care for a parent with dementia in Texas is priced from an assisted living base of about $5,666 a month, and VA Aid and Attendance can help a wartime veteran or a surviving spouse afford it.1 It raises the maximum rate of the basic VA pension rather than being paid on top of it, and it is meant for people who need help with everyday activities or supervision to stay safe, exactly the situation most families face after a dementia diagnosis.

If you are arranging care for a parent who served, this guide walks through what the benefit pays in 2026, why dementia so often meets the VA's standard, and a medical-expense rule that can help a family qualify even when their income looks too high at first glance.

In This Guide

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

How Much Memory Care Costs in Texas

The CareScout (formerly Genworth) Cost of Care Survey does not price memory care as its own category, but it gives the closest published benchmark: the 2025 Texas median for assisted living is about $5,666 a month, roughly $67,992 a year, which ranks 34th among the states and sits below the national median of $6,200 a month.1 In Texas, memory care is delivered inside licensed assisted living facilities, so that median is the base to price a memory care placement from, not the memory care rate itself. No statewide memory care median exists from CareScout.1

Prices also vary by metro area within the state, and these are industry-survey medians, not government figures.1 That cost is the reason families look hard at every benefit they can stack, and for a veteran or surviving spouse, Aid and Attendance can be one of those pieces.

How Aid and Attendance Helps Pay for Memory Care in Texas

Aid and Attendance is the basic VA pension paid at a higher maximum rate for people who need regular help from another person or supervision to stay safe.3 Pension is paid monthly, so the money can go toward a memory care community's monthly fee. The VA publishes these rates as annual maximums, and under 38 CFR 3.273 the monthly payment is the annual maximum minus your countable income, divided by 12.2 Here are the 2026 ceilings on the whole pension at the Aid and Attendance rate, effective December 1, 2025 through November 30, 2026:

Set against a memory care bill priced from the roughly $5,666-a-month ($67,992-a-year) assisted living base, even a pension paid at the full $29,093 veteran ceiling covers part of the cost rather than all of it, and a claimant with income for VA purposes is paid less than the ceiling.2,1 The rest has to come from other income, savings, or other coverage such as a long-term care policy.

Why Veterans With Dementia Often Qualify

The "aid and attendance" part of the benefit is about need, not a specific diagnosis. The VA looks for a person who needs help with daily activities such as bathing, dressing, or feeding themselves; or who needs protection from the ordinary hazards of daily life; or who is bedridden or a patient in a nursing home due to mental or physical incapacity.3

Dementia and Alzheimer's disease commonly meet that standard. As the condition progresses, a person typically needs hands-on help with personal care and constant supervision to avoid wandering, falls, or other everyday dangers, which is precisely why memory care exists. A medical examiner documents this need on the VA's examination form, and that documentation is what ties the diagnosis to the eligibility rule.3,5

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

VA pension, including the Aid and Attendance increase, is needs-based: to be eligible, the veteran's yearly family income and net worth must meet limits set by Congress.2 Because the benefit is keyed to income for VA purposes, you can lower that income by deducting unreimbursed medical expenses (UMEs), but only the portion above 5% of the applicable Maximum Annual Pension Rate (MAPR).2

The VA states that 5% floor as $872 per year for a veteran with no spouse or child. It rises for a veteran with dependents, but never with the Aid and Attendance or housebound increase.2

The cost of care at an assisted living or memory care community is covered by its own branch of the regulation, 38 CFR 3.278(d)(3), which governs a care facility other than a nursing home. The community must be licensed if Texas requires licensure for facilities of that type, and a residential facility must be staffed 24 hours a day with care providers, who need not be licensed health care providers.2 Payments for health care provided by a health care provider are medical expenses. Where the provider is not a health care provider, payments for help with daily activities count if the resident is receiving health care or custodial care in the community and either the resident needs Aid and Attendance or is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that a physical, mental, developmental, or cognitive disorder means the resident needs to be in a protected environment (38 CFR 3.278(d)(3)).2 Ask the doctor for that wording. Meals and lodging clear a separate gate at 38 CFR 3.278(d)(3)(iv): the community provides or contracts for the resident's health care or custodial care, or a clinician states in writing that the resident must live there to receive it.2

To see the effect, suppose a memory care bill matches the Texas assisted living median it is priced from, about $5,666 a month or $67,992 a year.1 For a veteran with no dependents, if the whole bill clears the 3.278(d)(3) conditions above, the portion above the $872 annual floor is deductible, which for a bill of this size is tens of thousands of dollars.2 A deduction that size lowers income for VA purposes, which can bring a veteran whose income first looked too high within the limit, and because the VA pays the maximum rate minus that income, a lower countable income means a larger payment.2

