What You Need to Know About Long Term Care for Veterans

In many instances, the costs of long term care can accumulate. Thankfully, for veterans and the surviving spouses of veterans who need care, assistance is available in the form of the Veterans Aid & Attendance (A&A) Benefit and Housebound Benefit. These are paid in addition to a vet’s basic pension, and can lend a measure of financial aid for in-home care, assisted living, and nursing home care. Here’s what you need to know.

What is the Veterans Aid & Attendance and Housebound Benefit?

According to the US Department of Veteran Affairs, the A&A Benefit is an increased monthly pension for veterans who have a limited income, are over the age of 65 (or disabled), “have served on active duty, at least 90 days, during a period of war” and “require the aid and attendance of another person, or are housebound.” More specifically, recipients must meet several qualifications. For the Aid & Attendance Benefit, you must meet one of the following:

  • You require the aid of another individual in performing activities of daily living
  • You are bedridden (their disabilities confine them to bed outside of their prescribed course of treatment)
  • You are a patient at a nursing home due to mental or physical incapacity
  • Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes; alternatively, you have concentric contraction of the visual field to 5 degrees or less

For the Housebound Benefit:

  • You are substantially confined to your immediate premises because of permanent disability

The money provided by both benefits is tax free, and there are no restrictions on how that money is used as long as it goes toward the benefit of a veteran or their surviving spouse (i.e., in-home care, board and care, assisted living, private nursing home).

There are, however, income limitations that apply to both the eligibility for these benefits and the total amount a veteran or their spouse can receive. According to Paying for Senior Care, “A veteran’s and their spouse’s joint, countable income must be less than the pension amount for which they are eligible.” The current Basic Pension MAPRs (Maximum Annual Pension Rate), Housebound Income Limits, and Aid & Attendance Income Limits are as follows:

2019 Basic / Housebound / Aid and Attendance Income Limits (effective 12/1/18 – 11/30/19)

Veteran Family Status Basic Pension
Income Limit

Income Limit

Aid & Attendance

Income Limit

Veteran with no dependents $13,537 $16,540 $22.577
Veteran with a spouse* or child** $17,724 $20,731 $26,765
Surviving spouse / death pension* $9,078 $11,095 $14,529


The VA calculates the monthly award you will receive, according to Veterans Aid Benefit, by first subtracting a year’s worth of “recurring and predictable medical expenses” that are greater than 5% of the applicable MAPR from your annual income to calculate your countable income. That countable income is then subtracted from the maximum aid allowance to determine your benefit totals. For example, if you’re a married veteran in assisted living with Aid and Attendance:

  • Yearly Income — $40,000
  • Medical Expenses — $30,000
  • 5% of MAPR — $863
  • Medical Expenses Minus 5% of MAPR — $29,137
  • Total Countable Income — $10,863
  • Aid & Attendance Limit for Veteran with Spouse/Dependent — $26,036
  • Yearly Pension — $15,173
  • Monthly Award — $1,264

Calculating your income and crunching these numbers for the numerous veteran family scenarios can be challenging, of course, so availing yourself of additional guides and resources will be of great benefit. How to Calculate Income for Veterans Pensions is a great place to start, as is The Nuts and Bolts Guide to Veterans Benefits.

How to Apply for the Benefits

Applying for Benefits

Applying for these pension benefits can be a long and tricky process. You can expect most applications to take six to eight months for approval. Thankfully, though, benefits are retroactive to the date of application and there are several ways for you to approach this task:

When applying for these benefits, you should include proof of your military service and evidence of your health claims, which the Department of Veterans Affairs defines as “a report from an attending physician validating the need for Aid and Attendance or Housebound type care.” You might also need to supply additional documentation. Here are some of the documents you may need in order to apply:

  • Discharge/Separation Papers (DD-214)
  • Copy of Marriage Certificate and all marital information (unless applying for veteran only)
  • Copy of the Death Certificate (surviving spouses only)
  • Copy of current Social Security award letter
  • Net worth information (bank accounts, CDs, trusts, stocks, bonds, annuities, etc.)
  • Proof of all income (pensions, retirement, interest income from investments, annuities, etc.)
  • Physician statement that includes current diagnosis, medical status, prognosis, name and address, ability to care for self, ability to travel unattended, etc.
  • Nursing Home Status Statement (If veteran and/or spouse is in nursing home or assisted living facility) and Statement of Occupancy from the facility (ask the facility for this document)
  • Proof of insurance premiums, medications, medical bills or any other medical expenses not reimbursed by insurance, Medicare, or Medicaid
  • List of all doctors and hospitals visited in the last year
  • Banking information for direct deposit of A&A monthly payments (include a voided check)
  • If court-appointed guardian of the veteran or surviving spouse, a certified copy of the court order is required

If you are a veteran or a spouse of a veteran, it’s important to find a senior community where you will be safe, feel happy, and can receive the financial assistance you deserve. The Cottages provides an environment where these needs can be met, and we invite you to reach out with any questions you might have today.

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