VA Aid and Attendance can help a wartime veteran or surviving spouse pay for memory care in Virginia, where secured dementia care often costs more than a family expects. Aid and Attendance is paid as part of a monthly VA pension for qualified veterans and survivors, at a higher maximum rate than the basic pension.

If you are arranging dementia care for a veteran parent, this guide walks through what the benefit pays in 2026, why a dementia diagnosis can meet the rules, and how the cost of care itself can help your parent qualify. The help to apply is free, and we will show you where to find it.

In This Guide

How Much Memory Care Costs in Virginia

In Virginia, memory care for Alzheimer's disease and other dementias is provided inside a "safe, secure environment," a special care unit that an assisted living facility may operate under Virginia Department of Social Services regulations. Its doors to unprotected areas must be monitored or secured, for example with door alarms, delayed-egress locks or constant staff oversight. To be admitted, a resident must have a serious cognitive impairment due to a primary psychiatric diagnosis of dementia and be unable to recognize danger or protect their own safety, assessed in writing beforehand by an independent clinical psychologist licensed in Virginia or an independent physician board certified or board eligible in a relevant specialty. The one exception to those admission criteria is a spouse, parent, adult sibling or adult child who asks in writing to live in the unit with the resident, with the facility's written agreement and, if the resident can decide, the resident's. The facility also needs written approval for each placement.

These units carry their own overnight staffing floor: at least two awake direct-care staff when 22 or fewer residents are present, rising as the census grows. None of the sources we rely on publishes a Virginia median for memory care itself, so the closest anchor is assisted living in general, which runs about $6,945 a month, or about $83,340 a year, in the CareScout (Genworth) 2025 Cost of Care Survey data tables., These are industry-survey medians rather than government figures. For comparison, a semi-private nursing home room in Virginia runs about $123,005 a year and a private room about $140,160 a year.

How Aid and Attendance Helps Pay for Memory Care in Virginia

Aid and Attendance is paid as part of a monthly VA pension for qualified veterans and survivors, at a higher maximum rate than the basic pension. This guide follows that pension route: you may be eligible for the increase if you get a VA pension and meet at least one further test, such as needing another person to help you perform daily activities like bathing, feeding, and dressing. The money can be put toward memory care costs. Here are the 2026 maximums, effective December 1, 2025 through November 30, 2026. VA publishes these rates as annual maximums. Your monthly payment is worked out from them: VA subtracts your countable income from the annual maximum, divides the remainder by 12 and rounds down to the whole dollar (38 CFR 3.273 and 3.29). Read each one as a ceiling on the entire pension, which already includes the basic rate, rather than as a separate amount paid alongside it:

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

These are maximums. VA pension is needs-based, so the VA pays the difference between your countable income and the applicable maximum annual pension rate, which is why lowering your countable income (covered below) matters so much.

Can Dementia Meet the Aid and Attendance Test?

To receive Aid and Attendance, a veteran must need help with daily activities (such as bathing, dressing, feeding themselves, or protecting themselves from hazards), or be bedridden, be a patient in a nursing home due to the loss of mental or physical abilities related to a disability, or have very limited eyesight. Dementia can meet this standard when it leaves a person needing regular care to stay safe from everyday hazards. In Virginia, admission to a secured memory care setting itself requires an independent clinician to find that the resident cannot recognize danger or protect their own safety, closely tracking the VA's "protection from daily hazards" criterion.

In practice, that means the same dementia that makes a secured memory care placement necessary can be the same condition that supports an Aid and Attendance claim. The need still has to be documented by a medical examiner, which we cover in the application section.

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

Because the pension is keyed to countable income, you can reduce that income by deducting unreimbursed medical expenses (UMEs). Assisted living and other residential care facilities have their own conditions. Payments for help with daily activities count as medical expenses when the resident receives health care or custodial care in the facility and either needs Aid and Attendance (or is housebound) or has a written statement from a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist that, due to a physical, mental, developmental, or cognitive disorder, they need to be in a protected environment. Meals and lodging count when the facility provides or contracts for that health or custodial care. The facility must be licensed if Virginia requires that type to be, and a residential facility must be staffed around the clock. A secured memory care unit is the kind of protected setting this rule describes, but the Aid and Attendance need or the clinician's written statement still has to be in place.,

There is a floor: only the portion of UMEs that exceeds 5% of the applicable maximum annual pension rate is deductible. For 2026 that annual threshold is $872 for a veteran with no dependents and $1,141 for a veteran with one dependent.

Here is how that works in practice, as an illustration. Say your mother is a wartime veteran in a Virginia memory care unit and the family is paying around the assisted-living reference figure of $6,945 a month (about $83,340 a year), since no Virginia memory care median is published. If the conditions above are met, only the first $872 (the 5% floor for a veteran with no dependents) is set aside, and the rest of that yearly cost can be deducted from countable income. So a veteran whose income looked too high on paper can still qualify once large care costs are deducted, because the pension is the annual maximum less countable income after those deductions.