Who Qualifies

To receive Aid and Attendance, a veteran must meet four basic tests:3

• Wartime service. The length requirement turns on when the veteran started active duty, not on which war. Started before September 8, 1980: at least 90 days of active duty with at least one day during a recognized wartime period (such as World War II, the Korean conflict, the Vietnam War era, or the Gulf War period, which began August 2, 1990 and has no end date set yet). Started as an enlisted person after September 7, 1980: at least 24 months, or the full period called or ordered to active duty (with some exceptions), again with at least one day during wartime. A third branch covers an officer who started active duty after October 16, 1981 and had not previously served on active duty for at least 24 months.3
• Discharge, plus age or disability. No dishonorable discharge, and at least one of these is true: age 65 or older; a permanent and total disability; a patient in a nursing home for long-term care because of a disability; or getting Social Security Disability Insurance or Supplemental Security Income.3 The nursing-home and SSDI/SSI branches stand on their own, so a wartime veteran under 65 who receives SSI meets this test without any permanent-and-total rating.3
• Net worth. Net worth under $163,699 for 2026.3 The VA's net worth calculation includes your and your dependents' assets and annual income for VA purposes, and it includes a spouse's net worth, so comparing your own assets alone against that limit gives you the wrong answer.3 The exclusions run the other way and they are large: the primary home, the car, and basic home items like appliances you wouldn't take with you if you moved are not counted at all, and the assets that are counted come in minus any mortgage. The house you live in doesn't push you over the limit, whatever a Texas appraisal district says it is worth.3
• Need for aid and attendance. A documented need for help with daily activities, or protection from daily hazards, as described above.

Be aware of the 3-year look-back: the VA reviews any assets transferred for less than fair market value in the 36 months before you file, and a transfer can trigger a penalty period.3 If you have recently moved money or property, talk to an accredited representative before applying.3

How Aid and Attendance Works with Texas Medicaid

In Texas, memory care is delivered inside assisted living facilities regulated under Texas Health and Safety Code Chapter 247 and 26 Texas Administrative Code Chapter 553, with licensing by the Texas Health and Human Services Commission (HHSC).6 A facility does not need HHSC's separate Alzheimer's classification to care for residents with dementia, but one that advertises memory care must tell each resident in writing whether it holds that classification (HHSC Form 3641 is the disclosure statement). A facility caring for residents with Alzheimer's disease or a related disorder without that certification must have its staff complete dementia training and annual continuing education.6

Texas Medicaid can help with memory care through the STAR+PLUS HCBS waiver, but it is important to understand what the waiver does and does not cover. STAR+PLUS HCBS pays for assisted living services, a 24-hour living arrangement in an HHSC-licensed personal care facility, while the resident remains responsible for room and board.6 To qualify, a person must have a valid medical necessity determination for a nursing facility level of care; TMHP clinical staff review the state's assessment and decide whether medical necessity is met.6

Because A&A is a VA benefit and STAR+PLUS HCBS is a Texas Medicaid program, families who may need both should confirm with HHSC and an accredited VA representative how the benefit and the waiver interact in their specific situation before counting on a particular combination.6

How to Apply and Get Free Help

Two forms sit at the center of an Aid and Attendance claim on the pension route, which is the route this guide describes, since the VA's condition is that you may be eligible for this benefit if you get a VA pension:5

• 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 assistance.
• VA Form 21P-527EZ, Application for Veterans Pension, filed by a wartime veteran who is pursuing that pension route and is not already receiving a VA pension.5 Form 21-2680 covers Aid and Attendance added to monthly compensation benefits as well as pension benefits, so a veteran who receives VA disability compensation may be on the compensation route instead of the pension route this guide describes. An accredited representative can confirm which route fits before anything is filed.5

You can file these 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.5 If you are still gathering information, you can submit VA Form 21-0966 (Intent to File) first, because 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.5 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, so it is worth filing as soon as the care need is documented.5

In Texas, you do not have to do this alone. The Texas Veterans Commission (TVC) is designated by the State of Texas to represent its veterans before the VA, and its accredited benefits advisors, all of them veterans, help file VA compensation, pension, and survivor benefit claims from forty-nine offices within the state, many of them inside VA facilities. Asked what it charges for those services, TVC's answer is "Nothing." You can reach TVC at 1-800-252-8387.4 Many of Texas's 249 counties also have a Veteran County Service Officer, who works with TVC under a formal agreement to help veterans at no fee; not every county has one, so the TVC line above is the place to start.4 TVC's help is not guaranteed for every case: Texas law has it decide when to prioritize a claim and, when it doesn't, point the veteran to another source of claims help.4 Using one of these accredited representatives costs nothing and is the safest way to file a clean, complete claim.

If your claim is denied, that isn't the end of the road. TVC's benefits advisors also 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 Assisted Living in Texas
• How Aid and Attendance Pays for a Nursing Home in Texas
• How Aid and Attendance Pays for In-Home 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.