VA Aid and Attendance for assisted living

If your loved one served in the military, or is the surviving spouse of someone who did, there may be VA money available to help pay for assisted living or memory care. Many families never apply because they don’t know the benefit exists, or because they assume it is only for veterans with a service-connected injury. This guide explains the benefit most often used for senior living, who may qualify, and how to get honest, free help applying.

The benefit most families mean: Pension with Aid and Attendance

The VA has several programs, but the one that most often helps with the cost of assisted living is the Veterans Pension with Aid and Attendance. Surviving spouses may qualify for a similar benefit, the Survivors Pension with Aid and Attendance.

The pension is a monthly payment for wartime veterans and surviving spouses with limited income and assets. Aid and Attendance is an additional amount added to that pension for people who need help from another person with daily living. Together, they can make a meaningful difference to a monthly care budget.

This is different from VA disability compensation, which is paid for conditions connected to military service. Some veterans receive disability compensation instead, and in some cases that can also include an Aid and Attendance amount. The VA decides which benefit applies.

Who may qualify

The VA looks at three areas. The details are set by the VA and can change, so check the current rules with the VA or an accredited representative.

Service

The veteran generally must have served on active duty, with at least some of that service during a recognized wartime period, and must not have been dishonorably discharged. Service in a combat zone isn’t required. Minimum length of service rules apply.

Need for help

To receive the Aid and Attendance amount, the person must need regular help from another person with everyday activities such as bathing, dressing, eating, toileting or staying safe, or be bedbound or living in a nursing facility because of a disability. Living in assisted living because of these needs is often part of the picture. A doctor usually completes a VA examination form, VA Form 21-2680, describing the person’s needs.

Income and net worth

The pension is needs-based. The VA counts income and assets against a net worth limit. Ongoing, unreimbursed medical and care costs, which can include the cost of assisted living care, may be deducted from income. That is why some families who assume they earn too much still qualify.

The VA also reviews assets that were transferred or given away during a three-year look-back period before the application. Moving money to qualify can lead to a penalty period.

Getting free, accredited help

Only people the VA has accredited are allowed to help prepare and present VA benefit claims. That includes:

• Veterans service organizations, such as the American Legion, the VFW and the DAV, whose service officers help for free
• The Arizona Department of Veterans’ Services, which offers free benefits counseling
• Accredited attorneys and claims agents

You can check whether someone is accredited using the search tool on the VA website. In most cases, an accredited representative may not charge you to help with an initial pension application.

Good to know: Be wary of anyone who offers to help you qualify for VA benefits for a fee, especially if they also sell annuities, trusts or other financial products. Some of these arrangements can cost families money or cause problems with other benefits such as ALTCS. Free help from an accredited representative is always available.

How to apply

1. Gather records. The veteran’s discharge papers (often a DD-214), marriage and death certificates if applying as a surviving spouse, income records, bank and investment statements, and a list of ongoing medical and care costs.
2. Get the doctor’s examination describing the need for help with daily living.
3. Contact an accredited representative to review everything and file the application with you.
4. Keep records of care costs. Invoices from the assisted living community or care home show the VA what the family is paying.
5. Respond promptly to any VA requests for more information.

Decisions can take months. The VA may pay benefits back to the date the claim was filed, so it is worth applying as soon as you have a clear picture, even if a move has already happened.

Planning around the timing

Because a VA decision can take time, most families pay privately while the claim is pending. Ask each community you are considering:

• Do you have other residents receiving VA benefits?
• Will you provide the itemized invoices the VA needs?
• If ALTCS may be needed later, do you accept ALTCS as well?

VA benefits and ALTCS have different rules. If your loved one may eventually need both, talk to an elder law attorney or accredited representative about how one affects the other before making financial decisions.

Common questions

Can you get VA Aid and Attendance and ALTCS at the same time?

Sometimes, but the two programs count income and assets differently, and one can affect the other. Talk to an accredited representative or an elder law attorney before making financial decisions that involve both.

Does the veteran need a service-connected disability?

No. The pension with Aid and Attendance is based on wartime service, financial need and needing help with daily living, not on an injury from service. Other VA benefits work differently.

Does the VA pay the assisted living community directly?

Generally no. The pension is paid to the veteran or surviving spouse, who uses it toward their costs. Confirm the current details with the VA.

Should I pay someone to help with a VA claim?

You don’t need to. Accredited veterans service organizations help for free, and in most cases an accredited representative can’t charge for help with an initial pension application. Be cautious with anyone who asks for a fee up front.

How we can help

We can make sure the communities on your list can provide the documentation the VA asks for, and we can point you to free, accredited help in the Valley. We can also help you find assisted living in the Phoenix area wherever your family needs it. We don’t file VA claims or give legal or financial advice, and we never charge for help with benefits. Tell us about your situation and we’ll help you work out where to start.