VA Aid & Attendance Pension Helps Veterans Cover the Costs of Long-Term Care

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The U.S. Department of Veterans Affairs (VA) is probably most well-known for providing veterans with health care coverage and medical services, but the VA also offers a wide array of other benefits to servicemembers and their families. One such program offers qualifying vets a monthly monetary benefit to supplement their income. This benefit is known as the basic Veterans Pension.

An “improved” version of the basic pension called the “Aid & Attendance” benefit is available to veterans who have limited income and assets and require the assistance of another person to complete activities of daily living (ADLs). These funds can help offset the everyday costs of living and the costs of long-term care, which can be provided in a veteran’s home or in a residential setting like an assisted living facility or a nursing home.

Eligibility Requirements for the Aid & Attendance Pension (A&A)

There are several eligibility requirements that veterans must meet to qualify for the A&A Pension program. The first and simplest requirement is that a veteran must have received a discharge other than dishonorable. Because A&A is an “improved” version of the basic Veterans Pension, many of the qualifications are the same except for additional functional requirements.

Wartime Service Requirements

The veteran must have served at least 90 days of active military, naval or air service, with at least one day taking place during a recognized period of war. The VA recognizes the following wartime periods:

  • Mexican Border Period: May 9, 1916 – April 5, 1917, for veterans who served in Mexico, on its borders or on adjacent waters
  • World War I: April 6, 1917 – November 11, 1918
  • World War II: December 7, 1941 – December 31, 1946
  • Korean Conflict: June 27, 1950 – January 31, 1955
  • Vietnam Era: February 28, 1961 – May 7, 1975, for veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964 – May 7, 1975
  • Gulf War: August 2, 1990, through a future date to be set by law or Presidential Proclamation

(Veterans who entered active duty after September 7, 1980, must have either served 24 months or the full period for which they were called into active duty with at least one day during a wartime period defined above.)

Financial Requirements

Because this pension is intended to supplement the income of financially needy veterans, it makes sense that the VA requires applicants to demonstrate their financial need. Prior to October 18, 2018, the VA only used a household income cap to determine if applicants were eligible for pension and, if so, the amount they were eligible to receive. There was no set maximum amount of assets that an applicant could have, which resulted in claims processors inconsistently and arbitrarily approving and denying applications. To eliminate these inconsistencies, the VA has switched to using an applicant’s net worth to determine financial eligibility.

The VA chose to use Medicaid’s maximum community spouse resource allowance (CSRA) as the new bright-line net worth limit for needs-based benefits like the veterans pension. As of December 1, 2021, the maximum CSRA is $138,489. Like Social Security benefits and the CSRA, a cost-of-living adjustment will be made annually to the VA’s net worth limit to ensure these numbers keep pace with inflation. In order to qualify for a VA pension under the new rules, an applicant’s net worth (assets plus annual income) must be less than or equal to the maximum CSRA.

Certain assets are not included in the VA’s net worth calculation, such as an applicant’s primary residence of any value (regardless of whether they currently live there, in a family member’s home or in a long-term care facility) and an applicant’s personal effects that are “consistent with a reasonable mode of life” (a car, household appliances, furniture, etc.). However, there is a two-acre limit to the size of the lot area upon which an applicant’s primary residence is located. Any additional marketable acreage is considered an asset by the VA.

The VA also enforces a separate annual household income limit. As with assets, certain sources of income are not included in the VA’s calculation. A veteran’s countable income (plus that of any dependents) must be less than a limit set by Congress called the maximum annual pension rate (MAPR).

An applicant’s individual MAPR depends on the type of pension they qualify for, how many dependents they have and whether they are married to a veteran who also qualifies for pension benefits. Currently, the MAPR for veterans who have no dependents and qualify for the A&A Pension is $24,610, while the MAPR for veterans who have one dependent and qualify for A&A is $29,175. The payment amount a veteran receives is still based on the difference between their MAPR and their household’s annual countable income.

Unreimbursed medical expenses that exceed five percent of the applicant’s current base MAPR can be used to reduce their countable income and net worth. At first glance, an applicant may appear to have excessive income and assets, but if he or she is very ill or requires extensive care, these medical expenses can greatly reduce his or her net worth. Factoring in high health care costs allows veterans in need to qualify financially for benefits like the A&A Pension.

