VA Aid and Attendance is one of the most useful, and most overlooked, benefits for paying for memory care in Vermont. It is an increased rate of a veteran's or surviving spouse's VA pension for those who need regular help with daily activities, and that higher payment can be applied directly to the cost of a secured dementia setting.

If you are arranging dementia care for a veteran parent, this guide walks through how the benefit works, why a dementia diagnosis so often qualifies, and how to apply at no cost. The numbers and rules here are current for 2026.

In This Guide

How Much Memory Care Costs in Vermont

Vermont does not issue a stand-alone memory-care license. Instead, dementia care is built into the state's assisted living residence and residential care home licensing framework, overseen by the Department of Disabilities, Aging and Independent Living through its Division of Licensing and Protection. A facility that runs a dementia or Alzheimer's special care unit must get special approval from the Division of Licensing and Protection before opening it, disclose in writing how the program meets the needs of residents with dementia, and provide dementia-specific training for its direct-care staff.

Because memory care is delivered inside an assisted living residence rather than under a separate license, the closest cost benchmark is assisted living, which runs about $103,137 a year (roughly $8,595 a month) in Vermont, well above the national median of about $74,400 a year ($6,200 a month), according to the CareScout 2025 Cost of Care Survey. Secured dementia settings and the specialized staffing they require typically push memory care above that standard assisted-living rate, so treat the assisted-living figure as a conservative floor and ask each facility for its specific memory-care pricing. For comparison, nursing home care in Vermont is far higher still: a private room runs about $186,333 a year (roughly $15,528 a month).

How Aid and Attendance Helps Pay for Memory Care in Vermont

Aid and Attendance is an increased rate of a veteran's or surviving spouse's VA pension for those who need help with daily activities, are bedridden, are in a nursing home due to disability, or have severely limited eyesight. The benefit is paid in cash to the veteran or spouse, so it can go toward whatever care they need, including a memory-care residence.

Here are the 2026 maximums, effective December 1, 2025 through November 30, 2026. The VA publishes them as annual rates, so the monthly figure is the yearly amount divided by 12:

Who is applying 2026 maximum (annual) Monthly equivalent
Veteran, no dependents $29,093 $2,424
Veteran with one dependent $34,488 $2,874
Surviving spouse $18,697 $1,558

These are ceilings, not payments. Because the pension is needs-based, the VA pays the difference between countable income and the maximum annual pension rate for the situation, so the actual monthly check depends on income and deductible expenses. That is why the medical-expense deduction below matters so much for a family paying for memory care.

Why Veterans With Dementia Often Qualify

One of the ways to meet the Aid and Attendance test is needing help with daily activities, such as bathing, dressing, feeding yourself, or protecting yourself from everyday hazards. A person living with Alzheimer's or another dementia frequently needs exactly this kind of help and supervision, which is why so many veterans with dementia qualify even when their bodies are otherwise healthy.

Being a patient in a nursing home because of the loss of mental or physical abilities related to a disability also satisfies the test on its own. The need for aid is documented by a medical examiner on the VA's examination form, so the diagnosis and the daily-care needs it creates are what carry the claim.

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

VA pension is needs-based: the VA pays the gap between your countable income and the maximum annual pension rate for your situation. You can shrink your countable income by deducting unreimbursed medical expenses, but only the portion that exceeds 5% of your maximum annual pension rate (counting any increase for family members, but not the aid-and-attendance or housebound increase) is deductible. For 2026 that annual floor is $872 for a veteran with no dependents and $1,141 for a veteran with one dependent.

Because Vermont licenses memory care inside its assisted living residence and residential care home framework, a memory-care bill runs through 38 CFR 3.278(d)(3), the branch covering a care facility other than a nursing home, and the expenses have to be unreimbursed to be deductible at all. Under that branch, payments for health care provided by a health care provider are medical expenses. Payments for help with activities of daily living and instrumental activities of daily living count even when the person providing that help is not a health care provider, but only if the resident is receiving health care or custodial care in the facility 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, because of a physical, mental, developmental, or cognitive disorder, the resident needs to be in a protected environment. That written protected-environment finding is one many memory-care residents can meet, but it has to actually be made, not assumed.

Meals and lodging have their own test at 3.278(d)(3)(iv): the room-and-board portion counts if the facility provides or contracts for the resident's health care or custodial care, or if one of those clinicians states in writing that the person must live in the facility (or a similar one) to receive health or custodial care from a third party, from family, or from friends. The facility itself also has to qualify under 3.278(b)(7): licensed, if Vermont requires facilities of that type to be licensed, and, if it is residential, staffed 24 hours a day with care providers, who do not have to be licensed health care providers. A separate provision at 3.278(d)(2) governs an in-home attendant and asks a different question, so do not read it onto a facility bill.

Here is what that means in practice. Suppose a single veteran pays the assisted-living benchmark of about $103,137 a year for a Vermont memory-care residence. The whole invoice is not automatically deductible: what counts is the portion of the bill that clears the tests above, less the $872 floor. In a secured dementia setting where the resident is receiving custodial care and the clinical statement is in hand, that qualifying portion is often large enough to erase most or all of the veteran's countable income, which is why a veteran whose income first looks too high can still qualify. Have an accredited Veterans Service Officer go through the facility's itemized bill with you before you file.

