VA Aid and Attendance Benefits: 2026 Rates, Eligibility and How to Apply

Aid and Attendance (A&A) is not a program on its own. It is a higher rate of Veterans Pension or Survivors Pension, the need-based benefits for wartime veterans and their surviving spouses. VA calls it "special monthly pension," and the rules are in 38 CFR 3.351. If you qualify for pension and you need regular help from another person, VA raises your Maximum Annual Pension Rate (MAPR), the cap on what pension can pay you each year.

There are 3 tiers of pension, and you get 1 of them:

• Basic pension. For a wartime veteran with low income and net worth who is 65 or older, permanently and totally disabled, in a nursing home, or receiving Social Security disability.
• Housebound allowance. A higher MAPR for a veteran who has a permanent disability and, in VA's words, spends "most of your time in your home." The regulation says a single permanent disability rated 100% plus other disabilities independently ratable at 60% or more also qualifies.
• Aid and Attendance. The highest MAPR, for a veteran who needs another person's help with daily living, is bedridden, is a nursing home patient, or has very limited vision. VA is clear: "You can't get Aid and Attendance benefits and Housebound benefits at the same time."

The other Aid and Attendance. Veterans with a service-connected disability rated for compensation have a separate route. Special Monthly Compensation (SMC) under 38 CFR 3.350 pays higher compensation rates, not pension, for the same kinds of need. SMC-L is the aid and attendance level: it covers a veteran who is permanently bedridden, blind in both eyes at 5/200 or less, has lost both feet or a hand and a foot, or needs "daily help with basic needs (like eating, dressing, and bathing)" because of service-connected disabilities. SMC-S is the housebound level. These have no income or net worth test and pay far more: SMC-L is $4,900.83 a month for a veteran alone effective December 1, 2025, against $2,424 a month for pension A&A. Higher SMC levels, up to R.2/T at $11,271.67, exist for veterans who need daily skilled care. The total disability benefits guide covers the full SMC table.

The rule of thumb: if your need for help comes from a service-connected disability, SMC through compensation is the larger benefit and is claimed on VA Form 21-526EZ. If it comes from age or a non-service condition and your income is low, pension with A&A is the route, and it is what the rest of this guide covers.

A&A is a 2-step test. You must qualify for pension first, then show the care need.

Step 1: pension. Under VA's eligibility rules, you may be eligible for Veterans Pension if all of these are true:

• You did not receive a dishonorable discharge, and
• Your yearly family income and net worth are under the limits set by Congress (see below), and
• You served at least 90 days on active duty with at least 1 day during a wartime period if you entered service before September 8, 1980, or at least 24 months (or the full period you were called up) if you entered after September 7, 1980, and
• At least 1 of these is true: you are 65 or older; you have a permanent and total disability; you are in a nursing home for long-term care because of a disability; or you receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Wartime periods include World War II (December 7, 1941 to December 31, 1946), the Korean conflict (June 27, 1950 to January 31, 1955), the Vietnam era (November 1, 1955 in country, or August 5, 1964, through May 7, 1975) and the Gulf War (August 2, 1990 to a date still to be set by law). You did not need to serve in combat, only during the dates. The pension eligibility guide has the full list and the discharge rules.

Step 2: the care need. VA lists 4 ways to meet it, and you need only 1:

• You need another person to help you with daily activities "like bathing, feeding, and dressing," or
• You have to stay in bed, or spend a large part of the day in bed, because of illness, or
• You are a patient in a nursing home because of the loss of mental or physical abilities related to a disability, or
• Your eyesight, even with glasses or contacts, is 5/200 or less in both eyes, or your visual field is narrowed to 5 degrees or less.

38 CFR 3.352(a) is what the rater applies to the first bullet. It lists the factors the physician's statement should address: whether you can dress and undress, keep yourself "ordinarily clean and presentable," adjust a prosthetic or orthopedic appliance, feed yourself, and attend to "the wants of nature," and whether you need regular care to protect yourself "from hazards or dangers incident to" your daily environment. You do not have to fail every item. The regulation also defines bedridden as a condition that actually requires you to stay in bed, not a doctor's advice to rest.

