Does an Aid and Attendance pension count as income for Medicaid?

Does an Aid and Attendance pension count as income for Medicaid?

Short answer: For eligibility, the Aid and Attendance portion of a VA pension is generally not counted. For the monthly patient liability, treatment varies by state.

Figures change periodically. Double-check current amounts before relying on them.

VA pensions can include a basic amount plus an Aid and Attendance (or Housebound) amount. Under the federal income rules most states use for older and disabled applicants, the Aid and Attendance and Housebound allowances, and VA payments based on unreimbursed medical expenses, are generally excluded when deciding whether someone meets Medicaid’s income test. The basic pension amount is generally counted.

That matters most in states with an income cap. A veteran whose Social Security and basic pension are under the cap may qualify even though the total VA payment is higher.

After approval, states calculate the patient liability, the amount the person pays toward care each month. Some states exclude Aid and Attendance from that calculation; others count part or all of it.

A separate federal rule applies to nursing home residents with no spouse or dependent child: once Medicaid pays for their nursing home care, the VA generally reduces the pension to $90 a month, and that $90 is protected and cannot be taken for the nursing home bill.

Ask the VA for an award letter that shows each part of the benefit separately and give it to the caseworker.

Getting help

Every situation is different, and small facts can change the answer. If this question affects a real decision, especially with a spouse at home, a home, gifts or a trust, a Certified Medicaid Planner can apply your state’s rules to your situation. As a rough guide, published fees for help with an application range from about $500 to $6,000, and hourly help from about $150 to $600.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.

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