VA Aid and Attendance is one of the most useful and most overlooked ways to help pay for in-home care in Virginia. It is a monthly cash benefit, most often paid as an increase to a veteran's or surviving spouse's VA pension, and because it is paid as cash, the money can go straight toward an aide who comes to the house. For a family trying to keep a parent at home rather than move them to a facility, that monthly check can be the deciding factor.

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

How Much In-Home Care Costs in Virginia

In-home care in Virginia runs above the national line. According to the CareScout (Genworth) 2025 Cost of Care Survey, released March 2026 and the most recent state-level data, non-medical in-home care in Virginia runs about $80,080 per year. In its 2025 survey, CareScout merged the former homemaker and home health aide categories into a single "non-medical caregiver" category.

A homemaker helps with errands, meals, and housekeeping, while a home health aide adds hands-on help with bathing, dressing, and similar daily tasks. These are industry-survey medians, not government figures, and Northern Virginia runs higher than rural parts of the state. Either way, paying for in-home care out of pocket adds up fast, which is why an extra monthly benefit matters. Cutting a fixed cost helps as much as adding income does. A veteran staying at home who holds a qualifying VA disability rating may owe no local real estate tax on that home under Virginia's exemption for disabled veterans; our guide to Virginia's disabled veteran property tax exemption covers the rating it takes and how to claim it.

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

Aid and Attendance is an increased monthly pension the VA pays a qualifying veteran or surviving spouse who needs help with daily activities, at a higher maximum rate than the basic VA pension. It is paid as cash, so unlike a benefit that only covers care at a specific facility, the money can go toward an in-home aide, a homemaker, or other care costs at home.

Here is what the benefit pays in 2026 (rates effective December 1, 2025 through November 30, 2026):

Category Maximum Annual Amount Approximate Monthly
Veteran alone $29,093 about $2,424
Veteran with one dependent $34,488 $2,874
Surviving spouse $18,697 about $1,558

The VA publishes annual rates; a monthly amount is the yearly award divided by 12. These are ceilings, not payments. The Maximum Annual Pension Rate is the maximum amount of pension payable, and the VA pays the difference between your income for VA purposes and that limit, so a claimant with countable income receives less than the figures above.

Against Virginia's roughly $80,080-a-year cost for in-home care, the maximum veteran rate covers a meaningful share of part-time care. It rarely covers full-time care on its own, but combined with other income it can keep a loved one safely at home.

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

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 set by Congress. Because the benefit is keyed to the income the VA counts, unreimbursed medical expenses can be subtracted from that 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 Maximum Annual Pension Rate (MAPR) counts. For 2026, the VA puts that floor at $872 for a veteran with no spouse or child; it rises with dependents, but never includes the aid-and-attendance or housebound increase.

In-home attendant care carries a condition of its own. The attendant has to be a health care provider unless the person needs aid and attendance or is housebound, or unless a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that a physical, mental, developmental, or cognitive disorder is why the person requires the health care or custodial care the attendant provides. The yearly cost of an aide clears the floor easily, so a documented care need is what turns those costs into a deduction that can lower the income the VA counts.

Who Qualifies

To qualify for Aid and Attendance, a veteran generally must meet all of the following:

  • Wartime service: at least 90 days of active duty with at least one day during a wartime period (such as World War II, Korea, Vietnam, or the Gulf War). Gulf War service has its own length-of-service rules.
  • Discharge, plus one of four qualifying circumstances: no dishonorable discharge, and at least one of these must be true: 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 meets this test with no adjudicated rating.
  • A need for aid and attendance: need help with daily activities such as bathing, dressing, or eating, or be bedridden, in a nursing home due to incapacity, or have severely limited eyesight.
  • Net worth under $163,699 for 2026, which counts assets and annual income but excludes the primary home, a vehicle, and basic household goods.

The VA reviews asset transfers made for less than fair market value during the three years before you file, so it is worth planning ahead. A surviving spouse can qualify under the Survivors Pension version of the benefit.

Using Aid and Attendance to Pay a Family Caregiver

Because Aid and Attendance is paid to the beneficiary as part of the monthly pension, families commonly use it to help compensate a relative who provides care at home.

If you want a more structured way to pay a family caregiver, ask your VA medical center about Veteran-Directed Care (VDC). VDC gives a veteran a flexible, clinically set budget to hire their own caregivers, including family members and even a spouse, with a financial management service handling payroll. Eligibility requires VA enrollment, a clinical need for personal care, and risk of needing institutional care. VDC is a separate program from the Aid and Attendance pension, but the two can both support care at home.