The condition behind the need does not have to be service-connected. Dementia, Parkinson's disease, a stroke, severe arthritis and frailty from age are all common reasons.

The figures below are the MAPR, the most pension can pay for a year, effective December 1, 2025 after the 2.8% cost-of-living adjustment. VA pays the difference between your countable income and the MAPR that fits you, in 12 monthly payments. Monthly figures are the annual amount divided by 12 and rounded.

Source: https://www.va.gov/pension/veterans-pension-rates/, effective December 1, 2025.

Source: https://www.va.gov/pension/survivors-pension-rates/, effective December 1, 2025.

2 married veterans where 1 has A&A and the other is Housebound have a MAPR of $38,350. The old version of this page carried figures from December 2023; use only the ones above. Rates change every December 1, and the 2026 rates post tracks the compensation side of the same adjustment.

Most people who ask about A&A have too much income for basic pension. Care costs change the math. VA lets you subtract unreimbursed medical expenses from your income, but only the part above 5% of your basic MAPR. For a veteran with no dependents that threshold is $872 a year (5% of $17,441). Assisted living fees, in-home care, nursing home charges, Medicare and supplement premiums, and prescriptions all count once you report them on VA Form 21P-8416, Medical Expense Report.

Take a widowed veteran, age 84, with $30,000 a year in Social Security and a small pension. On income alone he is over the $29,093 A&A MAPR, so basic pension pays nothing. He moves into assisted living at $4,500 a month, or $54,000 a year, because he needs help bathing and dressing. His physician confirms that on VA Form 21-2680.

1. Medical expenses: $54,000. Subtract the $872 threshold: $53,128 is deductible.
2. Countable income: $30,000 minus $53,128 is below zero, so VA counts it as $0.
3. Pension payable: $29,093 MAPR minus $0 countable income equals $29,093 a year, or about $2,424 a month.

The same veteran with $10,000 of care costs would have $20,872 of countable income ($30,000 minus $9,128) and receive $8,221 a year, about $685 a month. The care cost, not the diagnosis, decides the size of the check. The asset and income limits guide walks through what counts as income and what VA leaves out.

A&A does not pay a facility. It pays you, and you decide how to use it. What matters to VA is the documented need and the unreimbursed cost.

• At home. Care from a home health agency counts as a medical expense. Payments to a family caregiver may count in some situations; VA's rules on in-home attendants are detailed, so report the expense on VA Form 21P-8416 and let VA apply them. If a family member is your caregiver, the caregiver support programs guide and respite care services cover the VA programs that can help them.
• Assisted living or memory care. The facility's monthly fee is generally deductible when you live there because you need help with daily activities, which is the same finding the 21-2680 documents.
• Nursing home. If you are a patient because of a disability, you meet the care-need test outright. The facility completes VA Form 21-0779, Request for Nursing Home Information, which confirms your status and charges.

Costs that Medicare, Medicaid, long-term care insurance or anyone else reimburses do not count. Only what you pay out of pocket reduces your income.

Net worth. From December 1, 2025 through November 30, 2026, the net worth limit for Veterans Pension and Survivors Pension is $163,699. Under 38 CFR 3.274, net worth is "the sum of a claimant's or beneficiary's assets and annual income," and the limit rises each year with the Social Security cost-of-living adjustment. 38 CFR 3.275 leaves out your primary residence, including a lot of up to 2 acres (more if the extra land cannot be sold), and personal effects "such as appliances and family transportation vehicles." A mortgage on the home is not subtracted from your other assets. If you sell the home after pension starts, the proceeds become an asset unless you buy another home in the same calendar year.

Income. VA counts "your Social Security benefits, investment and retirement payments, and any income your dependents receive," then subtracts the medical expenses described above. There is no separate income cap; income above your MAPR simply means no payment until deductible expenses bring it down.

