VA Aid and Attendance is an increase to the VA pension, and for a Washington family it can put monthly money toward care at home. For a veteran or surviving spouse who qualifies for a VA pension, it is paid as part of that monthly pension, and because it arrives as cash, the money can go straight toward an aide who comes to the house. With Washington's in-home care costs second-highest in the country, that monthly check can be the difference between keeping a parent at home and not.

This guide explains exactly how Aid and Attendance works for in-home care, how much it pays in 2026, who qualifies, and where to get help filing the claim.

In This Guide

How Much In-Home Care Costs in Washington

Washington's median long-term care costs run above the national medians for in-home care, assisted living, nursing homes, and adult day health care, and in-home care ranks second in the country. According to the CareScout 2025 Cost of Care Survey (the Genworth/CareScout survey published March 2, 2026, from rates gathered from care providers July through November 2025), a non-medical caregiver in the home runs a median of about $8,580 a month, or roughly $102,960 a year, in Washington, CareScout's figure for 44 hours a week over 52 weeks. The national median for the same care is about $6,673 a month.

The 2025 survey merged what used to be two separate lines, a homemaker and a home health aide, into a single non-medical caregiver category. These are industry-survey medians, not government figures. Either way, paying for in-home care out of pocket adds up fast, which is why an extra monthly benefit matters.

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

Aid and Attendance is an increased monthly VA pension for a qualifying veteran or surviving spouse who needs help with daily activities. It raises the ceiling on the pension itself rather than paying a second benefit on top of the basic rate. That is the pension route, and it is the one this guide covers. Aid and Attendance is not limited to it: VA's own examination form, Form 21-2680, is used to apply for Aid and Attendance benefits "that will be added to your monthly compensation or pension benefits," so a veteran already receiving VA disability compensation seeks it on the compensation side instead. On the pension route, the benefit comes as monthly payments added to the pension, 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 are the 2026 maximums (rates effective December 1, 2025 through November 30, 2026). Each one is a ceiling rather than a payment: VA pays the difference between the limit and your income for VA purposes, so a claimant with income receives less. VA publishes these rates as annual amounts but pays pension monthly: under 38 CFR 3.273, it subtracts your countable income from the annual maximum and divides the remainder by 12.

Category Maximum Annual Amount
Veteran alone $29,093
Veteran with one dependent $34,488
Surviving spouse, no dependent child $18,697

Against Washington's roughly $102,960-a-year cost for a non-medical caregiver, a veteran's $29,093 ceiling covers a meaningful share of part-time in-home care, and countable income reduces the actual award below it. Even the full ceiling is well under that annual cost, so it cannot cover that level of care on its own, but combined with other income it can help keep a loved one at home.

How Washington 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 income, recurring out-of-pocket care costs can be subtracted from the income the VA counts, 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, that floor is $872 per year for a veteran with no spouse or child, and it rises for a veteran with dependents, though it never reflects the aid-and-attendance or housebound increase. In-home attendant care counts as a medical expense as long as the attendant provides health care or custodial care and the payments match the hours the attendant works. The attendant must be a health care provider unless the person needs aid and attendance or is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist puts in writing that a physical, mental, developmental, or cognitive disorder makes that care necessary.

For example, a veteran paying for an in-home aide might spend $28,000 over a year on that care. The first $872 does not count, but the remaining roughly $27,000 can be subtracted from countable income, which may lower it enough to qualify for the pension or increase the amount paid.

Who Qualifies

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

  • Wartime service: at least one day of active duty during a wartime period (such as World War II, Korea, Vietnam, or the Gulf War), plus a minimum length of service that depends on when you started. Someone who went on active duty before September 8, 1980 needs at least 90 days; an enlisted person who started after September 7, 1980 generally needs 24 months or the full period they were called up for, with some exceptions.
  • No dishonorable discharge.
  • Age or disability, on any one of four paths: be at least 65 years old, 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. Meeting any single one satisfies this test, so a wartime veteran under 65 on SSI qualifies here without a permanent-and-total rating.
  • A need for aid and attendance: need help with daily activities such as bathing, dressing, or eating, have to stay in bed or spend a large portion of the day in bed because of illness, be in a nursing home due to the loss of mental or physical abilities related to a disability, or have severely limited eyesight.
  • Net worth under $163,699 from December 1, 2025 through November 30, 2026. VA's net worth calculation includes your and your dependents' assets and annual income for VA purposes, so comparing savings alone against the limit gives the wrong answer; the primary home, a vehicle, and basic household goods are excluded.

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

Aid and Attendance comes as monthly payments added to the pension, and under 38 CFR 3.352(c), care given by a relative or another member of the household does not prevent VA from granting the allowance, so a parent cared for at home by family can still qualify.

If you want a more structured way to pay a family caregiver, ask your VA medical center about Veteran-Directed Care (VDC). VDC is a VA Geriatrics and Extended Care program that gives an enrolled veteran a flexible budget, managed by the veteran or a representative, to hire and supervise their own workers, and that budget can pay family, friends, or neighbors. VA medical centers run it through local aging and disability agencies, which help plan the care and arrange fiscal management services. An enrolled veteran is eligible if they are eligible for community care, meet the program's clinical criteria, and the program is available to them. VDC runs through VA health care rather than through the pension, but the two can both support care at home.

