VA Aid and Attendance, Worked Through: A Winston-Salem Surviving Spouse

Why so many families miss this benefit

VA pension with Aid and Attendance is one of the most useful ways to pay for assisted living, and one of the least claimed. Families often assume a parent's Social Security puts them over the income limit, or that the benefit is only for veterans with service-connected injuries. Neither is true. It is a needs-based pension for wartime veterans and their surviving spouses, and the way it counts income makes it work well for people paying for care.

The rates for the current year

Aid and Attendance raises the Maximum Annual Pension Rate the VA can pay. For December 1, 2025 through November 30, 2026, the maximums are:

Source: VA pension rate tables, effective December 1, 2025 through November 30, 2026.

The VA pays the difference between the maximum and the claimant's countable income. So the real question is what counts as income.

How care costs change the math

Countable income is total income minus unreimbursed medical expenses, and for someone who needs help with daily living, the cost of an adult care home, home care or a nursing home counts as a medical expense. Here is a worked example for a surviving spouse of a wartime veteran living in an adult care home in Winston-Salem, with figures rounded:

Illustration only; the VA calculates on annual figures and applies a small deductible to medical expenses.

In this example the pension would cover about 30% of the monthly bill. For a veteran with no dependents the maximum is $2,424 a month, which goes further.

The other rules

The veteran must have served at least one day during a wartime period, generally with at least 90 days of active duty, and must not have a dishonorable discharge. The claimant must need help with daily activities, be housebound, be in a nursing home or have limited eyesight. And net worth, assets plus annual income, must be at or below $163,699 for the current period. The home and a vehicle are generally excluded. The VA looks back three years for assets given away or sold below value to meet the limit.

How the VA pension fits with other programs

VA pension is income, so it affects other means-tested programs. A surviving spouse who receives Aid and Attendance will usually have too much income for Special Assistance in an adult care home, and in a nursing home on Medicaid, most income goes toward the patient monthly liability. Run the numbers for both routes before choosing.

For many middle-income families, VA pension is what makes private-pay assisted living affordable for a few more years, delaying or avoiding the need for Medicaid. For lower-income families, Special Assistance may cover more. A county veterans services officer and the county department of social services can each explain their side, and it is worth asking both before deciding which application to file first.

How to apply in the five counties

File through a county veterans services officer, an accredited service organization or directly with the VA. No one may charge to prepare or file an initial pension claim, so be wary of anyone who offers to restructure assets for a fee. Bring the veteran's DD-214, the marriage certificate and death certificate for a surviving spouse, income and bank records, the care home's statements and a physician's statement of need. Claims can take months, but benefits are generally paid back to the month after filing, so file as soon as care costs begin.