Who Qualifies

Beyond needing aid and attendance, the veteran must not have received a dishonorable discharge, and must meet three more tests:

  • Wartime service. The VA lists three service paths, and the length required turns on when the veteran started active duty, not on which war. Starting before September 8, 1980: at least 90 days of active duty with at least one day during a wartime period (WWII, Korea, Vietnam, or the Gulf War/post-9/11 era). Starting as an enlisted person after September 7, 1980: generally 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. Starting as an officer after October 16, 1981, without previously serving on active duty for at least 24 months, again with at least one day during wartime. Because of that third path and the exceptions to the 24-month rule, a post-1980 veteran with less than 24 months of service is not automatically ruled out.
  • Age, disability, nursing home, or SSDI/SSI. Any one of these satisfies the test on its own: 65 or older, 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. A wartime veteran under 65 who receives SSI qualifies here without any disability rating.
  • Net worth. Net worth under $163,699 for 2026, which counts the claimant's and dependents' assets and income but excludes the primary residence, the car, and basic home items. The home's exclusion covers a lot of up to 2 acres, so marketable land beyond that counts as an asset.

The VA also applies a 3-year (36-month) look-back: it reviews any assets transferred for less than fair market value in the three years before filing, and a transfer can trigger a penalty period of up to five years. Surviving spouses are subject to the same $163,699 net worth limit and the same look-back.

How Aid and Attendance Works with Virginia Medicaid

Many families need both VA benefits and Medicaid, and the two programs use different income rules, so coordination matters. On the VA side, unreimbursed medical expenses lower income for VA purposes, but only the amount above 5% of the applicable maximum annual pension rate. On the Medicaid side, Virginia is on the Social Security Administration's list of 209(b) states. These states use at least one eligibility rule stricter than SSI's, but they must let applicants spend income down to the eligibility level by incurring medical and remedial care costs that no health insurance covers. How that applies to a given applicant depends on the Medicaid pathway and is decided case by case. At the eligibility step, Virginia's manual is clear: when DMAS decides eligibility as an institutionalized individual, Aid and Attendance or housebound allowances and VA payments for unusual medical expenses are not income, in every covered group except those it labels F&C MN.

In Virginia, Medicaid is part of the Cardinal Care program, administered by the Department of Medical Assistance Services (DMAS). Cardinal Care provides long-term services and supports, and DMAS says eligibility is complicated, with additional special rules for people seeking long-term services and supports. Eligibility is only the first step, though. Once a person is eligible and receiving long-term care, Virginia calculates a monthly patient pay, the resident's share of the cost of care paid from their income. Here the VA money can come back in: the manual counts Aid and Attendance and pension payments above $90 a month toward patient pay for a veteran with no community spouse or dependent child, or a surviving spouse with no dependent child, and counts none of them when the veteran has a community spouse or dependent child or the surviving spouse has a dependent child. The federal post-eligibility rule for 209(b) states (42 CFR 435.733) covers medical institutions and intermediate care facilities, not waiver services, and its deduction list does not tell you what Virginia allows. Ask DMAS for the Virginia deductions, and how waiver services are treated, before you budget on any figure. One federal limit can matter more than any of that. If a veteran with no spouse or child, or a surviving spouse with no child, is covered by Medicaid for nursing facility care, VA can pay no more than $90 a month in pension for any period after the month of admission, and the facility's Medicaid payment may not be reduced by that $90. A State Veterans Home where VA makes the section 1741(a) per diem payment falls outside that rule, so check a specific home with an accredited Veteran Service Officer rather than assume the cap applies. A separate federal rule covers pension above $90 in a State veterans home with that per diem; ask DMAS how it and Virginia's rule apply together. 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 specific situation, ideally with a DVS benefits representative and DMAS.

How to Apply and Get Free Help

There are two main forms. First, VA 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 assistance. That form covers Aid and Attendance that will be added to either your monthly compensation or your pension benefits, so a veteran already receiving VA disability compensation rather than a pension uses it too. Second, on the pension route this guide covers, the VA's condition is that you may be eligible for this benefit if you get a VA pension. A wartime veteran taking that route who is not already receiving a VA pension also files VA Form 21P-527EZ (Application for Veterans Pension), the form a wartime veteran uses to file a pension claim. 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. How long a decision takes depends on the claim: the VA's own answer is "It depends." It works through claims in the order it receives them, unless a claim requires priority processing.

