VA Aid and Attendance can help pay for a nursing home in Virginia, but not in the way most families assume. The VA does not run or directly pay a nursing facility's bill. Instead, Aid and Attendance adds a monthly cash amount on top of a veteran's pension, and that money can go toward the cost of care. For a veteran already in a nursing home, the more powerful rule is often a quieter one: the cost of that care can be deducted from the income the VA counts, which is what makes many families eligible in the first place.

This guide explains how that works in Virginia, what a nursing home costs here, how Aid and Attendance interacts with Virginia Medicaid, and the one federal rule that caps the pension at $90 a month once Medicaid is paying the bill.

In This Guide

How Much a Nursing Home Costs in Virginia

A nursing home is the most expensive level of long-term care, and the figure families plan around is the semi-private (shared) room rate, because that is what most long-term residents pay.

In Virginia, a semi-private nursing home room runs about $104,025 a year, or roughly $8,669 a month, in 2026, according to the Genworth/CareScout Cost of Care Survey. A private room runs about $117,895 a year, or roughly $9,825 a month. Virginia's nursing-home costs run somewhat below the national semi-private median of about $111,325 a year, though Northern Virginia runs higher than rural parts of the state. These are industry-survey medians, not government figures, and costs rise as care needs grow.

Even below the national median, a year of shared-room care in Virginia is roughly $104,000. That is why families look hard at every benefit that can offset the bill, including VA Aid and Attendance.

How Aid and Attendance Helps Pay for It

Aid and Attendance is not a separate program. It is an increased monthly amount the VA adds to a veteran's or surviving spouse's pension when that person needs help with daily activities, is bedridden, or is a patient in a nursing home because of disability.

For 2026, the most a person can receive (the Maximum Annual Pension Rate paid monthly) is:

Who is receiving it Maximum monthly amount
Veteran, no dependents Up to $2,424
Veteran with one dependent (spouse) Up to $2,874
Surviving spouse Up to $1,558

Two points families miss. First, these are maximums, not flat checks: the VA pays the difference between your countable income and the cap, so the amount you receive depends on your other income. Second, the VA does not pay this money to the nursing home. It pays the veteran, who then applies it toward care. Against a Virginia semi-private room of about $8,669 a month, even the full $2,424 covers only part of the bill, so Aid and Attendance is best understood as one funding source among several, not a complete answer on its own.

How Nursing Home Costs Lower Your Countable Income

This is the part that changes outcomes. VA pension is needs-based: the VA pays the gap between your countable income and the pension cap. The higher your countable income, the smaller the benefit, and above the cap you get nothing.

But you can subtract continuing, unreimbursed medical expenses (UMEs) from that income, and nursing home fees you pay yourself, including meals and lodging the facility charges, count as a deductible medical expense. Only the portion of those expenses that exceeds 5% of the applicable Maximum Annual Pension Rate is deductible. For 2026 that floor is $872 a year for a veteran with no dependents (5% of the $17,441 MAPR) and $1,141 a year for a veteran with one dependent (5% of the $22,839 MAPR).

Consider what that means against a Virginia nursing home. A single veteran paying roughly $8,669 a month is spending about $104,000 a year on care, far above the $872 annual floor. Once that expense is deducted, countable income often drops to zero, which can unlock the full pension plus Aid and Attendance. A veteran whose income looked too high to qualify can become eligible precisely because the nursing home bill is so large.

A note on wording: those floors, $872 and $1,141, are annual figures, not monthly. The deduction is calculated against your yearly medical spending.

Who Qualifies

To receive 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 (WWII, Korea, Vietnam, or the Gulf War/post-9/11 era). Gulf War service requires 24 months of continuous active duty or the full period called to active duty.
  • Age or disability: 65 or older, or permanently and totally disabled.
  • Need for aid: help with daily activities such as bathing, dressing, or feeding; or being bedridden; or being a patient in a nursing home due to physical or mental incapacity.
  • Net worth under $163,699 for 2026, counting assets and annual income but excluding the primary home and vehicle.

