VA Aid and Attendance: extra pension for veterans and surviving spouses who need care
Aid and Attendance is an addition to the VA pension for wartime veterans and surviving spouses who need help with daily activities, are largely bedbound, live in a nursing home, or have very poor eyesight. For 2026 the maximum is $29,093 a year for a veteran alone, $34,488 for a veteran with a spouse, and $18,697 for a surviving spouse. Net worth must be $163,699 or less, and the VA looks back three years at transfers.
The numbers
| Max annual pension with A&A — veteran, no dependents | $29,093 |
| Max annual pension with A&A — veteran with spouse | $34,488 |
| Max annual pension with A&A — surviving spouse, no dependents | $18,697 |
| Net-worth limit (1 Dec 2025 – 30 Nov 2026) | $163,699 |
| Look-back for asset transfers | 3 years |
| Longest transfer penalty | 5 years |
| Medical expenses deductible above | 5% of your maximum pension rate |
Who qualifies
The veteran must have served on active duty during wartime (for service starting before September 8, 1980: at least 90 days with at least one day in wartime), and be 65 or older, or permanently disabled, or in a nursing home. A surviving spouse may qualify on the veteran's service. Aid and Attendance is added if the person:
- Needs another person to help with bathing, feeding, dressing or similar activities
- Must stay in bed, or spend much of the day in bed, due to illness
- Lives in a nursing home because of lost physical or mental abilities
- Has eyesight of 5/200 or less in both eyes
How the payment is worked out
The VA pays the difference between your countable income and the maximum rate. Unreimbursed medical costs — which can include paid home care or assisted living care — reduce countable income, but only the part above 5% of your maximum rate.
Net worth includes assets and yearly income. Your house, car and most furnishings are not counted.
How to apply
Apply for the pension and include VA Form 21-2680 (a doctor's examination for Aid and Attendance). If in a nursing home, add VA Form 21-0779. The Cape Cod District veterans' services office helps with these forms free of charge.
Mistakes families make
- Paying someone to help with the application; accredited help is free.
- Giving away assets to get under the net-worth limit; the VA looks back three years and can impose a penalty of up to five years.
- Leaving out care costs. Unreimbursed medical and care expenses can greatly increase the payment.
- Assuming a surviving spouse cannot apply.
Who to call on Cape Cod
| Who | Number | For |
|---|---|---|
| Cape Cod District Department of Veterans' Services | (508) 778-8740 | Free help applying; 66 Falmouth Road, Hyannis (serves most Cape towns) |
What we could not confirm: Rates are those effective 1 Dec 2025; the VA normally updates them each 1 December, so check after that date. The Cape Cod District office lists Barnstable, Bourne, Brewster, Chatham, Dennis, Eastham, Harwich, Mashpee, Orleans, Provincetown, Sandwich, Truro, Wareham, Wellfleet and Yarmouth; residents of other towns (for example Falmouth) should call their town veterans' agent.
Next: All the ways to pay for care · Two-minute benefits check · What care costs on the Cape · Elder law attorneys
This page explains the rules; it is not legal advice. For your own situation, talk to an elder law attorney or SHINE.