VA Aid and Attendance is one of the most useful, and most overlooked, benefits for paying for memory care in Vermont. It raises the VA pension of a veteran or surviving spouse who meets one of four care-need tests, 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, how dementia-related care needs are weighed against the VA's need-for-aid test, 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 has no stand-alone memory-care licensing. Dementia care is delivered inside the state's assisted living residence and residential care home licensing framework, overseen by the Department of Disabilities, Aging and Independent Living (DAIL) through its Division of Licensing and Protection, under consolidated rules that took effect April 1, 2025. A home must get approval from the licensing agency before it establishes and operates a special care unit, and a home with a dementia unit has to describe in its uniform consumer disclosure form and its admission agreement how it can meet those residents' specialized needs. Every staff member who regularly interacts with residents of a dementia or memory-care unit needs at least eight hours of dementia training before working independently with them, plus at least two hours each year. Before you tour, know that a home may not call itself a special care unit unless DAIL has licensed the unit, and that it must let families read its unit proposal and training curriculum.

Because memory care sits inside that assisted living framework, the closest cost benchmark is assisted living, which runs about $103,167 a year 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. CareScout notes that costs vary within the state and rise as care needs grow, so treat the assisted-living figure as a benchmark rather than a quote, and ask each home for its own memory-care pricing. For comparison, nursing home care in Vermont is far higher still: a private room runs about $186,333 a year.

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, paid only to someone who already gets a VA pension and who needs another person's help with daily activities, has to stay in bed for much of the day because of illness, is in a nursing home due to the loss of mental or physical abilities related to a disability, or has severely limited eyesight. It comes as part of the monthly pension payment to the veteran or surviving spouse, so the family can put it toward a memory-care residence.

Here are the 2026 maximums, effective December 1, 2025 through November 30, 2026. The VA publishes them as annual rates. Pension is paid monthly, and under 38 CFR 3.273 and 3.29 the monthly payment is the maximum rate minus countable income, divided by 12 and rounded down to the whole dollar:

Who is applying 2026 maximum (annual)
Veteran, no dependents $29,093
Veteran with one dependent $34,488
Surviving spouse $18,697

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.

How Dementia Fits the Need-for-Aid Test

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. The diagnosis alone does not settle it. Under 38 CFR 3.352(a), the VA weighs factors such as being unable to dress, keep clean, or feed oneself, and a physical or mental incapacity requiring regular care to protect the person from the hazards of daily life. The need must be regular, not constant, and the decision rests on the actual need for personal help from others.

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 documented daily-care needs, not the diagnosis alone, 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 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 $103,167 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 can be large enough to offset much 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, with at least one day during wartime. Because the enlisted path has exceptions and also accepts the full period of a call to active duty, 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 before the claim: a transfer for less than fair market value that would have pushed net worth over the limit 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) and includes the Choices for Care program. A person may qualify for both, and the programs interact in two steps. At eligibility, a state applies SSI income methodologies to aged, blind, and disabled applicants, and under them the aid-and-attendance and housebound allowances are not income, so generally only the basic VA pension counts toward the Medicaid income limit; a state with criteria more restrictive than SSI may count it, so its own rule governs there.

At the second step, working out the patient share for someone already receiving long-term care, 42 CFR 435.725 (which covers people in medical institutions and intermediate care facilities) says income disregarded at eligibility must be considered, before deductions such as a personal needs allowance and incurred medical expenses. Vermont's Health Benefits Eligibility and Enrollment rule section 24.04 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 gross income when the patient share is worked out. That deduction names nursing-facility residents only, so ask DVHA how Aid and Attendance is treated in a memory-care residence or under Choices for Care.

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 a nursing facility receives under a Medicaid plan may not be reduced by any amount of pension permitted to be paid under that $90 cap, and the VA says you "would keep the full $90 for personal expenses." That describes the facility's cost of care, not Vermont's Medicaid personal needs allowance, a separate post-eligibility deduction; whether a state treats the $90 as additional to that allowance or in place of it varies from state to state. The $90 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. The cap does not reach a State veterans home for which the VA pays a nursing-home per diem (38 U.S.C. 5503(d)(1)(B)). There, under 42 U.S.C. 1396a(r)(1)(B), a Medicaid-eligible veteran with no spouse or child, or surviving spouse with no child, has pension above $90 a month, including any Aid and Attendance amount, counted as income only toward the home's cost of nursing home care. Because treatment, and the order in which to apply, vary by situation and by state Medicaid rules, confirm with DVHA or an accredited Vermont Veterans Service Officer how the benefit will be treated before applying.

How to Apply and Get Free Help

The steps below are the pension route: 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 application for the wartime, needs-based Veterans Pension that Aid and Attendance raises.,

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 help you file it. 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. You elect one of the three, not several at once: while a review is pending final adjudication, you can't file under a different option (38 CFR 3.2500(b)). A Higher-Level Review or a Board Appeal must generally be elected within one year of the date the VA issues notice of its decision; 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), 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. That last appeal goes to the Court, not to the VA. Mail the notice of appeal and it is deemed received on the date of the U.S. Postal Service postmark stamped on the envelope, provided the notice is properly addressed to the Court and the postmark is legible, so a notice postmarked inside the 120 days holds even if the Court receives it after. An accredited Veterans Service Organization representative can help you request the decision review, and the VA says that representative's services are always free.

Frequently Asked Questions

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

No. The VA does not grant the benefit on a diagnosis. It looks for a documented, regular need for help with daily activities or for care that protects the person from the hazards of daily life. 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 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 $103,167 a year, and costs rise as care needs grow, the qualifying deductions can be substantial.

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

Possibly; some people qualify for both. The Aid and Attendance amount is generally not counted as income at the eligibility step. At the patient-share step, Vermont's rule section 24.04 deducts VA aid-and-attendance payments to a veteran, or a veteran's surviving spouse, residing in a nursing facility; ask DVHA how that applies to a memory-care residence. A veteran with neither spouse nor child whose nursing-facility care Medicaid covers has the VA pension capped at $90 a month after the month of admission, though the cap does not reach a State veterans home that receives a VA per diem. 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, whose certified service officers complete the application for you., 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, annual rates up to $34,488, 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 maximum annual rate of $29,093 for a veteran alone, UME income offset, and free VSO help. Care TypesCost of Senior Care in VermontWhat senior care costs in Vermont in 2026: assisted living about $103,167 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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