If the VA denies the claim or grants less than you expected, you are not out of options. After an initial decision, you can choose one of three paths: a Supplemental Claim filing new and relevant evidence the VA did not have when it reviewed the case before, a Higher-Level Review by a higher-level reviewer with no new evidence submitted, or a Board Appeal for review by a Veterans Law Judge at the Board of Veterans' Appeals. That choice is exclusive. Under 38 CFR 3.2500(b), once you have filed under one of these options you may not file under a different one on the same claim or issue while that review is pending final adjudication, and none of them is open while the benefit is on appeal before a federal court. So pick the route that fits the reason for the denial rather than filing two to hedge. 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. The regulation carves out a few exceptions, such as a contested claim, where several people claim a benefit only one can receive, which may go only to the Board and within 60 days. A Supplemental Claim can otherwise be filed at any time after that notice, but file it inside that same year if you can. 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 day the VA receives it, so filing late can cost back pay reaching to the original claim date. After a Higher-Level Review decision the menu narrows to a Supplemental Claim or a Board Appeal, and after a Board decision to a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, which must be filed within 120 days of the date on the Board's decision letter. That one is filed with the Court itself, not with the VA. A notice of appeal you mail is deemed received on the date of the U.S. Postal Service postmark on the envelope, as long as the notice is properly addressed to the Court and the postmark is legible, so postmarking inside the 120 days protects you even if the envelope arrives later. An accredited attorney, claims agent, or Veterans Service Organization representative can help you request the review, and the claims help DVS offers is free.,

You should not have to pay to file. The Virginia Department of Veterans Services (DVS) provides benefits claims assistance through a statewide network of 38 benefit service offices across the Commonwealth, and states that all services are provided free of charge. Disability Claims and Pensions are among the areas DVS handles; many of its team members are veterans or military spouses who have been through the claims process themselves, and they receive comprehensive training. DVS highly encourages Virginia veterans to seek help from a DVS Veterans Services Representative before filing a claim, which it says affords a number of advantages over self-filing. You can find your nearest office through the DVS Benefits & Services locator at dvs.virginia.gov/benefits-services.

Frequently Asked Questions

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

Not automatically, but it can. Aid and Attendance requires a need for help with daily activities or regular care to stay safe from everyday hazards. A veteran admitted to a secured memory care unit in Virginia has already been assessed in writing as unable to recognize danger or protect their own safety, which closely tracks that hazard test. A medical examiner still has to document the need in the examination section of VA Form 21-2680.

Can the cost of memory care help my parent qualify even if their income seems too high?

Yes, if the facility-care conditions are met. The pension is needs-based, and unreimbursed care costs can be deducted from countable income. Only the amount above 5% of the applicable maximum annual pension rate is deductible ($872 a year for a veteran with no dependents). A year of assisted living in Virginia runs about $83,340, far past that floor.

How much does Aid and Attendance pay in 2026?

In 2026, the maximum is $29,093 a year for a veteran with no dependents, $34,488 a year for a veteran with one dependent, and $18,697 a year for a surviving spouse with no dependents. VA pays monthly: it subtracts countable income from the annual maximum, divides by 12 and rounds down to the whole dollar. These are maximums; the VA pays the difference between your countable income and the applicable rate.

What if the VA denies the claim?

You can request a review through a Supplemental Claim with new evidence, a Higher-Level Review, or a Board Appeal to the Board of Veterans' Appeals. You elect one of them, not two: under 38 CFR 3.2500(b) you cannot file under a second option on the same claim or issue while the first review is pending final adjudication. 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 usually be filed at any time after that notice, but one received more than a year later takes an effective date no earlier than the day VA receives it. An accredited representative can help you request the review, and DVS claims help is free.,

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

The two can be coordinated, but they use different income rules. Virginia is a 209(b) state that must let applicants spend income down by incurring medical costs no insurance covers. Its manual does not count Aid and Attendance as income at the eligibility step for an institutionalized applicant (outside the F&C MN groups). Once eligible, Aid and Attendance and pension payments above $90 a month count toward patient pay, unless the veteran has a community spouse or dependent child or the surviving spouse has a dependent child. For a veteran with no spouse or child in a Medicaid-covered nursing facility, federal law caps VA pension at $90 a month after the month of admission, unless the facility is a State Veterans Home where VA pays the section 1741(a) per diem. Have your situation reviewed with a DVS representative and DMAS.

Next Steps

Start by gathering your veteran's discharge papers and a clear picture of monthly memory care costs, then book the medical examination that completes VA Form 21-2680. If you are still gathering that information, you can submit VA Form 21-0966 (Intent to File) first: submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive. Before you file anything, contact the Virginia Department of Veterans Services at dvs.virginia.gov/benefits-services for free help. DVS encourages veterans to work with a Veterans Services Representative before filing; schedule an appointment at your nearest office and bring the documents DVS lists, among them the DD-214 and a photo ID.

Compare Care Settings in Virginia

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

Learn More

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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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