The VA will calculate (or recalculate) a claimant's net worth when it receives a new pension claim, a secondary claim following a period of non-entitlement, a request to establish a new dependent, or finds information that an applicant’s net worth has increased or decreased. An example of a change in information would be the income tax reporting that is required whenever anyone sells real estate, such as a house.

Keep in mind that beginning October 18, 2018, the VA has established a 36-month look-back period for disqualifying transfers and an associated penalty period not to exceed five years for applicants who dispose of assets for less than fair market value in an attempt to qualify for pension. For more information on VA rule changes and financial eligibility requirements, read Needs-Based VA Benefits Get New Eligibility Rules.

Functional Requirements

The VA enforces certain functional requirements for recipients of this pension as well to ensure that vets who are unable to work, whether due to disability or age, receive the financial assistance they deserve. An eligible applicant must meet at least ONE of the following criteria for the basic pension:

  • Be at least 65 years old
  • Be permanently and totally disabled (non-service-connected)
  • Live in a nursing home
  • Receive Social Security Disability Insurance (SSDI)
  • Receive Supplemental Security Income (SSI)

Because A&A is specifically intended to help ill, disabled and aging veterans pay for the high level of care they need, veterans must also meet at least ONE of the following criteria to qualify for the higher pension amount:

  • Require the help of another person to perform activities of daily living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices or protecting oneself from the hazards of one’s daily environment
  • Have a disability that causes one to be bedridden apart from any prescribed course of recovery or treatment
  • Live in a nursing home due to physical or mental incapacity
  • Have eyesight that is limited to a corrected 5/200 visual acuity or less in both eyes
  • Have concentric contraction of the visual field to 5 degrees or less

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How Veterans Can Use Pension Funds

Veterans pensions are paid out on a monthly basis, considered tax-free income and can be used however the recipient sees fit. For example, pension funds can help cover the costs of housing, food, medical expenses, in-home care services, long-term care, clothing, bills, transportation, etc. VA pension funds can even be used to pay a family caregiver to provide services using a personal care agreement.

Read: Personal Care Agreements: A Must for Caregiver Compensation and Medicaid Planning

How to Apply for VA Pension

Although many veterans are eligible for pensions, navigating the filing process is often overwhelming and frustrating. If you think you or a veteran you know may qualify for a veterans pension, the first step is to locate discharge papers (also known as DD Form 214.)

Many veterans have misplaced their discharge records, but there are a couple of options for tracking them down. The first place to look is at the county courthouse where many vets filed their discharge records upon returning home from active duty. If you do not have access to or cannot find this document, it is also possible to submit an online request through the National Archives eVetRecs site or submit a request via mail or fax using a SF-180 form. Certain fees may apply for requesting replacement documents. Emergency requests can be made, but regular turn-around times are around 10 days.

Veterans filing for the Aid & Attendance Pension will also need to complete and gather the following:

  • VA Form 21P-527EZ (Application for Veterans Pension)
  • Additional personal and household evidence including proof of income, net worth information, and all relevant medical records or where to find them (specifics are outlined in the beginning pages of the above form)
  • VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance)
  • A statement from an attending physician attesting to the veteran’s need for A&A care.
  • If the veteran is currently in a nursing home, he or she will also need to submit VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance)

Where to Find Help Applying for VA Benefits

Including specific and comprehensive information in a VA application is crucial for timely processing and determination of benefits, but many families need help locating and compiling the necessary paperwork. Accredited veterans service organizations (VSOs) like regional offices of the American Legion, Disabled American Veterans (DAV) and Veterans of Foreign Wars (VFW) can provide this assistance free of charge.

Once an application is submitted, there is a waiting period before a veteran will receive an approval or denial. The amount of time varies according to the backlog of claims the VA is processing, but the average wait time is usually a few months. However, longer waits are to be expected if a vet files an incomplete or incorrect application.

Sources: VA Aid and Attendance Benefits and Housebound Allowance (https://www.va.gov/pension/aid-attendance-housebound/); 2022 VA pension rates for Veterans (https://www.va.gov/pension/veterans-pension-rates/); Net Worth, Asset Transfers, and Income Exclusions for Needs-Based Benefits (https://www.federalregister.gov/documents/2018/09/18/2018-19895/net-worth-asset-transfers-and-income-exclusions-for-needs-based-benefits)

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