VA Aid and Attendance for Memory Care in Washington

When a loved one has Alzheimer's or another dementia, a veteran or surviving spouse in Washington may have a monthly VA benefit to help pay for secured memory care. That benefit, VA Aid and Attendance, is paid as an increase on top of a Veterans Pension or Survivors Pension for people who need another person's help with everyday activities.1

If you are arranging dementia care for a veteran parent, this guide walks you through what the benefit pays in 2026, why a dementia diagnosis so often qualifies, how memory-care costs can lower the income the VA counts against you, and how to apply at no charge.2

In This Guide

• Key Takeaways
• How Much Memory Care Costs in Washington
• How VA Aid and Attendance Helps Pay for Memory Care in Washington
• Why Veterans With Dementia Often Qualify
• How Memory Care Costs Lower Your Countable Income
• Who Qualifies
• How Aid and Attendance Works with Washington Medicaid
• How to Apply and Get Free Help
• Frequently Asked Questions
• Next Steps
• Learn More

How Much Memory Care Costs in Washington

Memory care is residential care built specifically for people with Alzheimer's disease or another dementia. In Washington, it is most often delivered in an assisted living facility, and the dedicated, secured dementia setting and specially trained staff typically push memory care above the standard assisted-living rate.4 Standard assisted living in Washington runs about $7,600 a month, or roughly $91,200 a year, according to the CareScout 2025 Cost of Care Survey, so a memory-care budget generally starts from that figure and climbs.3

Washington has its own structure for dementia care. The state's Specialized Dementia Care Program (SDCP) is a Washington Apple Health (Medicaid) program offered inside assisted living facilities that hold a special contract with the Department of Social and Health Services; those facilities must have a separate unit or wing dedicated solely to residents with dementia, meet state physical-plant and care standards, and employ workers who have completed dementia specialty training.4 Private-pay memory care is also offered in assisted living facilities and adult family homes across the state.4 These are industry-survey medians, and the Seattle metro area runs higher than rural counties, so treat the numbers as a starting point and price specific facilities near you.3

How VA Aid and Attendance Helps Pay for Memory Care in Washington

Aid and Attendance is not a separate program. It is an increased monthly amount added to a Veterans Pension or Survivors Pension for someone who needs another person's help with daily activities, is largely bedridden, or lives in a facility because of disability.1 The money is paid directly to the veteran or surviving spouse, who can then use it toward memory-care fees.

Here are the 2026 ceilings (rates effective December 1, 2025 through November 30, 2026). The VA publishes these rates as annual maximums, so a monthly amount is the yearly award divided by 12.1

These are ceilings, not payments. Nobody simply receives the figure: VA Pension is needs-based, and the VA bases the payment on the difference between your income for VA purposes and the limit Congress sets.1 So the exact check depends on your income and your deductible medical expenses, covered in the section below.1

Why Veterans With Dementia Often Qualify

The "aid and attendance" requirement is about function, not a specific diagnosis. The VA looks for a need for help with daily activities (such as bathing, dressing, feeding yourself, or protecting yourself from everyday hazards), or being bedridden, or being a patient in a nursing home because of mental or physical incapacity.2

That is why a veteran with Alzheimer's disease or another dementia so often meets the standard. As dementia progresses, it commonly leaves a person unable to manage daily tasks safely and in need of supervision to stay safe from hazards, exactly the kind of need the benefit is designed to recognize.2 A medical examiner documents that need on the VA's examination form, which we cover under How to Apply.6

How Memory Care Costs Lower Your Countable Income

Aid and Attendance is needs-based, so families with retirement income sometimes assume they earn too much to qualify. The medical-expense rule is what changes that math.1

The VA lets you deduct unreimbursed medical expenses (UMEs) from the income it counts, and memory-care fees count. Care in an assisted living or other residential facility is a deductible expense when the facility provides health or custodial care and the person either qualifies for Aid and Attendance or has a written statement from a physician, physician assistant, nurse practitioner, or clinical nurse specialist that they need that care or must live in a protected environment because of a cognitive disorder.1 The meals and lodging the facility charges count too.1

There is one threshold. Only the portion of your medical expenses that exceeds 5% of the applicable maximum annual pension rate is deductible, counting any increase for family members but not the aid-and-attendance or housebound increase. For 2026 the VA puts that floor at $872 a year for a veteran with no spouse or child, and it rises if you have dependents.1

Consider a worked example. A veteran's parent moves into memory care anchored to Washington's assisted-living rate of about $7,600 a month, roughly $91,200 a year before any dementia premium.3 The first $872 of medical expenses is not deductible, but essentially all of that large annual care cost above the floor reduces countable income.1 For most families, a care bill that size wipes out countable income entirely, which is how a veteran who looked "too high" on paper ends up qualifying for the maximum benefit.1

Who Qualifies

Aid and Attendance has four main requirements:2

• Wartime service. At least one day during a wartime period (World War II, Korea, Vietnam, or the Gulf War / post-9/11 era), plus a length of service set by when the veteran started active duty, not by which war. Started before September 8, 1980: at least 90 days of active duty. Started as an enlisted person after September 7, 1980: at least 24 months, or the full period called or ordered to active duty (with some exceptions). An officer who started on active duty after October 16, 1981 and had not previously served on active duty for at least 24 months meets the service test as well.2
• No dishonorable discharge, plus any one of four tests. The veteran must not have received a dishonorable discharge, and at least one of these must be true: at least 65 years old; has a permanent and total disability; is a patient in a nursing home for long-term care because of a disability; or is getting Social Security Disability Insurance or Supplemental Security Income. Any one of the four is enough on its own, so a wartime veteran under 65 who receives SSI qualifies without a permanent-and-total rating.2
• Net worth under $163,699 for 2026. VA's net worth calculation counts your and your dependents' assets plus annual income, but excludes the primary home, the car, and basic home items.2
• A need for aid and attendance: the functional standard described above.2

One thing to plan around: VA pension carries a 3-year (36-month) look-back. The VA reviews assets transferred for less than fair market value in the three years before you file, and such transfers can trigger a penalty period of up to five years.2 If you have given away or sold assets cheaply, talk to an accredited representative before filing.