How Aid and Attendance Works with Washington Medicaid

For a Washington senior who also needs Medicaid long-term care through Washington Apple Health, administered by the state Health Care Authority, the interaction matters because Apple Health counts most income when determining eligibility and a client's share of cost. Washington's eligibility rule, WAC 182-512-0840, excludes veteran's aid and attendance, the housebound allowance, and unreimbursed medical expenses paid by the VA when determining eligibility for SSI-related Apple Health.

In other words, the attendance, housebound, and medical-expense portions of a VA pension are not countable income for eligibility, while the basic pension amount is treated as income. The federal rule points the same way: Washington must follow SSI's income methods, and under SSI the VA aid and attendance and housebound allowances are not income.

That exclusion governs eligibility only. For someone receiving care in a nursing facility or other medical institution, Washington's rule, WAC 182-513-1340, treats aid and attendance, housebound, and unreimbursed-medical-expense payments as third-party resources: excluded when deciding eligibility, but available when the agency works out what the institutionalized client contributes toward the cost of care, and a client may have to pay those resources in addition to their participation. Federal law limits how far that reaches: the facility's Medicaid payment cannot be reduced by any pension paid under the $90 cap described below, so the third-party-resource rule can apply only to an allowance paid to a resident whose pension has not been cut to that cap, such as a veteran with a spouse or a child. Not all of a resident's income goes to the facility, because federal rules require deductions first, including a personal needs allowance, an amount for a spouse or family still at home, and incurred medical expenses that no third party pays. Ask the Health Care Authority or your DSHS case manager which deductions apply and in what amounts before you budget on the gross figure.

One federal rule can shrink the pension itself. If Apple Health covers nursing-facility care for a veteran with no spouse or child, or a surviving spouse with no child, the VA pension is capped at $90 a month for months after the month of admission, and the Medicaid payment to the facility cannot be reduced by that $90. The cap does not reach a State veterans home for which VA pays a nursing-home per diem, so check a specific stay with an accredited Veteran Service Officer.

These institutional rules do not set the share of cost for a client getting in-home care through an Apple Health waiver, so ask the agency how that client's contribution is figured rather than assuming it from the nursing-facility rules.

How to Apply and Get Free Help

Every Aid and Attendance claim starts with 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.

The steps that follow are the pension route, which is what this guide covers: VA's condition is that you may be eligible for this benefit if you get a VA pension. On that route, a wartime veteran who is not already receiving a VA pension files a pension claim as well, on Form 21P-527EZ (Application for Veterans Pension). That form is the wartime, means-tested pension application, so it belongs to the pension route only, and a veteran whose Aid and Attendance would be added to monthly disability compensation should not be sent to it. 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 file the claim for you. Asked how long a decision takes, VA answers "It depends," and says it processes claims in the order it receives them, unless a claim requires priority processing.

You don't have to do this alone, and free help is available. Washington veterans and their families can get help filing VA claims through the Washington State Department of Veterans Affairs (WDVA). WDVA strongly recommends working with an accredited Veteran Service Officer, whose help is free and who guides you through claims and appeals. Its Service Center in Olympia takes in-person and virtual appointments from across the state and lists VA Pension or Survivors Pension among the benefits it assists with filing for, alongside VA Disability Compensation and VA Health Care. WDVA also warns that unaccredited people who prepare or present VA claims are violating federal law. To start, find a Service Officer near you on WDVA's county map; its Claims Assistance page lists 1-800-562-2308 and benefits@dva.wa.gov.

Frequently Asked Questions

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

Yes. On the pension route, Aid and Attendance comes as monthly payments added to the 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?

The 2026 maximum is $29,093 a year for a veteran alone, $34,488 a year for a veteran with one dependent, and $18,697 a year for a surviving spouse with no dependent child. VA publishes these as annual maximums and pays monthly, subtracting your countable income from the annual maximum and dividing the remainder by 12. They are ceilings, not payments: VA pays the difference between the limit and your countable income.

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

Not necessarily. The VA subtracts unreimbursed care costs above a yearly floor of $872 for a veteran with no spouse or child, higher with dependents, from the income it counts, so families that look over the limit may still qualify once in-home care costs are counted.

Can a veteran get both Aid and Attendance and Washington Apple Health?

Yes, it can be. When Apple Health decides eligibility, the Aid and Attendance allowance, the housebound allowance, and unreimbursed medical expenses paid by the VA are excluded, though the basic pension amount counts as income. That exclusion applies to eligibility only. A veteran with no spouse or child whose nursing-facility care Apple Health covers sees the pension capped at $90 a month after the month of admission, and the facility's Medicaid payment cannot be reduced by that amount; the cap does not reach a State veterans home for which VA pays a nursing-home per diem. For a nursing-facility client whose pension has not been cut to that cap, such as a veteran with a spouse or a child, Washington treats those payments as third-party resources available toward the cost of care, which the client may have to pay in addition to their participation. Those rules don't set the share of cost for in-home waiver services, so ask the Health Care Authority or a DSHS case manager how a specific case is figured.

Compare Care Settings in Washington

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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