Who Qualifies

To receive Aid and Attendance, a veteran must not have received a dishonorable discharge, and generally must meet four conditions:

  • Wartime service: the test turns on when active duty started, not on which war. The VA lists three service paths. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty with at least one day during a wartime period (World War II, Korea, Vietnam, the Gulf War). A veteran who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months (with some exceptions), or the full period for which they were called or ordered to active duty, again with at least one day during wartime. The third path covers a veteran who started active duty as an officer after October 16, 1981 and had not previously served on active duty for at least 24 months. Because these are the VA's paths rather than an exhaustive gate, a post-1980 veteran with under 24 months of service is not automatically ruled out.,
  • Age or status: the veteran must meet at least one of four alternatives, and any single one is enough: at least 65 years old; 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. The nursing-home and SSDI/SSI branches stand on their own, so a wartime veteran under 65 who receives SSI qualifies without any adjudicated permanent-and-total rating.
  • Net worth under $163,699 for 2026. The calculation includes the claimant's and dependents' assets and income for VA purposes; assets exclude the primary residence, the car, and basic home items like appliances.
  • A documented need for aid: needing help with daily activities, being bedridden, being in a nursing home due to incapacity, or having severely limited eyesight.

The VA applies a 3-year (36-month) look-back on assets transferred for less than fair market value before filing, and a transfer can trigger a penalty period of up to five years. A surviving spouse can qualify under the Survivors Pension with the same net worth limit.

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), primarily through the Choices for Care program. A person may potentially qualify for both, but the programs interact in two separate steps. When a state first decides whether an aged, blind, or disabled applicant is financially eligible, it applies SSI income methodologies, and under those methodologies the aid-and-attendance and housebound allowances are not income, so generally only the basic VA pension, not the Aid and Attendance increase, counts toward the Medicaid income limit; a state that uses eligibility criteria more restrictive than SSI may count it, so the state's own rule governs there.

At the second step, once Medicaid is paying for long-term care, the federal baseline at 42 CFR 435.725 is that income disregarded at eligibility must be considered in the patient-share calculation, with incurred medical expenses then deducted. Vermont's own rule is more generous than that baseline for nursing-facility residents: Vermont's Health Benefits Eligibility and Enrollment rule section 24.04, on 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 when the actual patient share is worked out. That deduction as written names nursing-facility residents, so it does not tell you how Aid and Attendance is treated in a memory-care residence or under Choices for Care; ask DVHA directly about a home and community-based setting.

Separately, under 38 U.S.C. 5503(d)(2), a veteran having neither spouse nor child who is covered by a Medicaid plan for nursing-facility services may be paid no more than $90 a month in VA pension for any period after the month of admission, and 38 U.S.C. 5503(d)(5)(A) applies the same rule to a surviving spouse having no child. Under 38 U.S.C. 5503(d)(3), the payment the nursing facility receives under a Medicaid plan may not be reduced by any amount of the pension the beneficiary is permitted to keep, and the VA describes the effect of that anti-offset rule this way: "your facility can't count this monthly payment as income toward your cost of care. You would keep the full $90 for personal expenses." That statement is about the facility's cost of care. It does not settle how the $90 relates to Vermont's Medicaid personal needs allowance, which is a separate deduction taken under the state's own post-eligibility rules, and whether a state treats the $90 as additional to its personal needs allowance or in place of it varies from state to state. That cap applies to Medicaid-paid nursing-facility care, not to privately paid memory care, so a family using Aid and Attendance to help cover a memory-care residence is in a different situation. Because the precise treatment of VA pension income and the order in which to apply varies by situation and by state Medicaid rules, confirm how DVHA will treat the benefit before applying, ideally with an accredited Vermont Veterans Service Officer or DVHA directly.

How to Apply and Get Free Help

The steps below are the pension route, which is how most families paying for memory care apply: the VA's condition is that you may be eligible for this benefit if you get a VA pension. Aid and Attendance can also be added to monthly compensation, and VA Form 21-2680 covers that route too. On the pension route, applying takes two VA forms:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), with a medical examiner filling out the examination information section to document the need for assistance.
  • VA Form 21P-527EZ (Application for Veterans Pension), for a wartime veteran pursuing the pension route who is not already receiving a VA pension. This is the wartime, means-tested pension application, so a veteran who receives VA disability compensation rather than a pension is not the person who files it.

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. The VA's answer to how long a decision takes is "It depends." It processes claims in the order it receives them unless a claim requires priority processing.

You do not have to do this alone, or pay anyone. The Vermont Office of Veterans Affairs runs a Veteran Service Officer (VSO) program for veterans applying for federal VA benefits, and the office's advice is blunt: do not file for Disability Compensation or Improved Pension by yourself. Its certified service officers complete the application and make sure the VA has everything it needs to process it, which increases the chances of success and helps prevent delays. The VA says the services an accredited VSO representative provides on your claim are always free, while an accredited attorney or claims agent can charge fees. To speak with a Veteran Service Officer, call 802-828-1082. The office is at 118 State Street, Montpelier, VT 05620-4401; its main line is (802) 828-3379 and its toll-free number, for Vermont only, is (888) 666-9844.

