VA Aid and Attendance is a monthly benefit that can help a veteran or surviving spouse pay for memory care in Washington — the secured, specialized care that families turn to when a loved one has Alzheimer's disease or another dementia. It is paid as an increase added on top of a 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, 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.

In This Guide

Key Takeaways

  • In 2026, Aid and Attendance adds up to $2,424 a month for a veteran, $2,874 for a veteran with one dependent, and $1,558 for a surviving spouse.
  • A dementia diagnosis often meets the benefit's standard, because it usually means a person needs help with daily activities or protection from everyday hazards.
  • Memory care in Washington generally costs more than standard assisted living, which runs about $6,975 a month.
  • Your memory-care bills can be deducted as unreimbursed medical expenses, lowering the income the VA counts and helping a family that looks "too high" to qualify.
  • Free, qualified help filing the claim is available through the Washington State Department of Veterans Affairs.

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. Standard assisted living in Washington runs about $6,975 a month, or roughly $83,700 a year, so a memory-care budget generally starts from that figure and climbs.

Washington has its own structure for dementia care. The state's Specialized Dementia Care Program (SDCP) is a Medicaid (Apple Health) 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. Private-pay memory care is also offered in assisted living facilities and adult family homes across the state. 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.

How Aid and Attendance Helps Pay for Memory Care

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. 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):

Who is receiving the benefit Maximum monthly Aid and Attendance
Veteran, no dependents $2,424
Veteran with one dependent $2,874
Surviving spouse $1,558

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.

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.

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. A doctor 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 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. The meals and lodging the facility charges count too.

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.

Consider a worked example. A veteran's parent moves into memory care anchored to Washington's assisted-living rate of about $6,975 a month — roughly $83,700 a year before any dementia premium. The first $872 of medical expenses is not deductible, but essentially all of that large annual care cost above the floor reduces countable income. 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.

Who Qualifies

Aid and Attendance has four main requirements:

  • 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.
  • Age or disability. Age 65 or older, or permanently and totally disabled.
  • Net worth under $163,699 for 2026. This limit counts assets plus annual income but excludes the primary home, vehicles, and basic household 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 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. 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 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.

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. 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.

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

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

  • 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.
  • VA Form 21P-527EZ, the Application for Veterans Pension, if you are not already receiving a VA pension.

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

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. 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. Under federal law, an accredited representative cannot charge a fee simply to prepare and file an original benefits claim.

Frequently Asked Questions

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

Not automatically — the benefit is based on function, not diagnosis. But a dementia that leaves a person needing help with daily activities or supervision to stay safe from hazards usually meets the standard, which is why so many veterans with Alzheimer's or another dementia qualify. A doctor documents that need on VA Form 21-2680.

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

In 2026, the maximum is $2,424 a month for a veteran, $2,874 for a veteran with one dependent, and $1,558 for a surviving spouse. The actual amount depends on 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 continuing, unreimbursed medical expenses, including memory-care fees, above a small annual floor — $872 for a veteran with no dependents in 2026. A large memory-care bill often reduces 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 rules, the Aid and Attendance allowance and the medical-expense portion of a VA pension are not counted as income for SSI-related Apple Health and are split out from the total VA payment, while the basic pension is treated as income. Because the exact treatment depends on your case, confirm with the Health Care Authority or DSHS.

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. 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.

Compare Care Settings in Washington

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

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.

BC

Brevy Care Team

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