VA Aid and Attendance is one of the few benefits that puts real cash toward assisted living in Virginia, where the median bill runs about $83,328 a year., It's a monthly pension payment for wartime veterans and their surviving spouses who need help with daily activities, and the money is yours to spend on care, including the cost of an assisted living community.

This guide explains what assisted living costs in Virginia, how much Aid and Attendance pays, how your care bills can actually help you qualify, and where to get free help applying.

In This Guide

How Much Assisted Living Costs in Virginia

Assisted living is a real expense in Virginia. According to the CareScout 2025 Cost of Care Survey, the median cost of assisted living in Virginia is about $83,328 per year, or roughly $6,944 a month. That runs above the national median of about $74,400, and Northern Virginia tends to run higher than rural parts of the state.

These are industry-survey medians, not government figures, so the price at any specific community will vary with location, level of care, and apartment size. But the number tells you what families are up against, and it's why a benefit like Aid and Attendance can make the difference between affording care and not.

How Aid and Attendance Helps Pay for Assisted Living in Virginia

Aid and Attendance is the VA Pension paid at a higher maximum rate for qualified veterans and survivors, not a second payment on top of it, and one way to qualify is needing another person to help with daily activities such as bathing, feeding, and dressing. It's paid in cash, and you can use it for whatever care you need, including the monthly bill at an assisted living community.

Here is the 2026 rate table:

Category Maximum Annual Rate Monthly (annual / 12)
Veteran alone Up to $29,093 Up to $2,424
Veteran with one dependent Up to $34,488 Up to $2,874
Surviving spouse Up to $18,697 Up to $1,558

A few things to keep in mind. The VA publishes these as annual maximum pension rates, and the monthly figure is the yearly award divided by 12, which is how the VA works out a monthly payment in its own example. The ceiling covers the whole pension, the basic amount plus the Aid and Attendance increase, so a veteran with no dependents moves from a $17,441 basic rate to $29,093 at the Aid and Attendance level, rather than getting $29,093 on top of the basic pension. Aid and Attendance is also not a payment to a facility: on the pension route it is paid as part of the VA pension, which comes to you (or your representative) as a monthly payment, and you pay the community yourself. Nor is the ceiling a flat payment. VA Pension is needs-based, keyed to your yearly family income and net worth, and VA bases the award on the difference between your income for VA purposes and the applicable rate, so a veteran with other income receives less. That is exactly why your care costs matter, which is the next section.

Wondering how much Aid and Attendance your family could receive? Chat with Brevy for a quick estimate.

How Assisted-Living Costs Lower Your Countable Income for Aid and Attendance in Virginia

This is the part most families miss, and it's the reason a veteran whose income looks too high can still qualify.

VA Pension is needs-based: to be eligible, your yearly family income and net worth have to meet limits set by Congress. You can lower the income the VA counts by deducting unreimbursed medical expenses (UMEs), and to be deductible they have to be unreimbursed in the first place.

Assisted living has its own branch of the rule, at 38 CFR 3.278(d)(3), covering a care facility other than a nursing home. Under that branch:

  • The care portion. 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.
  • Meals and lodging have a separate 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 has to qualify under 3.278(b)(7): licensed, if Virginia 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.

So a Virginia assisted living bill is deductible through those gates, not automatically in full because the resident lives in an assisted living community. A separate provision, at 3.278(d)(2), governs an in-home attendant and asks a different question, whether the individual requires the care the attendant provides, so do not read it onto a facility bill.

There is one catch: only the portion of your UMEs that exceeds 5% of the applicable MAPR is deductible. For 2026, that 5% floor is $872 for a veteran with no spouse or child, and it rises for a veteran with dependents, though it is always figured on the basic rate, never on the higher aid-and-attendance or housebound one.

In practice, that floor is small next to a $6,944-a-month assisted living bill. Once the charges that clear the tests above are deducted, your countable income can drop sharply, often to zero, which is what unlocks a higher monthly payment. So the assisted living bill that feels like the problem is also part of what qualifies you. Which line items count is the whole question, so have a DVS Veterans Services Representative go through the facility's itemized bill with you before you file.

Who Qualifies

To receive Aid and Attendance, a veteran must meet all of the following:

  • Have wartime service. The test turns on when active duty started, not on which war: a veteran who started before September 8, 1980 needs at least 90 days of active duty with at least one day during a wartime period, while a veteran who started as an enlisted person after September 7, 1980 generally needs at least 24 months, or the full period for which they were 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 on active duty after October 16, 1981 and had not previously served on active duty for at least 24 months
  • Not have received a dishonorable discharge
  • Meet at least one of these four, any one of which satisfies the test on its own: be 65 or older; 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
  • Have a net worth under $163,699. The calculation includes the claimant's and dependents' assets and income for VA purposes, and assets exclude the primary residence, the car, and basic home items like appliances
  • Need aid and attendance under the criteria at 38 CFR 3.352(a): needing another person's regular help to dress, stay clean and presentable, eat, or attend to the wants of nature, needing frequent adjustment of a prosthetic or orthopedic appliance, or having a physical or mental incapacity that requires care or assistance on a regular basis to protect against hazards of daily life; or being bedridden; or being a patient in a nursing home because of a loss of mental or physical abilities related to a disability; or having eyesight of 5/200 or less in both eyes or a visual field contracted to 5 degrees or less. Moving into an assisted living community is not listed among these criteria, so the claim rests on the level of care your family member actually needs, not on where they live

The VA enforces a 3-year look-back on assets transferred for less than fair market value before you file, and a penalty period can apply. A surviving spouse of a wartime veteran may qualify under the Survivors Pension, with the same $163,699 net worth limit.