How Aid and Attendance Works with Virginia Medicaid

VA Pension, including Aid and Attendance, generally counts as income when a senior applies for Medicaid long-term care, but the two programs use different income rules, so coordination matters. Under federal VA rules, a pension claimant's countable income can be reduced by unreimbursed medical expenses such as home health services, which is why much of the Aid and Attendance amount is often effectively attributable to medical costs. For Medicaid, that medical-expense portion can frequently be offset so that not all of the VA pension counts against Medicaid's much lower income limits, though the precise treatment depends on the pathway and is determined case by case.

In Virginia, Medicaid is called Cardinal Care and is administered by the Department of Medical Assistance Services (DMAS); it provides long-term services and supports, including nursing-facility care and home- and community-based waiver services such as the Commonwealth Coordinated Care Plus waiver. Eligibility is only the first step, though. Once a person is eligible and receiving nursing-facility care, income that was disregarded at the eligibility stage must be counted again in the post-eligibility share-of-cost calculation (42 CFR 435.725), so any Aid and Attendance amount set aside earlier 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 personal needs or for a spouse still living at home, before you budget on the gross figure. A Commonwealth Coordinated Care Plus waiver client at home 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. A veteran receiving Aid and Attendance who also needs Medicaid long-term care should have the income and unreimbursed-medical-expense treatment reviewed for their situation, ideally with a DVS benefits representative or DMAS.

How to Apply and Get Free Help

The steps below are the pension route, the one this guide covers: the VA says you may be eligible for this benefit if you get a VA pension. You apply using two VA forms: Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination information section a medical examiner fills out to document the need for help, and, for a wartime veteran on the pension route who is not already receiving a VA pension, Form 21P-527EZ (Application for Veterans Pension), the means-tested wartime pension application. Form 21-2680 is not limited to pension claims: the VA describes it as applying for Aid and Attendance benefits that will be added to your monthly compensation or pension benefits, so a veteran who receives VA disability compensation rather than a pension uses the same form to seek Aid and Attendance added to that compensation. You can apply online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office, and an accredited attorney, accredited claims agent, or accredited Veterans Service Organization representative can also help you file. Asked how long a decision takes, the VA answers, "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.

Do not do this alone. The Virginia Department of Veterans Services (DVS) provides claims assistance through a statewide network of 38 benefit service offices across the Commonwealth, and states that all of its services are provided free of charge. DVS handles disability claims and pensions; many of its team members are veterans or military spouses who have been through the claims process themselves, and they receive comprehensive training. Virginia veterans are highly encouraged to seek assistance from a DVS Veterans Services Representative before filing a claim, which DVS says affords a number of advantages over self-filing. You can find your nearest office through the office locator at dvs.virginia.gov.

If your claim is denied, you have options, and a DVS representative can help you pursue them. You can file a Supplemental Claim with new and relevant evidence the VA did not have when it reviewed the case before, request a Higher-Level Review in which a higher-level reviewer looks at the case again to decide whether an error or a difference of opinion changes the decision (no new evidence may be submitted), or appeal to the Board of Veterans' Appeals for review by a Veterans Law Judge. For most VA benefits, a Higher-Level Review or Board Appeal must be requested within one year of the date on your decision letter, and certain benefits carry shorter deadlines, so check the deadline your letter states. A Supplemental Claim can be filed at any time, though the VA recommends filing within one year to keep your effective date. The VA's online claim-status tool covers pension claims, decision reviews, and appeals, and for questions the VA benefits hotline is 800-827-1000 (TTY: 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.

Frequently Asked Questions

Can Aid and Attendance be used to pay for in-home care in Virginia?

Yes. Aid and Attendance is paid as cash, usually as part of a VA pension, so the money can go directly toward an in-home aide, a homemaker, or other care at home. It is not tied to a specific facility, which makes it well suited to families keeping a loved one at home.

How much does Aid and Attendance pay in 2026?

Up to $29,093 a year, about $2,424 a month, for a veteran alone; up to $34,488 a year ($2,874 a month) for a veteran with one dependent; and up to $18,697 a year, about $1,558 a month, for a surviving spouse. The VA publishes annual rates, and a monthly amount is the yearly award divided by 12. These are maximums, and the actual amount depends on your countable income.

Does my parent's income disqualify them if it looks too high?

Not necessarily. The VA deducts unreimbursed medical expenses above a yearly floor, which it puts at $872 for a veteran with no spouse or child in 2026, from the income it counts, so families that look over the limit can still qualify once those costs are deducted.

Can a veteran get both Aid and Attendance and Virginia Medicaid?

Often yes. VA pension generally counts as income for Cardinal Care, but the medical-expense portion can frequently be offset so not all of it counts against Medicaid's limits. Have the treatment reviewed with a DVS representative or DMAS.

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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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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