VA Aid and Attendance for In-Home Care in Vermont

If you are keeping a veteran parent at home in Vermont, VA Aid and Attendance can help a family carry the cost of the aide who helps them. This guide covers the VA pension route, where the VA describes Aid and Attendance as monthly payments added to a veteran's or surviving spouse's monthly VA pension, and where what a family pays an in-home attendant can count as an unreimbursed medical expense that lowers the income the VA counts. With Vermont's in-home care among the costliest in the country, every part of that matters.

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

How Much In-Home Care Costs in Vermont

Vermont's long-term care costs run well above the national medians, and in-home care is no exception. According to the CareScout 2025 Cost of Care Survey (released March 2026, the most recent state-level data), a non-medical caregiver in Vermont runs about $102,960 a year, the second-highest rate in the country and up 3 percent from 2024, well above the national median of about $80,080 a year ($35 an hour, assuming 44 hours of care a week). CareScout's monthly table puts the same Vermont rate at $8,580 a month.3

Beginning with the 2025 survey, CareScout combined the former homemaker and home health aide categories into a single non-medical caregiver rate. These are industry-survey medians, not government figures, so the real number for any one family depends on how many hours of care are needed each week and where in the state you live. Either way, paying for in-home care out of pocket adds up fast, which is why an extra monthly benefit matters.

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

Aid and Attendance is an increased monthly VA pension for a veteran or surviving spouse who gets a VA pension and meets at least one aid-and-attendance requirement, such as needing another person's help with daily activities. The VA describes it as monthly payments added to the amount of a monthly VA pension.2 It raises the ceiling on the pension itself rather than paying a second benefit on top of the basic rate.1 For in-home care, the other half of the picture is on the income side: what a family pays an in-home attendant can count as an unreimbursed medical expense, which lowers countable income and can raise the pension (see the next section).1

Here is what the benefit pays in 2026 (rates effective December 1, 2025 through November 30, 2026). The VA publishes these as maximum annual pension rates. Pension is paid monthly: under 38 CFR 3.273, the VA takes the annual rate, subtracts countable income, and divides what is left by 12.1

Do not budget from those figures. They are ceilings, not payments. The VA bases the payment amount on the difference between your income for VA purposes and a limit Congress sets, and the Maximum Annual Pension Rate is that limit: the maximum amount of pension payable. A veteran with other income receives the maximum less that countable income, and a veteran whose countable income reaches the limit receives nothing.1 The next section is the reason this is not as bleak as it sounds: qualifying, unreimbursed in-home care costs above a yearly floor come off countable income, which can lift a family back toward the top of the range. Build your budget from the award letter the VA sends you, not from the table above.

Against Vermont's roughly $102,960-a-year cost for a non-medical caregiver, about $8,580 a month, even the full $29,093 veteran ceiling is a fraction of what a family would pay.3,1 Plan on the pension as one piece of the budget alongside other income, not the whole of it.

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

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 Congress sets.1 These are two separate limits: the income limit is the Maximum Annual Pension Rate (MAPR), and the net worth limit is its own figure, $163,699 for 2026.1 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 spouse or child, and it rises if you have dependents.1 Payments to an in-home attendant for help with daily activities count as medical expenses when the attendant provides health care or custodial care, paid in line with the hours worked. The attendant does not have to be a health care provider if the person needs Aid and Attendance or is housebound, or if a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that the person requires that care.1

For example, the VA subtracts only the unreimbursed care costs above the $872 yearly floor. Vermont's non-medical caregiver cost of about $102,960 a year, or $8,580 a month, is far above that floor, so when payments to an in-home aide meet the attendant conditions above, nearly all of what a family pays can count, which can lower countable income enough to qualify for the pension or increase the amount paid.1,3

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 the VA recognizes (such as World War II, the Korean conflict, the Vietnam War era, or the Gulf War), plus a minimum length of service. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty. One who started later generally needs at least 24 months or the full period for which they were called or ordered to active duty, with some exceptions.
• No dishonorable discharge. The VA also says a veteran with an other than honorable or bad conduct discharge may not be eligible, and names two ways to try to qualify: applying for a discharge upgrade or asking for a VA Character of Discharge review.
• Age, disability, or benefit status: meet at least one of four alternatives, any one of which satisfies this test on its own: 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 or Supplemental Security Income. A wartime veteran under 65 who receives SSDI or SSI meets it without any permanent-and-total rating.
• A need for aid and attendance: at least one of these must be true: needing another person to help with daily activities like bathing, feeding, and dressing; having to stay in bed, or spend a large portion of the day in bed, because of illness; being a patient in a nursing home due to the loss of mental or physical abilities related to a disability; or limited eyesight (even with glasses or contact lenses, 5/200 or less in both eyes, or a visual field of 5 degrees or less).
• Net worth under $163,699 for 2026, which counts your and your dependents' assets and income for VA purposes but excludes your primary home, your car, and basic home items like appliances.1,2 The home exclusion covers a residential lot of up to 2 acres, unless the extra acreage is not marketable, so the value of marketable land beyond 2 acres counts toward net worth.1

The VA looks back 36 months from the date it receives your pension claim. Transferring an asset for less than fair market value in that window can bring a penalty period of up to 5 years if, had you kept it, the asset would have pushed your net worth over the limit, so it is worth planning ahead.2 A surviving spouse can qualify under the Survivors Pension version of the benefit.

