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.5 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.4

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.5 Private-pay memory care is also offered in assisted living facilities and adult family homes across the state.5 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.4

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 is what the benefit pays in 2026 (rates effective December 1, 2025 through November 30, 2026):3

These are maximums. Because VA Pension is needs-based, the VA pays the difference between your countable income and the maximum annual pension rate for your situation, so the exact monthly check depends on your income and your deductible medical expenses, covered in the section below.3

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 doctor documents that need on the VA's examination form, which we cover under How to Apply.7

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.3

The VA lets you deduct continuing, unreimbursed medical expenses (UMEs) from your countable income, 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.3 The meals and lodging the facility charges count too.3

There is one threshold. Only the portion of your medical 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 and $1,141 a year for a veteran with one dependent.3

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.4 The first $872 of medical expenses is not deductible, but essentially all of that large annual care cost above the floor reduces countable income.3 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.3

Who Qualifies

Aid and Attendance has four main requirements:2

• Wartime service. At least 90 days of active duty with at least one day during a wartime period (World War II, 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.2
• Age or disability. Age 65 or older, or permanently and totally disabled.2
• Net worth under $163,699 for 2026. This limit counts assets plus annual income but excludes the primary home, vehicles, and basic household items.3
• 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

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

There are two forms at the heart of an Aid and Attendance claim:7

• VA Form 21-2680, the Examination for Housebound Status or Permanent Need for Regular Aid and Attendance, completed with a doctor's examination documenting the need for help, the place where a dementia diagnosis and care needs are recorded.7
• VA Form 21P-527EZ, the Application for Veterans Pension, if you are not already receiving a VA pension.7

You can file online at va.gov, by mail, or through an accredited representative.7 In practice, claims often take three to six months or longer, since the VA processes them in the order received.7

You do not have to do this alone, and you should not have to pay for the filing. Washington veterans and families can get free, qualified help through the Washington State Department of Veterans Affairs (WDVA) and county veterans service officers, who assist with VA Pension, Survivors (Widows) Pension, and Aid and Attendance claims and represent veterans before the VA Regional Office in Seattle.6 You can reach WDVA claims assistance at 1-800-562-2308 or benefits@dva.wa.gov, and WDVA maintains a directory of county-level services so you can find the officer nearest you.6 Under federal law, an accredited representative cannot charge a fee simply to prepare and file an original benefits claim.6

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 generally have one year from the date on the decision letter to ask for a review, through one of three options: a Supplemental Claim (submit new and relevant evidence the VA did not have before), a Higher-Level Review (a more senior reviewer re-examines the same evidence), or an appeal to the Board of Veterans' Appeals (a Veterans Law Judge reviews the case).8 The same WDVA or county veterans service officer can prepare and file the review at no cost, and you can reach the VA benefits hotline at 800-827-1000 (TTY: 711) with questions about a decision.9

Next Steps

Start by having your parent's doctor complete VA Form 21-2680 to document the dementia-related need for care, and gather proof of wartime service, income, assets, and current care bills.7 Then contact the Washington State Department of Veterans Affairs at 1-800-562-2308 for free help filing the claim. There is no charge for assistance with an original claim, and a service officer can make sure your medical expenses are documented correctly.6

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.