The VA also enforces a 3-year look-back on assets transferred for less than fair market value, with a penalty period that can reach five years. A veteran living in a nursing home because of disability satisfies the "need for aid" test, so for nursing-home residents the eligibility question usually turns on wartime service, net worth, and income.

The $90/Month Nursing-Home Pension Cap

Here is the rule that surprises families most. Once Virginia Medicaid is paying for a veteran's nursing-home care, federal law sharply limits the VA pension.

Under 38 U.S.C. 5503(d)(2), implemented at 38 CFR 3.551, when a single veteran with no spouse or dependent children is covered by Medicaid in a nursing facility, the VA reduces the pension, including any Aid and Attendance amount, to no more than $90 a month for any period after the month of admission. That $90 is treated as a personal allowance the veteran keeps for personal needs, not as a contribution toward the cost of care.

The takeaway: Aid and Attendance is most valuable while the veteran is paying privately or through other means. Once Medicaid takes over the nursing-home bill, the large monthly pension effectively goes away for a single veteran, and only the $90 personal allowance remains. This cap applies to the single, no-dependents situation; a married veteran's circumstances differ, which is exactly the kind of timing question a VA-accredited representative should review before you file.

How Aid and Attendance Works with Virginia Medicaid

VA Aid and Attendance and Virginia Medicaid are separate programs run under different rules, and a Virginia veteran or surviving spouse can often qualify for both. 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.

The two programs count income differently. VA pension, including the Aid and Attendance amount, generally counts as income when a senior applies for Medicaid long-term care, but much of that amount is often attributable to medical costs, and the unreimbursed-medical-expense portion can frequently be offset so that not all of it counts against Medicaid's much lower income limits. The precise treatment depends on the Medicaid pathway and is determined case by case, so a veteran receiving Aid and Attendance who also needs Medicaid should have the income and expense treatment reviewed with a DVS benefits representative or DMAS before applying.

How to Apply and Get Free Help

You apply for Aid and Attendance by filing for VA pension with the aid-and-attendance increase. Two forms do the work:

  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), completed by the veteran's physician, documenting the need for help.
  • VA Form 21P-527EZ (Application for Veterans Pension), if the veteran is not already receiving a VA pension.

You can file online at va.gov, by mail, or through an accredited representative. Processing commonly takes three to six months.

Do not do this alone, and do not pay anyone to file an initial claim. The Virginia Department of Veterans Services (DVS) provides free claims assistance through a statewide network of benefit offices, where accredited Veterans Service Representatives help veterans identify, apply for, and file claims for VA pension and Aid and Attendance. All DVS benefits services are provided at no charge, and DVS encourages veterans to work with a representative before filing rather than self-filing or paying a third party.

Frequently Asked Questions

No. The VA does not run or pay your nursing facility's bill through Aid and Attendance. It pays a monthly cash benefit to the veteran (or surviving spouse), who then applies it toward the cost of care. Long-term nursing-home coverage in Virginia typically comes from Cardinal Care (Virginia Medicaid) once a person qualifies, not from the VA pension.

Often, yes, but with an important limit. A Virginia veteran can qualify for both, but once Cardinal Care is paying for nursing-home care, a single veteran's pension is capped at $90 a month under federal law. Because VA income generally counts toward Medicaid eligibility, have the treatment reviewed with DVS or DMAS before applying.

The fees you pay yourself for nursing-home care count as unreimbursed medical expenses, and you can deduct the portion above 5% of your pension cap, which is $872 a year for a single veteran in 2026. Because a Virginia nursing home costs far more than that floor, the deduction often lowers your countable income enough to qualify.

Up to $2,424 a month for a single veteran, up to $2,874 for a veteran with a spouse, and up to $1,558 for a surviving spouse. These are maximums; the VA pays the difference between your countable income and the cap, so the actual amount depends on your other income.

Compare Care Settings in Virginia

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

Learn More

Find personalized help using VA benefits to pay for a nursing home 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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.