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 memory care. That benefit, VA Aid and Attendance, is a higher rate of Veterans Pension or Survivors Pension for people who need another person's help with everyday activities.

If you are arranging dementia care for a veteran parent, this guide walks you through what the benefit pays in 2026, how the VA decides whether a person with dementia meets its care test, how memory-care costs can lower the income the VA counts against you, and how to apply at no charge.

In This Guide

How Much Memory Care Costs in Washington

Memory care is a specialized form of assisted living for people with Alzheimer's disease and other dementias. The resident pays for the room or apartment and may need to pay extra for any special care, so a memory-care bill can run above a standard assisted-living bill. Standard assisted living in Washington runs about $7,600 a month, or roughly $90,550 to $91,200 a year (CareScout's own publications differ on the yearly median), according to the CareScout 2025 Cost of Care Survey, so use that as a reference point for a memory-care budget.

Washington has its own structure for dementia care. One route to Medicaid-funded memory care is the state's Specialized Dementia Care Program (SDCP), a Department of Social and Health Services (DSHS) program for people receiving or eligible for Medicaid (Washington Apple Health), delivered inside assisted living facilities that hold a specialized dementia care contract with DSHS. To qualify, the person must have Alzheimer's disease or another irreversible dementia, be receiving or eligible for Medicaid, and be assessed by a DSHS case manager as needing specialized dementia care. The package includes dementia-specific training for staff, awake staff 24 hours a day, and a safe outdoor area with walking paths, and a contracting facility must have provided licensed specialized dementia care for at least 12 months, either in a building dedicated to dementia care or in a separate dedicated unit or wing. Funding is limited, so DSHS contracts with only a small number of assisted living facilities statewide, and a space has to be open. Outside the program, DSHS notes that some adult family homes offer nursing care or specialized support for dementia. The cost figures above are industry-survey medians, not government figures, so treat them as a starting point and price specific facilities near you.

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

Aid and Attendance is not a separate program. It is an increased rate of Veterans Pension or Survivors Pension, paid only to someone already eligible for that pension, who needs another person's help with daily activities, has to spend much of the day in bed because of illness, is a nursing-home patient because of a disability, or has severely limited eyesight. The higher Aid and Attendance maximum replaces the basic pension rate rather than paying on top of it. The family can then put that pension toward memory-care fees.

Here are the 2026 ceilings (rates effective December 1, 2025 through November 30, 2026). The VA publishes these rates as yearly maximums. Pension is paid monthly: the VA takes the yearly maximum, subtracts your countable income, divides the remainder by 12, and rounds down to the whole dollar.

Who is receiving the benefit Maximum annual pension with Aid and Attendance
Veteran, no dependents Up to $29,093
Veteran with one dependent Up to $34,488
Surviving spouse, no dependents Up to $18,697

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. So the exact check depends on your income and your deductible medical expenses, covered in the section below.

Wondering how much Aid and Attendance could cover for your family's memory care in Washington? Chat with Brevy for a quick estimate.

When a Veteran With Dementia Meets the Care Test

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 lost mental or physical abilities related to a disability, or severely limited eyesight.

A diagnosis of Alzheimer's disease or another dementia does not meet that standard by itself. The VA weighs the person's actual need for help from others, including being unable to dress, keep clean, or feed oneself, or a physical or mental incapacity that requires regular care to protect them from everyday hazards. Not every factor has to be present, and the need must be regular, not constant. A medical examiner documents that need on the VA's examination form, which we cover under How to Apply.

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.

The VA lets you deduct unreimbursed medical expenses (UMEs) from the income it counts, and memory-care fees can count on the conditions below. In an assisted living or other care facility that isn't a nursing home, payments for help with daily activities are deductible when the person is receiving health or custodial care there 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, because of a physical, mental, developmental, or cognitive disorder, they need to be in a protected environment. The facility must be licensed if the state requires that type to be, and a residential facility must be staffed with care providers 24 hours a day. The facility's meals and lodging count too, as long as the facility provides or contracts for the person's health or custodial care, or one of those clinicians states in writing that the person must live in that facility, or one like it, to receive health or custodial care from an outside provider or from family or friends.

