VA Aid and Attendance is a monthly payment added to a VA pension. It goes to wartime veterans and surviving spouses who need another person's help with daily life, and families can put it toward care at home. Many Oʻahu households with a qualifying parent or spouse have never heard of it.
The VA Aid and Attendance requirements come in layers. The pension comes first, with its rules about service, age or disability, income and net worth. The care need sits on top, and a medical examiner records it on a VA form. Each layer has its own checklist, and the application moves faster when you know the order.
This post covers who qualifies, how VA figures the payment, and how to apply, including the free help available on Oʻahu. It also shows how families use the payment for in-home care.
What Is VA Aid and Attendance?
VA Aid and Attendance is an extra amount that VA adds to a monthly pension payment. It attaches to the Veterans Pension for wartime veterans and to the Survivors Pension for their surviving spouses. Because the add-on rides on the pension, a person qualifies for the pension first, and the care need then moves the payment to a higher rate.
The money arrives each month, and the family decides how to spend it. Some use it for help at home, some for an assisted living community, and some for a nursing home. VA describes its pension benefits as tax-free.
Hawaiʻi has 87,697 veterans, so many Oʻahu families have a wartime veteran or a surviving spouse in the household or close by. A veteran who never filed for a pension, or a widow who assumed the benefit ended with her husband, may hold a claim worth checking.
Two other benefits have similar names. The Housebound allowance is a smaller add-on for people who spend most of their time at home because of a permanent disability. VA pays Housebound or Aid and Attendance, one at a time. The Aid and Attendance level of Special Monthly Compensation is a separate benefit for veterans with service-connected disabilities, and VA pays it through disability compensation. This post covers the pension add-on.
The Pension Requirements Come First
Aid and Attendance rides on the pension, so the pension rules apply first. They make up most of VA Aid and Attendance eligibility, and they are the best place for a family to begin.
Service comes first. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty, with at least 1 day during a wartime period. A veteran who enlisted after September 7, 1980 needs at least 24 months, or the full period the person was ordered to serve, with at least 1 day during wartime. VA lists a few exceptions, including some for officers.
The discharge must be something other than dishonorable. A veteran with an other than honorable or bad conduct discharge can ask for a discharge upgrade or a VA Character of Discharge review.
The veteran also needs at least one of these: age 65 or older, a permanent and total disability, long-term nursing home care because of a disability, or receipt of Social Security Disability Insurance or Supplemental Security Income.
VA recognizes these wartime periods:
- Mexican Border period: May 9, 1916 to April 5, 1917, for veterans who served in Mexico, on its borders or in adjacent waters
- World War I: April 6, 1917 to November 11, 1918
- World War II: December 7, 1941 to December 31, 1946
- Korean conflict: June 27, 1950 to January 31, 1955
- Vietnam War era, served in the Republic of Vietnam: November 1, 1955 to May 7, 1975
- Vietnam War era, served outside the Republic of Vietnam: August 5, 1964 to May 7, 1975
- Gulf War: August 2, 1990 through a date yet to be set by law or presidential proclamation
Wartime service of any kind counts, from a desk in Honolulu to a combat zone. Any health condition can create the care need, including conditions that began long after service.
The Care Needs That Qualify
Once the pension rules are met, VA looks at the care need. At least one of these must be true:
- The person needs another person's help with daily activities such as bathing, eating and dressing.
- Illness keeps the person in bed, or in bed for a large part of the day.
- The person is a nursing home patient because of a loss of mental or physical abilities.
- The person's eyesight meets the limits VA sets: 5/200 or less in both eyes, even with glasses or contact lenses, or a visual field of 5 degrees or less.
A medical examiner fills out the examination section of VA Form 21-2680, the Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. That form records a detailed picture of a typical day and the help it takes.
Specifics help the examiner. A note such as "needs a person beside him for every shower and to stand up from the bed each morning" paints a clear picture. Before the exam visit, families can jot down a normal day: who helps with meals, who stands by during bathing, how often someone helps with trips to the bathroom, and what the night looks like.
Income and Net Worth Limits
VA applies two money tests. The first is income for VA purposes, which adds up Social Security, retirement and investment income, and any income a spouse receives.
Medical expenses lower that number. Costs that insurance does not reimburse can be deducted, and what a family pays for care counts among them. VA lets a household deduct only the amount above 5% of the maximum pension rate, which works out to $872 for a veteran with no spouse or child and $1,141 for a veteran with one dependent.
The second test is net worth, which combines the applicant's and dependents' assets with income for VA purposes. The limit is $163,699 for the period that runs through November 30, 2026. Assets include savings, investments, boats, antique furniture and land, valued at fair market value minus any mortgage. The home where the veteran lives most of the time, the car and basic household items such as appliances are left out of the count.
VA also reviews the three years before a claim for assets that were given away or sold for less than fair market value. A transfer that would have pushed net worth over the limit can bring a penalty period of up to 5 years, and VA pays no pension during that time. The rule took effect on October 18, 2018. An accredited representative can look at the timeline for a family before any transfer is made.
How Much Aid and Attendance Pays
VA starts with the Maximum Annual Pension Rate, or MAPR, for the household. It subtracts income for VA purposes and pays the difference in monthly installments. Some websites quote only the Aid and Attendance add-on, which makes the amounts look smaller. The figures here are the full yearly maximums with Aid and Attendance included.
