If you’re a Veteran or a family member caring for one, you should know about the Aid and Attendance (A&A) benefit. As an additional financial benefit through the VA, it boosts monthly payments by adding to your VA pension. It’s designed for Veterans and surviving spouses who need help with things like bathing, dressing, eating, or moving around safely.
If you qualify, these funds can help you pay for caregivers, assisted living facilities, or nursing homes. They’re meant to ease the financial burden and help maintain dignity and quality of life.
Note: It’s important to point out that A&A is not a benefit you can add to military retirement. It’s only something added to VA pension benefits.
Aid and Attendance Eligibility
The first part of determining eligibility is ensuring you qualify for VA pension. If you’re able to receive VA pension, then you may be eligible if:
- You are a wartime Veteran or a surviving spouse of a wartime Veteran.
- You need help with activities of daily living, such as bathing, feeding, dressing, or moving around.
- You are bedridden due to illness.
- You are a patient in a nursing home due to mental or physical incapacity.
- Your eyesight is severely limited (5/200 visual acuity or less, or concentric contraction of the visual field to 5 degrees or less).
Veterans also have some service requirements that include:
- At least 90 days of active duty, with at least one day during a wartime period, and
- You received a discharge other than dishonorable.
If you’re a surviving spouse, you must meet the VA’s requirements, including not having remarried (unless exceptions apply).
Note: You cannot receive Aid and Attendance and VA disability pay benefits at the same time. If you’re eligible for both, you will receive the benefit that pays the higher amount.
Using Aid and Attendance
The VA pension benefits are aimed at helping folks living under a certain income. Some eligible Veterans may not live with a disability, so the Aid and Attendance benefits help with the additional financial burdens of those living with a disability or illness.
A&A can help pay for programs like:
- In-home personal care services
- Assisted living facility costs
- Skilled nursing care
- Medical expenses not covered by insurance
Note: This additional payment is tax-free and does not need to be repaid.
How Much Does the VA Pay for Aid and Attendance Benefits?
If you qualify for VA pension and Aid and Attendance benefits, the VA calculates your benefits based on the difference between your countable income (what you earn, minus some expenses) and the maximum annual pension rate.
The VA pension rate table is above, but you can see survivor’s pension rate tables to calculate Aid and Attendance given the changing totals each year.
The VA implemented a three-year look-back period in 2018. If you file a claim after that date, the VA looks to see if you sold assets below market value or gifted them to reduce your net worth below the upper eligibility limit.
The VA will not count certain assets toward your net worth and will deduct certain expenses from your income. These include:
- Unreimbursed medical expenses – deducted from your income
- Educational expenses – deducted from your income
- State and municipal veterans’ benefits – up to $5,000 per year is excluded
- Primary residence and lot (up to two acres) – not included as an asset even if you live in a nursing home, care facility or with a family member for care
Read more about how the VA determines assets and income
You may also qualify for Housebound benefits. However, you can only receive either Aid and Attendance or Housebound benefits, not both.
Housebound Benefits
VA Housebound benefits pay a monthly allowance to VA pension-eligible veterans who spend most of their time in their homes because of a permanent disability.
This benefit is not automatic; you must apply for it.
Step-by-Step Guide to Apply for Aid and Attendance
The application process for these benefits can seem overwhelming, but I promise you it’s not as bad as it may seem. Plus, to help, I included this step-by-step guide on what you need and why to apply for Aid and Attendance.
Step 1: Gather Required Documents
Maybe the most complicated part of the process is the paperwork requirement. The good news is that the information should not be too hard to locate. Plus, you’ve likely already used most of the paperwork to get other benefits.
Some of the documentation you’ll need are:
- Discharge papers (Also called DD-214 form)
- Marriage certificate (if you’re a surviving spouse)
- Medical evidence (a doctor’s report detailing your need for assistance)
- Financial information (income, assets, expenses)
Step 2: Complete the Correct Form
Once you gather all that paperwork, you’ll need to fill out the official VA forms.
Veterans or Surviving Spouses: VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance)
Living in a Nursing Home: VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance)
Step 3: How to Fill Out VA Form 21-2680
The first two sections (Section I and Section II) are pretty straightforward; just fill out your personal information (name, address, Social Security number, Veteran service number).
The third section (Section III) is the specific claim you’re applying to receive. There, you’ll see a box next to Special Monthly Compensation (SMC) and a box next to Special Monthly Pension (SMP).
There is a difference.
Special Monthly Compensation (SMC) is if you’re filing for additional assistance for a Veteran who lives with a service-connected disability. Special Monthly Pension (SMP) is for a Veteran who is permanently or totally disabled, but the condition isn’t related to service.
So if you’re filing this out as a Veteran or for a Veteran who suffered a service-connected injury or illness, you’ll need to make sure to check the box next to SMC.
The fourth section (Section IV) is just basic information about any hospitalization. Section five (Section V) is simply a signature.
Sections six through eight (Section VI, VII, and VIII) are specifically for your physician to fill out and date.
Note: Medical evidence should be recent (within the last 12 months) and clearly describe how your disabilities affect your daily living.
Step 4: Submit Your Application
You can send your completed forms to your VA Pension Management Center based on your state of residence. Find addresses at VA Pension Centers.
Alternatively, you can work with a Veterans Service Organization (VSO) to assist you in filing correctly.
Step 5: Follow Up
After submission, the VA may contact you for more information. Always respond quickly to avoid delays.
Processing times can vary, but expect a decision within several months. If approved, benefits are often paid retroactively to the date you submitted your claim.
Final Thoughts
If you or a loved one struggles with daily activities, don’t leave these important benefits on the table. Aid and Attendance exists to honor your service and help you maintain a good quality of life. Filing can feel overwhelming, but the right preparation—and a little persistence—can make all the difference.
Remember, make your application as strong as possible by including as much detailed medical evidence from your doctor as you can. Be as detailed and specific about how the disabilities affect your daily life, and always consider help from either VSOs or accredited representatives.
You served. You’ve earned it. Make sure you get the support you deserve.
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Jon Rehagan covers financial topics and military news, aimed at helping those who've served our country and everyday civilians