VA Aid and Attendance in Delaware: Benefits for Nursing Home and Home Care

What VA Aid and Attendance Pays For

Aid and Attendance (A&A) is an enhanced VA pension benefit for wartime veterans and their surviving spouses who need help with daily activities or are housebound. It provides a monthly cash payment — not tied to a specific provider or facility — that can be used to pay for nursing home care, assisted living, home health aides, or adult day care.

For December 1, 2025 through November 30, 2026, the VA publishes maximum annual pension rates (MAPRs), not guaranteed flat monthly payments. The maximum annual A&A rates before countable income are:

The actual payment is the difference between the applicable MAPR and countable income for VA purposes, after allowed medical expense deductions. The benefit can significantly offset home care or assisted living expenses, but the actual payment is not necessarily the maximum shown above.

Eligibility Requirements

Military service: For veterans who began active duty before September 8, 1980, VA generally requires at least 90 days of active duty with at least one day during a wartime period. For those who began after September 7, 1980, VA generally requires 24 months or the full period called or ordered to active duty, with exceptions. Discharge must be other than dishonorable.

Medical need: The veteran or surviving spouse must meet at least one of these criteria:

• Requires the aid of another person to perform activities of daily living (bathing, dressing, eating, toileting)
• Is bedridden
• Is a patient in a nursing home due to physical or mental incapacity
• Has corrected visual acuity of 5/200 or less in both eyes, or a visual field of 5 degrees or less

Income and asset limits: The VA applies a net worth limit of $163,699 for the period December 1, 2025 through November 30, 2026, adjusted annually. This includes countable assets and income for VA purposes. The VA also applies a lookback period for certain asset transfers, separate from Medicaid's five-year lookback.

How A&A Interacts with Delaware Medicaid

This is where families need to be careful. VA A&A and Delaware Medicaid serve different functions and have different rules, but they affect each other:

A&A as income for Medicaid purposes: A&A can count as income for some Medicaid determinations, but Delaware treats A&A as excluded from Miller Trusts. Confirm the treatment with DMMA before assuming it must be deposited into a QIT.

The Miller Trust exception: Do not deposit A&A payments into a Qualified Income Trust without confirming the treatment with DMMA. If DMMA determines that a QIT is required for other income, follow the trust's approved terms and funding rules.

Timing strategy: Some families use A&A as bridge funding during the Medicaid eligibility review. Timing depends on the completeness of the claim and the agencies' reviews, so do not assume the VA and Medicaid decisions will arrive on the same schedule.

Dual eligibility: A person may receive both VA benefits and Medicaid, but the interaction depends on the benefit category and care setting. A person with no dependents in a Medicaid-covered nursing facility may receive a $90 VA pension rate instead of disability compensation or DIC if VA awards that rate; do not treat $90 as a universal A&A reduction.

Delaware-Specific VA Resources

Delaware Office of Veterans Services: The service office is headquartered in Dover and provides statewide assistance with benefits claims at no cost. Its accredited service officers can help veterans and survivors prepare an application.

VA Medical Center — Wilmington: The Wilmington VAMC provides geriatric assessments that can support the medical documentation needed for the A&A claim. If your parent is already in the VA healthcare system, their primary care physician can complete the examination for A&A purposes.

Delaware Veterans Home — Milford: The state-operated veterans home in Milford accepts both private-pay and Medicaid residents. Veterans who qualify for both A&A and Medicaid may find this facility a cost-effective option, though bed availability varies.

When A&A Is Not Enough

For Delaware families facing nursing home placement, A&A alone will not cover the cost. Even the maximum annual veteran rate of $29,093 (about $2,424 per month before countable income) covers less than 17% of the average $14,494 monthly nursing home bill. A&A is most useful as supplemental funding — either during a Medicaid application gap, or to cover the room-and-board portion of assisted living that Medicaid does not pay.

The Delaware Medicaid Long-Term Care & Asset Protection Guide covers how to coordinate A&A benefits with the Medicaid application process, including the Miller Trust requirements that apply when A&A pushes your parent's income above Delaware's $2,485 cap.

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