Paying a Family Caregiver

VA rules leave room for care to stay in the family: having a relative or another member of the household provide the needed aid and attendance does not prevent the VA from granting the Aid and Attendance allowance.2 If you pay a relative for that care, ask an accredited Veterans Service Officer how the VA will treat those payments before you count on them.

If you want a more structured way to pay a family caregiver, ask your VA medical center about Veteran-Directed Care (VDC). VDC 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 hire family, friends, or neighbors to provide services. A local aging and disability network agency, through an options counselor, helps plan the care and arranges fiscal management services. Enrolled veterans are eligible if they are eligible for VA community care, meet the clinical criteria for the service, and it is available where they live.5 VDC is a VA home and community-based care program, not a pension payment, so it is worth asking about alongside Aid and Attendance.

How Aid and Attendance Works with Vermont Medicaid

Aid and Attendance is a separate federal benefit from Medicaid long-term care, which in Vermont is administered by the Department of Vermont Health Access (DVHA) and includes the Choices for Care program.6 A person may potentially qualify for both, but the programs interact at two distinct steps. When Medicaid eligibility is determined, a state applies SSI income methodology to aged, blind, and disabled applicants, and under SSI rules a VA aid-and-attendance or housebound allowance is not income, so generally only the basic VA pension amount, not the Aid and Attendance increase, counts toward the income limit; states that use eligibility criteria more restrictive than SSI may count it, so the state's own rule governs there.6 The second step is the patient-share calculation for someone already eligible and receiving long-term care services. For people in medical institutions, federal rules count income that was disregarded at the eligibility step, and Vermont's rule § 24.04, "Allowable deductions from patient-share," lists "VA payments for aid and attendance paid to a veteran residing in a nursing facility or to the veteran's surviving spouse residing in a nursing facility" among the items "deducted from the individual's gross income." So under § 24.04, a nursing-facility resident's Aid and Attendance payment is deducted from gross income when Vermont works out the patient share.6 The rule then takes a second set of deductions from the patient share: a personal-needs allowance for someone in an institutional setting or a community-maintenance allowance for someone in a home and community-based setting, home-upkeep expenses where they apply, allocations to a spouse or family members living in the community, and reasonable medical expenses incurred. If a spouse or dependent relative still lives at home, ask DVHA for that allocation by name. That Aid and Attendance deduction, as written, names nursing-facility residents, so for care at home through Choices for Care, ask DVHA how the payment will be treated in a home and community-based setting.6

Because the precise treatment of VA pension income and the order in which to apply varies by situation and by state Medicaid rules, families should confirm how DVHA and Vermont Medicaid will treat the benefit before applying, ideally with an accredited Vermont Veterans Service Officer or DVHA.6

How to Apply and Get Free Help

The steps here are the pension route: the VA says you may be eligible for this benefit if you get a VA pension. Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation benefits, so a veteran who receives VA disability compensation rather than a pension should ask an accredited representative which route applies before filing anything.7

On the pension route, you apply using Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination section a medical examiner fills out to document the need for help. A wartime veteran who is not already receiving a VA pension also files Form 21P-527EZ (Application for Veterans Pension). If you are still gathering information, you can send 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.7 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 attorney, claims agent, or Veterans Service Organization representative can file it for you. Asked how long a decision takes, the VA answers "It depends," adding that it processes claims in the order it receives them unless a claim requires priority processing.7 If the VA denies the claim or decides it for less than you expected, you can ask for a decision review: a Supplemental Claim with new and relevant evidence, a Higher-Level Review, or a Board Appeal, and the last two must be requested within one year of the date on the decision letter. An accredited Veterans Service Organization representative can help you request one.8

Do not do this alone. The Vermont Office of Veterans Affairs runs a Veteran Service Officer program for veterans applying for federal VA benefits, including VA pension and the Aid and Attendance allowance.4 Its certified service officers complete the application and make sure the VA has everything it needs to process it, and the VA says the services an accredited VSO representative provides on a VA benefit claim are always free. The program can be reached toll-free in Vermont at (888) 666-9844 or by office phone at (802) 828-3379.4

Compare Care Settings in Vermont

See how Aid and Attendance works with other care settings in Vermont:

• How Aid and Attendance Pays for Assisted Living in Vermont
• How Aid and Attendance Pays for a Nursing Home in Vermont
• How Aid and Attendance Pays for Memory Care in Vermont

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.