Watch out: VA looks back 3 years. When you file, VA reviews any assets transferred for less than fair market value in the 36 months before the claim. If those transfers would have put you over the net worth limit, VA can impose a penalty period of up to 5 years during which no pension is paid. This applies to claims filed on or after October 18, 2018. Giving assets to children shortly before applying is the most common way people trigger it.

1. Submit an Intent to File, VA Form 21-0966. It sets a potential start date for pension and gives you 1 year to finish the application. If you apply online with a verified VA.gov account, VA records the intent for you.
2. Have a physician complete VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. This 1 form covers both tiers. The doctor should describe what you cannot do without help, using the 38 CFR 3.352 factors above: dressing, bathing, feeding, toileting, adjusting appliances, protection from hazards, whether you are bedridden, and vision.
3. Add VA Form 21-0779 if you are in a nursing home. A facility official completes it.
4. List your expenses on VA Form 21P-8416. Attach facility invoices, agency statements or caregiver receipts, and insurance premium statements.
5. File the pension application, VA Form 21P-527EZ (veterans) or VA Form 21P-534EZ (surviving spouses). Claim A&A on the same application; there is no separate step. Submit online at VA.gov, upload through QuickSubmit, mail to Department of Veterans Affairs, Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365, take it to a VA regional office, or file through a VA-accredited representative. Include your DD214, marriage and dependent records, and bank and income statements.
6. Respond to any VA request for records or an exam, then watch the decision letter for the effective date and the monthly amount.

VA processes pension claims "in the order we receive them" and does not publish an average processing time for pension the way it does for disability compensation. An incomplete 21-2680 or missing expense proof means VA has to write back for it, which adds time. If approved, VA pays from the effective date, which is why the Intent to File in step 1 matters. VA-accredited Veterans Service Organizations (VSOs) help with pension applications at no charge.

A surviving spouse can receive A&A as part of Survivors Pension. You may be eligible if all of these are true:

• You have not remarried since the veteran's death, and
• The veteran had the wartime service described above and no dishonorable discharge, and
• Your income and net worth are within the limits, and
• You meet 1 of the 4 care-need tests.

The spouse's own care need is what counts; the veteran did not need A&A. The MAPR for a surviving spouse alone with A&A is $18,697 a year, about $1,558 a month, and the same medical expense deduction applies. The 5% threshold for a spouse with no dependents is $584. The application is VA Form 21P-534EZ with the same 21-2680 attached. The Survivors Pension guide covers the rest of the survivor rules. A surviving spouse receiving Dependency and Indemnity Compensation (DIC) instead of pension has a separate A&A add-on, described in the survivor benefits guide.

Does A&A count as income for Medicaid? The federal SSI rule in 20 CFR 416.1103 does not treat VA payments "resulting from unusual medical expenses" as income, and gives cash VA provides for aid and attendance as an example of assistance that is not income. States run Medicaid and set their own income rules, so confirm with your state Medicaid office how it treats the A&A portion of your pension before you rely on either answer.

Medicaid nursing home care. Under 38 U.S.C. 5503(d), a veteran with no spouse or child whose nursing home care is paid by Medicaid has pension reduced to $90 a month. Medicaid may not reduce what it pays the facility by that $90, so it stays with the veteran for personal needs. The rule runs through January 31, 2033.

State veterans homes. State Veterans Homes are nursing, domiciliary and adult day care facilities owned and run by the states. VA certifies them and pays a per diem "to help defray the cost of care," and each state sets its own admission rules and charges. Because the resident still pays part of the cost, A&A is often used to cover that share.

State benefits sit alongside A&A rather than replacing it. Most states run at least 1 state veterans home with reduced charges for veterans, and some also cover spouses. Some states add property tax relief keyed to age or income, and many county veteran service officers help with the 21P-527EZ at no cost. Pick your state to see what is available.