VA Pensions: Aid and Attendance and Housebound Benefits
The VA pension, often called “Aid and Attendance” after its best-known add-on, is a monthly payment from the Department of Veterans Affairs to wartime veterans and their surviving spouses who have limited income and assets. For older veterans who need help with daily activities, it can be a meaningful source of money to pay for home care, assisted living or a nursing home. This guide explains what the pension is, the three levels of benefit, how the amount is calculated and how it fits with Medicaid. For the eligibility rules in detail, see VA pension eligibility.
Figures change periodically. Double-check current amounts before relying on them.
What the VA pension is (and is not)
The VA pension is not the same as VA disability compensation. Compensation pays veterans for disabilities caused or made worse by military service, regardless of income. The pension is a needs-based benefit for wartime veterans who are 65 or older or permanently and totally disabled, and whose income and net worth are below set limits. It does not require any service-connected disability.
The pension is also not a military retirement pension. Many people who receive the VA pension never served long enough to retire from the military.
The three levels
| Level | Who it is for |
|---|---|
| Basic pension | Wartime veterans (or surviving spouses) with limited income and net worth who meet the age or disability requirement |
| Housebound | Pension recipients who are substantially confined to their home because of a permanent disability |
| Aid and Attendance (A&A) | Pension recipients who need help from another person with daily activities, are bedbound, are in a nursing home because of mental or physical incapacity, or have very limited eyesight |
A person cannot receive Housebound and Aid and Attendance at the same time. Aid and Attendance pays the most.
Who qualifies for Aid and Attendance
According to the VA, a pension recipient may qualify for Aid and Attendance if at least one of these is true:
- they need another person to help with daily activities such as bathing, feeding and dressing;
- they must stay in bed, or spend a large part of the day in bed, because of illness;
- they are a patient in a nursing home because of the loss of mental or physical abilities related to a disability;
- their eyesight is limited to 5/200 or less in both eyes (even with glasses or contacts), or their visual field is 5 degrees or less.
How much the pension pays
The pension is based on a Maximum Annual Pension Rate (MAPR), set by law and adjusted each December 1 for cost of living. The pension pays the difference between the MAPR and the person’s countable annual income, in 12 monthly payments.
Rates from December 1, 2025, to November 30, 2026
Veterans
| Situation | Basic | Housebound | Aid and Attendance |
|---|---|---|---|
| Veteran with no dependents | $17,441 a year | $21,313 a year | $29,093 a year |
| Veteran with one dependent (spouse or child) | $22,839 a year | $26,710 a year | $34,488 a year |
| Each additional dependent child | add $2,984 | add $2,984 | add $2,984 |
Two veterans married to each other have their own combined rates. For example, the rate is $34,488 if one qualifies for Aid and Attendance and $46,143 if both do.
Surviving spouses
| Situation | Basic | Housebound | Aid and Attendance |
|---|---|---|---|
| Surviving spouse with no dependent child | $11,699 a year | $14,298 a year | $18,697 a year |
| Surviving spouse with one dependent child | $15,311 a year | $17,902 a year | $22,304 a year |
These rates change each December 1. On a monthly basis, the 2026 Aid and Attendance rate for a veteran with no dependents is about $2,424, for a veteran with one dependent about $2,874, and for a surviving spouse about $1,558.
How countable income works
The VA counts most income from every source: Social Security, pensions, annuities, wages, interest and so on. But it lets people deduct unreimbursed medical expenses above 5 percent of the MAPR. Medical expenses can include:
- health insurance premiums, including Medicare Part B and supplement premiums;
- payments to home care agencies or in-home caregivers;
- assisted living costs, in many cases, when the person needs help with daily activities;
- nursing home costs;
- prescription and other medical costs not covered by insurance.
Because long-term care is expensive, these deductions often bring countable income close to zero, which means many veterans paying for care receive the full MAPR.