A single veteran has a MAPR of $29,093. A veteran with one dependent has $34,488, plus $2,984 for each additional dependent. A surviving spouse with no dependents has $18,697, and a surviving spouse with one dependent child has $22,304.
Here is how the math works. A single veteran whose income for VA purposes is $9,000 a year after medical deductions subtracts that from $29,093. The result is $20,093 a year, or about $1,674 a month.
VA adjusts these rates every December with the cost-of-living adjustment. The tables took effect on December 1, 2025 with a 2.8% increase, and VA's rates page always lists the current figures.
What Surviving Spouses Need to Know
Many widows and widowers assume the benefit ended when the veteran died. The Survivors Pension can continue help for the spouse of a wartime veteran, and it carries Aid and Attendance too.
The veteran's service must meet the same wartime and discharge rules. The surviving spouse has not remarried and lived with the veteran from the wedding until the death, a condition VA calls continuous cohabitation. VA recognizes separations caused by health, work or the veteran's misconduct, so a couple who lived apart for one of those reasons may still meet it.
The care need is the same set of four conditions, and the net worth limit is the same $163,699. The rates come from a separate table, with a maximum of $18,697 a year for a surviving spouse with no dependents and $22,304 with one dependent child. Surviving spouses apply with VA Form 21P-534EZ, and the same intent to file step can hold the start date.
How to Apply for Aid and Attendance
Anyone asking how to qualify for VA Aid and Attendance ends up at the same place: a folder of records and a set of forms. The steps run in this order:
- Gather the records: the DD214 discharge papers, medical evidence of the care need, income and asset records, and records of what the household pays for care.
- Submit an intent to file. It holds the potential start date for benefits while the rest of the paperwork comes together.
- Ask a medical examiner to complete the examination section of VA Form 21-2680. A nursing home resident also needs VA Form 21-0779.
- File the pension application online, by mail to the VA Pension Intake Center in Janesville, Wisconsin, or in person at a VA regional office.
VA processes claims in the order it receives them unless a claim needs priority handling, so the timeline depends. After an intent to file, the applicant has 1 year to complete the claim, and an approved claim can bring retroactive payments back to that date.
Help with the application costs nothing through an accredited Veterans Service Organization representative, because VA says that help is always free. Accredited attorneys and claims agents can charge fees. On Oʻahu, the State of Hawaiʻi Office of Veterans' Services has Veterans Services Counselors at Tripler Army Medical Center in Honolulu and the Daniel K. Akaka VA Clinic in Kapolei.
Using Aid and Attendance for Care at Home on Oʻahu
Many families put the payment toward in-home help with the same daily activities the benefit is built around: bathing, dressing, eating, using the bathroom and getting around the house. Paid care adds up quickly. The national median for non-medical in-home caregivers was $35 an hour in 2025, which comes to $80,080 a year at 44 hours a week. What a family pays for that care also counts as a medical expense in VA's income calculation, and that can lower income for VA purposes.
Aid and Attendance sits apart from VA's Homemaker and Home Health Aide program. That program is a VA health care service for enrolled veterans who are eligible for community care and meet the clinical criteria, and a copay may apply depending on service-connected disability status. The pension is a cash payment that the family directs.
Wilson Care Group is a veteran-owned business and an authorized VA provider. Through its veteran care services, caregivers help veterans with eating, getting dressed, grooming, bathing, using the bathroom and moving from place to place, and Wilson Care Group is a participating TRICARE provider. Its home care across Oʻahu includes nurse aide care for hands-on personal help, 24-hour home care for round-the-clock support, and skilled nursing from a licensed LPN or RN.
Where to Start
Start with the pension requirements: wartime service, a discharge other than dishonorable, and age or disability. Then look at the care need and what a typical day takes. After that, gather the DD214, medical evidence, income and asset records and care costs, and submit the intent to file to hold the start date.
A family that wants to talk through the daily help a veteran or spouse needs at home can schedule a complimentary care consultation with Wilson Care Group. The team will listen to the family's situation and walk through the care options available on Oʻahu.
Frequently Asked Questions
Can a surviving spouse get Aid and Attendance?
Yes, when the spouse qualifies for the Survivors Pension. The Survivors Pension has its own Aid and Attendance rates, with a maximum annual rate of $18,697 for a surviving spouse with no dependents.
Does my home count toward the net worth limit?
The home where you live most of the time, your car and basic household items are left out of the $163,699 net worth limit. Other property, such as land, counts at its fair market value minus any mortgage.
Can I get Aid and Attendance and Housebound benefits at the same time?
VA pays one or the other. A person who qualifies for Aid and Attendance receives that rate, which carries the higher maximum of the two.
Is Aid and Attendance taxable?
VA describes its pension benefits as tax-free, and Aid and Attendance is an add-on to the pension.
Who can help me apply for free?
Accredited Veterans Service Organization representatives help with VA claims at no charge. On Oʻahu, the State Office of Veterans' Services has counselors at Tripler Army Medical Center and in Kapolei, and their office locations and hours are listed on the state's contact page.
Is Aid and Attendance the same as VA in-home aide services?
The two are separate programs. Aid and Attendance is a cash pension payment. VA's Homemaker and Home Health Aide care is a health care service for enrolled veterans who meet clinical criteria, and Wilson Care Group is an authorized VA provider of in-home personal care for veterans.
