Guide · updated 2026-08-03
Who Qualifies for VA Aid and Attendance
Aid and Attendance is an increased pension for wartime veterans and surviving spouses who need help with daily activities. Four separate tests have to be met, and the one that decides most cases is not the medical one — it is how unreimbursed medical expenses reduce countable income.
Four tests, all of which must be met
There is a service test. It generally requires active-duty service that includes a period during a recognized wartime era. There is a medical test. It is met by needing help with daily activities such as bathing, dressing or eating, by living in a nursing home, or by specified visual impairment. There is a net-worth limit. It counts assets and annual income together against a published ceiling. And there is an income test, which is the one that decides most applications and the one most often misunderstood.
Unreimbursed medical expenses reduce the income that counts
The income test does not compare gross income to the maximum annual pension rate. It compares countable income. That is income after subtracting continuing unreimbursed medical expenses: the cost of assisted living or in-home care, insurance premiums, and other out-of-pocket medical costs. Care is exactly what an applicant is paying for, so this often brings countable income far below the ceiling. Applicants who assume their pension income disqualifies them often have not done this subtraction.
The award is the gap, not a fixed amount
The payment is generally the difference between countable income and the applicable maximum annual pension rate, divided into monthly amounts. So it is not a fixed benefit paid at the same level to everyone eligible. Two households with identical care costs but different incomes receive different amounts. A household whose countable income already exceeds the rate receives nothing at all. This is why an estimate needs both the income and the medical expenses, not just the service record.
Accredited help is free, and paid filing help is a warning sign
VA-accredited attorneys, claims agents and Veterans Service Organization representatives are the people authorized to help with a claim. Help from a VSO is free. Federal rules sharply restrict charging fees for preparing an initial claim. Some companies charge to file, or bundle filing help with the sale of a financial product such as an annuity. The VA itself warns about that pattern. The free route reaches the same place.
Official sources for this guide
Now do the math →
🎖️ VA Aid and Attendance Calculator
Annual update alerts — new IRS and state figures the week they drop
One email when the numbers change. Double opt-in, no spam, unsubscribe anytime.