Example. A widowed veteran has $2,200 a month ($26,400 a year) in Social Security and pays $4,000 a month ($48,000 a year) for assisted living, where staff help him bathe and dress. His medical expenses far exceed 5 percent of the MAPR, so his countable income is reduced to zero. If he meets the other rules and qualifies for Aid and Attendance, he could receive up to $29,093 a year, about $2,424 a month.
Net worth limit
To qualify, the veteran’s (and spouse’s) net worth must be at or below a limit. From December 1, 2025, to November 30, 2026, the net worth limit is $163,699. Net worth means assets plus annual income. The primary residence (on a lot up to a certain size) and personal belongings and a vehicle are generally not counted. See The VA look-back and net worth rules.
Wartime service
The veteran must have served during a recognized wartime period, meet minimum active-duty requirements and have been discharged under other than dishonorable conditions. See VA pension eligibility for the periods and rules.
Surviving spouses
The Survivors Pension (sometimes still called “death pension”) works the same way for the surviving spouse (and dependent children) of a wartime veteran who meets the service rules. The surviving spouse must generally not have remarried. Survivors can also receive Housebound or Aid and Attendance amounts if they qualify. The survivor rates are lower than veterans’ rates.
How to apply
Applications are filed with the VA, usually on the VA’s application form for veterans’ pension (or the survivors’ form), with a medical exam report or physician’s statement for Aid and Attendance or Housebound. Applications can be filed online, by mail or with help in person. Helpful tips:
- File an “intent to file” if you need time to gather documents; it can protect an earlier effective date.
- Include proof of medical expenses (care agreements, invoices, insurance premiums) so the VA can deduct them.
- Include the discharge papers (DD-214) or other proof of service.
Help with VA claims is available at no cost from accredited veterans service officers, including county veterans service officers and those at veterans service organizations. Only VA-accredited representatives, agents or attorneys may help prepare and present claims, and federal rules restrict charging fees for help with an initial pension application.
How the pension fits with Medicaid
The VA pension and Medicaid can work together, but they interact in specific ways:
- For Medicaid eligibility, the Aid and Attendance and Housebound portions and payments based on unreimbursed medical expenses are generally not counted as income. The basic pension amount generally is counted.
- A veteran (or surviving spouse) with no dependents who is in a nursing home paid for by Medicaid generally has the VA pension reduced to $90 a month. That $90 is protected and does not go toward the nursing home bill.
- The VA’s 36-month look-back and Medicaid’s five-year look-back are different. A transfer that is planned for one may cause a penalty under the other.
See How VA benefits count for Medicaid and VA pension vs. Medicaid.
Watch out for pension “advisers”
Some businesses market “free” help with VA pensions, then sell annuities or trusts that make the veteran eligible for the VA pension but disqualify them for Medicaid for years, or charge fees that VA rules do not allow. Be wary of anyone who recommends moving assets into a product before explaining both VA and Medicaid consequences. See Scams and red flags.
Getting experienced help
VA pensions and Medicaid have different rules for assets, income and transfers. A plan that maximizes one benefit can cost the family the other. Experienced help is important when a veteran may need a nursing home within a few years, when there is a spouse at home, or when assets are near either program’s limits. A Certified Medicaid Planner can explain how both programs treat the family’s situation; claims themselves should be handled by a VA-accredited representative. As a rough guide, full planning ranges from about $2,500 to $15,000 or more and hourly help from about $150 to $600.
Frequently asked questions
Does the veteran need a service-connected disability? No. The pension is based on wartime service, age or disability, and financial need.
Can a veteran get both disability compensation and the pension? Generally the VA pays whichever benefit is greater, not both.
Can a surviving spouse get Aid and Attendance? Yes, if they qualify for the Survivors Pension and meet the Aid and Attendance criteria.
Is the pension taxable? VA pension benefits are generally not taxable income for federal income tax purposes.
Related guides
- VA pension eligibility
- The VA look-back and net worth rules
- VA pension eligibility self-check
- Veterans hub
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.