What If the Claim Is Denied

If the VA denies the claim or grants less than you expected, you have three decision review options after that initial decision. You can file a Supplemental Claim with new and relevant evidence the VA did not have when it reviewed the case before, such as an updated VA Form 21-2680 or added medical records; request a Higher-Level Review, where a higher-level reviewer reviews the case and no new evidence is submitted; or file a Board Appeal, where a Veterans Law Judge at the Board of Veterans' Appeals reviews the case. A Higher-Level Review or a Board Appeal must be elected within one year of the date the VA issues notice of its decision, the limit for most VA benefits, with certain benefits carrying shorter ones your decision letter names; a Supplemental Claim can be filed at any time after that notice, but waiting past the one-year mark has a price. A Supplemental Claim the VA receives more than one year after the date on the decision notice takes an effective date no earlier than the date the VA receives it (38 CFR 3.2500(h)(2)), and continuous pursuit of the claim is broken unless the VA grants an extension of the one-year period for good cause (38 CFR 3.109(b)). In practice that can cost back pay all the way to the original claim date, so file inside the year even though the door stays open. That menu is also decision-dependent: after a Higher-Level Review decision the options are a Supplemental Claim or a Board Appeal, and after a Board decision a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, filed within 120 days of the date on the Board's decision letter. A denial often comes down to thin documentation of the daily-care need, so a stronger dementia exam frequently turns a claim around. The same Vermont Veterans Service Officer who filed the claim can prepare and file the decision review at no cost.

Frequently Asked Questions

Does a dementia diagnosis automatically qualify a veteran for Aid and Attendance?

Not automatically, but it often qualifies in practice. The benefit looks for a need for help with daily activities or protection from everyday hazards, and dementia commonly creates exactly that need. A medical examiner documents the need on VA Form 21-2680, and the veteran must also have no dishonorable discharge and meet the wartime-service and net-worth conditions, plus one of four status tests: 65 or older, permanently and totally disabled, in a nursing home for long-term care because of a disability, or receiving SSDI or SSI.,

How much will Aid and Attendance actually pay toward memory care?

In 2026, the maximum annual pension at the Aid and Attendance level is $29,093 (about $2,424 a month) for a veteran with no dependents, $34,488 with one dependent, and $18,697 for a surviving spouse. That is a ceiling, not a payment: the actual amount depends on countable income, because the VA pays the difference between that income and the maximum rate for the situation.

Our income seems too high. Should we still apply?

Often, yes. Memory-care charges that meet the conditions in 38 CFR 3.278(d)(3) can be deducted as unreimbursed medical expenses, and only the part above the annual floor is deductible: $872 for a veteran with no dependents, $1,141 with one dependent. Given that Vermont's assisted-living benchmark alone is about $103,137 a year, and secured dementia settings typically cost more, the qualifying deductions are usually substantial.

Can my parent receive both Aid and Attendance and Vermont Medicaid?

Possibly. The two are separate programs and some people qualify for both. The Aid and Attendance amount itself is generally not counted as income at the eligibility step. At the patient-share step the federal baseline is that it is counted, but Vermont's own rule deducts VA aid-and-attendance payments made to a veteran, or to a veteran's surviving spouse, residing in a nursing facility; that deduction as written names nursing facilities, so ask DVHA how it applies to a memory-care residence. And a veteran having neither spouse nor child whose nursing-facility care is covered by Medicaid has the VA pension capped at $90 a month. Because the treatment varies by situation, confirm with DVHA or an accredited Vermont Veterans Service Officer before applying.

Next Steps

Start by having your parent's doctor or another medical examiner complete VA Form 21-2680 to document the dementia-related need for care, then contact the Vermont Office of Veterans Affairs to have an accredited VSO prepare and file the claim for free. Gather your parent's care costs and income now, so the VSO can show how memory-care expenses lower countable income. If Medicaid may also be in the picture, ask the VSO or DVHA how the two programs fit together before you decide the order in which to apply.

Compare Care Settings in Vermont

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

Learn More

VA BenefitsVA Aid and Attendance in VermontVA Aid and Attendance in Vermont for 2026: who qualifies, monthly rates up to $2,874, how to apply, and free help from the Vermont Office of Veterans Affairs. Care TypesMemory Care in VermontVermont has no separate memory care license. Dementia care lives in assisted living, with special-care-unit approval, a written disclosure, and trained staff. VA BenefitsVA Aid and Attendance for Assisted Living in VermontVA Aid and Attendance helps pay for assisted living in Vermont. 2026 rates up to $2,874/mo, eligibility rules, UME income offset, and free Vermont VSO help. Care TypesCost of Senior Care in VermontWhat senior care costs in Vermont in 2026: assisted living about $103,137 a year, a private nursing-home room about $186,333. See every setting and how to pay.
Your next step Find personalized help using VA benefits to pay for memory care in Vermont 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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