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.

Consider a worked example. A veteran parent with no dependents moves into memory care priced at Washington's assisted-living median of about $7,600 a month, roughly $90,550 to $91,200 a year, before any extra charge for dementia care. If the bill meets the VA's conditions above, only the first $872 of medical expenses is not deductible, and the care cost above that floor reduces countable income. Since the VA pays the ceiling minus income for VA purposes, every dollar of lower income moves the payment toward that ceiling, the most it will pay. That is how a veteran who looked "too high" on paper can still qualify.

Who Qualifies

Aid and Attendance has four main requirements:

  • Wartime service. At least one day during a wartime period (such as World War II, the Korean conflict, the Vietnam War era, or the Gulf War period, which began August 2, 1990 and has no end date set yet), 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.
  • 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 meets this test without a permanent-and-total rating.
  • Net worth under $163,699 for 2026. VA's net worth calculation counts your, your spouse's, and your dependents' assets plus yearly income for VA purposes, but assets don't include the primary home, the car, or basic home items.
  • A need for aid and attendance: the functional standard described above.

One thing to plan around: VA pension carries a 3-year (36-month) look-back. The VA looks at the 36 months before it receives your claim, and an asset transferred for less than fair market value in that window, if keeping it would have put your net worth over the limit, can bring a penalty period of up to five years. 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. 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.

Washington's eligibility rule, WAC 182-512-0840, lists the VA's aid and attendance, housebound allowance, and unusual or unreimbursed medical expense (UME) payments among the things Apple Health excludes for its SSI-related medical programs, so those portions of a VA pension are not counted as income there, while the basic pension amount is treated as income. The same rule points people receiving Apple Health long-term care services on to chapter 182-513 WAC. The federal rule points the same way: Medicaid eligibility for older adults follows SSI's methods, and under SSI the VA aid and attendance and housebound allowances are not income, so only the basic pension counts toward the income limit.

That exclusion governs eligibility only. Once a person is eligible and living in a nursing facility or other medical institution, 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 (42 CFR 435.832 for the medically needy). Washington's own rule, WAC 182-513-1340, says the aid and attendance, housebound and UME payments excluded at eligibility are available as a third-party resource when the agency sets what an institutionalized client contributes toward the cost of care, and a client may have to pay them in addition to their participation. Not all of a resident's income goes to the facility. The agency must first deduct, in order, a personal needs allowance for the resident, an amount for the maintenance needs of a spouse or family still at home, incurred medical expenses that no third party pays, and any SSI the person still receives. Federal law sets the personal needs allowance floor at $30 a month for one person, and a state may protect more, so ask the Health Care Authority or your DSHS case manager what Washington protects before you budget on the gross figure. One federal rule can shrink the pension itself: when Medicaid covers a nursing facility's care for a veteran with no spouse or child, or a surviving spouse with no child, VA pension is capped at $90 a month after the month of admission. Federal law also bars reducing the facility's Medicaid payment by that capped pension, so Washington's third-party-resource rule reaches an allowance only when the pension isn't capped, for example for a veteran with a spouse or child. The cap doesn't reach a State home for which the VA pays a nursing-home per diem, so check a State Veterans Home stay with an accredited Service Officer. If your family member uses an Apple Health home and community-based waiver rather than a nursing facility, don't read the nursing-facility rule as setting their share of cost. Washington's own long-term-care post-eligibility rules live in chapter 182-513 WAC, and the agency can tell you how they apply.

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.

How to Apply and Get Free Help

The steps below describe the pension route: 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 on a different route, which the pension steps below don't describe.

  • 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 assistance.
  • 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.
  • 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.

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 help you file the claim. 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.

You do not have to do this alone. Washington veterans, families, and survivors can get help filing VA claims through the Washington State Department of Veterans Affairs (WDVA). WDVA strongly recommends an accredited Veteran Service Officer, whose help is free and who guides you through claims and appeals. Its Olympia Service Center lists VA Pension and Survivors Pension among the benefits it helps you file for. To start, find a Service Officer on the county map on WDVA's website; its Claims Assistance page lists 1-800-562-2308 and benefits@dva.wa.gov. For a pension claim, bring what you have of the DD-214, marriage and divorce dates, and proof of income, net worth, and medical expenses, including facility care bills. The Service Officer can help request the rest. 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.