How Aid and Attendance Works with Washington Medicaid

In Washington, Medicaid long-term care is delivered through Washington Apple Health, administered by the state Health Care Authority.1 If a veteran needs both Aid and Attendance and Apple Health, how the VA payment is treated matters, because Apple Health counts most income when it determines eligibility and a client's share of long-term-care cost.1

Under Washington's published Apple Health rules, the Aid and Attendance allowance, the housebound allowance, and the amounts a VA pension includes for unreimbursed or unusual medical expenses are not counted as income for SSI-related Apple Health and must be split out from the total VA payment, while the basic pension amount is treated as income.1 This mirrors the general federal Medicaid rule that the Aid and Attendance and medical-expense portion of a VA pension is set aside rather than counted.1

That exclusion governs eligibility only. Once a person is eligible and receiving nursing-facility care, income that was disregarded in deciding eligibility must be considered again in the post-eligibility calculation under the federal rule at 42 CFR 435.725, so the Aid and Attendance amount is counted back in against the client's participation in the cost of care under Apple Health. The agency must then subtract the deductions that rule requires before the remainder is billed, and incurred medical expenses that no third party pays are one of them. Ask the Health Care Authority or your DSHS case manager which deductions apply and in what amounts, including whether anything is set aside for the client's own personal needs or for a spouse still living at home, before you budget on the gross figure. A client on a home and community-based waiver also has a post-eligibility calculation, but the rules that set it are the agency's to state rather than something to assume from the nursing-facility rule.1

Because the exact countable-income mechanics and any client-participation calculation depend on your situation, confirm the details with the Health Care Authority or DSHS for your specific case before you rely on them.1

How to Apply and Get Free Help

The steps below describe the pension route, the one that fits most memory-care families: the VA's condition for this benefit is that you may be eligible if you get a VA pension. Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation benefits, so a veteran who receives VA disability compensation rather than a pension uses that form and does not file the pension application below.6

• VA Form 21-2680, the 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 place where a dementia diagnosis and care needs are recorded.6
• VA Form 21P-527EZ, the Application for Veterans Pension, filed by a wartime veteran pursuing the pension route who is not already receiving a VA pension.6
• VA Form 21-0966, the Intent to File, if you are still gathering information. Submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive, so file it first if the rest will take you weeks.6

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 representative can file the claim for you.6 Asked how long a decision takes, the VA's answer is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.6

You do not have to do this alone. Washington veterans and families can get qualified help through the Washington State Department of Veterans Affairs (WDVA), a full-service state agency whose Veterans Service Offices and statewide referral service are staffed with Service Officers who assist with VA Pension or Widows Pension, Aid & Attendance, and health care benefits, and who represent veterans in cases adjudicated with the U.S. Department of Veterans Affairs in Seattle.5 WDVA's Claims Assistance page tells families to locate a Service Officer near them, and gives contact information of 1-800-562-2308 and benefits@dva.wa.gov.5 The services an accredited VSO representative provides on a VA benefit claim are always free, and only accredited claims agents and attorneys may charge a claimant a fee at all. Even they may charge only for representation provided after the VA has issued notice of its initial decision on the claim, so no one should charge you to prepare and file the initial pension application.7

If Your Claim Is Denied

A denial is not the end of the road. If the VA turns down the Aid and Attendance claim, or grants less than you expected, you have three decision review options: a Supplemental Claim (file new and relevant evidence the VA did not have when it reviewed the case before), a Higher-Level Review (a higher-level reviewer re-examines the case, with no new evidence submitted), or a Board Appeal to the Board of Veterans' Appeals (a Veterans Law Judge reviews the case). A Higher-Level Review or a Board Appeal has to be elected within one year from the date the VA issues notice of its decision for most VA benefits; certain benefits carry time limits shorter than a year, and your decision letter states the deadline that applies to you. A Supplemental Claim can be filed at any time after that notice, though the VA recommends filing within one year to keep your effective date.8 The same WDVA Service Officer can help you with the review, and you can reach the VA benefits hotline at 800-827-1000 (TTY: 711) with questions about a decision.7

Next Steps

Start by having a medical examiner, your parent's doctor for example, complete the examination section of VA Form 21-2680 to document the dementia-related need for care, and gather proof of wartime service, income, assets, and current care bills.6 Then contact the Washington State Department of Veterans Affairs at 1-800-562-2308 for help filing the claim. Its Service Officers assist with Aid & Attendance claims, and one of them can make sure your medical expenses are documented correctly.5

Compare Care Settings in Washington

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

• How Aid and Attendance Pays for Assisted Living in Washington
• How Aid and Attendance Pays for a Nursing Home in Washington
• How Aid and Attendance Pays for In-Home Care in Washington

Learn More

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.