VA Aid and Attendance Benefit Virginia — How Veterans Can Pay for Long-Term Care

If your parent served in the military, they may be eligible for a monthly benefit that most Virginia families never hear about. The VA Aid and Attendance (A&A) pension provides $1,558 to $3,570 per month to help pay for assisted living, in-home care, or nursing home costs — and it can be combined with Virginia Medicaid for even more comprehensive coverage.

Unlike VA disability compensation, Aid and Attendance does not require a service-connected injury. It is a needs-based pension for wartime veterans and their surviving spouses who need help with daily activities.

Who Qualifies

The veteran (or their surviving spouse) must meet three requirements:

Military service. At least 90 days of active duty, with at least one day during a wartime period. Qualifying wartime periods include World War II (December 7, 1941 – December 31, 1946), the Korean War (June 27, 1950 – January 31, 1955), the Vietnam era (August 5, 1964 – May 7, 1975, or February 28, 1961 for those who served in-country), and the Persian Gulf War (August 2, 1990 – ongoing). The veteran must have been discharged under conditions other than dishonorable.

Medical need. The veteran or surviving spouse requires the aid and attendance of another person to perform at least two activities of daily living (bathing, dressing, eating, toileting, transferring), is bedridden, is a patient in a nursing home due to mental or physical incapacity, or has corrected visual acuity of 5/200 or less in both eyes.

Financial limits. The VA applies an income and net worth test. In 2026, the net worth limit is approximately $155,356 (adjusted annually for inflation). This includes most assets but excludes the primary residence and personal property. The income limit varies by the specific benefit tier and is reduced by unreimbursed medical expenses, including the cost of care.

Benefit Amounts (2026)

The monthly benefit depends on the claimant's status:

• Veteran with spouse: up to $3,570 per month
• Single veteran: up to $2,727 per month
• Surviving spouse of veteran: up to $1,558 per month

These are maximum rates. The actual payment depends on the claimant's income and medical expenses. The VA subtracts countable income from the maximum rate, but unreimbursed medical expenses (including assisted living costs, in-home aide fees, and adult day care) are deducted from income first — which is why many families with moderate income still qualify for a significant monthly benefit.

How A&A Works With Virginia Medicaid

Aid and Attendance and Medicaid are not mutually exclusive. A Virginia parent can receive both, but the interaction requires careful coordination.

VA A&A payments are counted as income for Medicaid eligibility purposes. If a veteran receives $2,727 per month in A&A and also has $1,800 in Social Security, their total countable income for Medicaid purposes is $4,527. In an income-cap state, this would make Medicaid qualification extremely difficult.

But because Virginia is a medically needy state, the parent can qualify for Medicaid by spending down their excess income on care costs each month. The A&A benefit effectively flows through to the care provider — it pays part of the nursing home or assisted living bill, and Medicaid picks up the rest after the spend-down.

The timing matters: families should generally apply for A&A first, since the VA application can take 6 to 12 months for approval. Medicaid applications in Virginia typically take 45 to 90 days. Starting the VA claim early ensures the benefit is in place by the time it is needed.

The Three-Year Lookback

The VA implemented its own asset transfer lookback rule in 2018. Any assets transferred for less than fair market value within 36 months of the application date can trigger a penalty period of up to five years.

This is separate from Virginia Medicaid's 60-month lookback. A transfer that clears the VA's 36-month window might still trigger a Medicaid penalty if it falls within Medicaid's 60-month window. Families planning to apply for both programs must account for both lookback periods.

How to Apply

VA Aid and Attendance applications are filed through the VA's regional office. Virginia veterans can apply through:

• VA.gov — the online application portal
• Local VA regional office in Roanoke (for most of Virginia) or Washington, DC (for Northern Virginia)
• A Veterans Service Organization (VSO) — accredited representatives from the VFW, American Legion, or Disabled American Veterans can file the claim at no cost

The application requires the veteran's DD-214 (discharge papers), medical evidence documenting the need for aid and attendance (a physician's statement using VA Form 21-2680), financial documentation including bank statements and income records, and marriage and death certificates if the claimant is a surviving spouse.

Processing times vary, but families should expect 6 to 12 months from filing to the first payment. The VA does pay retroactively to the application date once approved, which makes early filing critical.

A Funding Source Most Families Miss

Many Virginia families spend months researching Medicaid eligibility without ever considering VA benefits. For families where a parent or their deceased spouse served during wartime, Aid and Attendance can provide $18,000 to $42,000 per year toward care costs — often enough to cover assisted living without Medicaid or to bridge the gap until Medicaid is approved.

The Virginia Medicaid Long-Term Care & Asset Protection Guide includes a funding comparison worksheet that maps all available payment sources — private pay, long-term care insurance, VA A&A, the Virginia Auxiliary Grant, and Medicaid — so families can see the full picture before making decisions.

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