How Aid and Attendance Works with Virginia Medicaid

Many Virginia families need both benefits. Aid and Attendance and Medicaid can work together, but they use different income rules, so coordination matters.

VA Pension, including Aid and Attendance, generally counts as income when a senior applies for Medicaid long-term care. The good news is that the medical-expense portion can frequently be offset or deducted, so not all of the VA pension counts against Medicaid's much lower income limits. The precise treatment depends on the Medicaid pathway and is determined case by case. Eligibility is only the first step, though. Once a person is eligible and receiving nursing-facility care, income that was disregarded in determining eligibility has to be considered again in the post-eligibility share-of-cost calculation (42 CFR 435.725), so any Aid and Attendance amount set aside at the eligibility stage is counted back in. DMAS must then subtract the deductions those post-eligibility rules require before the remainder is billed, and incurred medical expenses that no third party pays are one of them. Ask DMAS which deductions it will apply and in what amounts, including whether anything is set aside for the resident's own personal needs or for a spouse still living at home, before you budget on the gross figure. Someone on a home and community-based waiver such as Commonwealth Coordinated Care Plus also has a post-eligibility calculation, but the rules that set it are DMAS's to state rather than something to assume from the nursing-facility rule.

In Virginia, Medicaid is called Cardinal Care and is administered by the Department of Medical Assistance Services (DMAS). It covers long-term services and supports, including nursing-facility care and home- and community-based waiver services such as the Commonwealth Coordinated Care Plus waiver, and DMAS applies special income and resource rules to applicants seeking long-term care. Because the interaction is complex, a veteran receiving Aid and Attendance who also needs Medicaid should have the income and medical-expense treatment reviewed for their specific situation, ideally with a DVS benefits representative or DMAS.

How to Apply and Get Free Help

First, know which route you are on. VA Form 21-2680 is used to apply for Aid and Attendance benefits "that will be added to your monthly compensation or pension benefits," so it serves two routes. The steps below are the pension route, the one VA describes when it says "You may be eligible for this benefit if you get a VA pension." VA Form 21P-527EZ is the wartime, means-tested Veterans Pension application, so it belongs to the pension route only.

On the pension route, you apply with these VA forms:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), with the examination information section filled out by a medical examiner to document the need for help
  • VA Form 21P-527EZ (Application for Veterans Pension), the form a wartime veteran pursuing the pension route uses to file a pension claim, if you are not already receiving a VA pension
  • VA Form 21-0966 (Intent to File), if you are still gathering information and want to start the filing process. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive

You can apply online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office; an accredited attorney, accredited claims agent, or accredited Veterans Service Organization representative can also help you file.

Do not file alone. The Virginia Department of Veterans Services (DVS) provides benefits claims assistance through a statewide network of 38 benefit service offices, and says all of its services are free of charge. Its team members receive comprehensive training, and many are veterans or military spouses themselves. DVS highly encourages veterans to get help from a DVS Veterans Services Representative before filing, which it says carries a number of advantages over filing on your own.

Frequently Asked Questions

Does the VA pay my assisted living facility directly?

Not through this benefit. On the pension route, Aid and Attendance is the VA pension paid at its higher Aid and Attendance rate, and it goes to the veteran or surviving spouse, so you pay the facility yourself. The money reaches your household rather than the assisted living community. A DVS representative can tell you what else your family member may be entitled to through the VA.

My income seems too high. Can I still qualify?

Often, yes. VA Pension is needs-based, and you can deduct unreimbursed medical expenses from the income the VA counts. Assisted living charges can count when they meet the 38 CFR 3.278(d)(3) conditions described above. Only the portion above 5% of your MAPR ($872 for a veteran with no spouse or child in 2026, and higher with dependents) is deductible, but the qualifying part of a large assisted living bill usually clears that floor easily and can reduce countable income to near zero.

How much does assisted living cost in Virginia?

The median cost of assisted living in Virginia is about $83,328 per year, or roughly $6,944 a month, per the CareScout 2025 Cost of Care Survey. That is above the national median, and Northern Virginia tends to run higher than rural areas.

How long does it take to get approved?

Asked how long a decision takes, the VA's own answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing. DVS highly encourages veterans to get help from a DVS Veterans Services Representative before filing, which it says carries a number of advantages over filing on your own. You can apply while your loved one is already living in assisted living.

Compare Care Settings in Virginia

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

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Your next step Find personalized help paying for assisted living with VA benefits in Virginia 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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