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). You elect one of the three, not several at once: under 38 CFR 3.2500(b), only one of those reviews may be pending on the same claim or issue at a time, so a second cannot be filed while the first is pending final adjudication. 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, but timing still matters: one received more than a year after the notice generally takes an effective date no earlier than the day the VA receives it, so filing within the year protects an earlier effective date., The same WDVA Service Officer can help you with the review, since WDVA says its Service Officers guide you through claims and appeals. You can reach the VA benefits hotline at 800-827-1000 (TTY: 711) with questions about a decision.

Frequently Asked Questions

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

No. The benefit is based on need, not diagnosis. A person with dementia meets the standard when the VA finds a regular need for another person's help, for example with dressing, keeping clean or eating, or with care on a regular basis to protect them from everyday hazards. A medical examiner documents that need on VA Form 21-2680.,

How much will Aid and Attendance pay toward memory care in Washington?

In 2026, the yearly pension ceiling at the Aid and Attendance rate is up to $29,093 for a veteran, up to $34,488 for a veteran with one dependent, and up to $18,697 for a surviving spouse. The VA publishes these rates as yearly maximums and pays monthly: the ceiling minus your countable income, divided by 12 and rounded down to the whole dollar. No one receives the full figure automatically: the VA pays the difference between the ceiling and your countable income after deductible medical expenses, because the benefit is needs-based.

We have retirement income: are we earning too much to qualify?

Maybe not. The VA lets you deduct unreimbursed medical expenses, including memory-care fees that meet its conditions, above a small annual floor of $872 for a veteran with no spouse or child in 2026. A large deductible memory-care bill can reduce countable income to the point where a family that looked "too high" on paper qualifies.

Will Aid and Attendance affect Washington Apple Health (Medicaid)?

Under Washington's Apple Health eligibility rule, the Aid and Attendance allowance, the housebound allowance, and the medical-expense portion of a VA pension are not counted as income for SSI-related Apple Health, while the basic pension is treated as income. That exclusion applies to eligibility. Once someone receiving Apple Health long-term care lives in a nursing facility, Washington treats an Aid and Attendance allowance still being paid as a third-party resource when it works out what they contribute toward the cost of care, and they may have to pay it in addition to their participation. For a veteran with no spouse or child, or a surviving spouse with no child, whose nursing-facility care Medicaid covers, VA pension is capped at $90 a month after the month of admission, and federal law bars reducing the facility's Medicaid payment by that capped pension. The cap doesn't apply in a State home for which the VA pays a nursing-home per diem. A family using an Apple Health waiver rather than a nursing facility should not assume the nursing-facility rule sets their share of cost. Because the exact treatment depends on your case, confirm with the Health Care Authority or DSHS.

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. Then contact the Washington State Department of Veterans Affairs at 1-800-562-2308 for help filing the claim. Its accredited Veteran Service Officers help with VA claims and appeals and charge nothing.

Compare Care Settings in Washington

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

Learn More

VA BenefitsVA Aid and Attendance in WashingtonVA Aid and Attendance in Washington 2026: who qualifies, up to $34,488 a year for a veteran with a spouse, how to apply, and free WDVA help. Care TypesMemory Care in WashingtonMemory care in Washington is the Medicaid Specialized Dementia Care Program in an assisted living facility. See the standards, cost, and how to vet a place. VA BenefitsVA Aid and Attendance for Assisted Living in WashingtonHow VA Aid and Attendance helps pay for assisted living in Washington: 2026 rates up to $34,488 a year, how care costs cut countable income, and free help. Care TypesCost of Senior Care in WashingtonWhat senior care costs in Washington in 2026: assisted living runs about $7,600 a month, a nursing home about $13,155 a month. See every setting and how to pay.
Your next step Find personalized help using VA benefits to pay for memory care in Washington 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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