VA pension with Aid and Attendance: help paying for care

What is VA Aid and Attendance?

Aid and Attendance is an add-on to the VA's needs-based pension for wartime veterans and their surviving spouses who need another person's help with daily activities, are bedridden, are in a nursing home or have limited eyesight; it raises the maximum pension the VA can pay.

VA Maximum Annual Pension Rates in effect December 1, 2025 through November 30, 2026.

It is not a separate check. The VA pays the difference between the Maximum Annual Pension Rate and the claimant's countable income, so the actual award depends on income after care costs are subtracted.

How do care costs help a veteran qualify for the pension?

Unreimbursed medical expenses, which can include adult care home fees, home care or nursing home costs paid out of pocket, reduce countable income, so a veteran whose Social Security looks too high on paper may still qualify once care costs are counted.

That is why Aid and Attendance is so useful for assisted living. A surviving spouse with $2,000 a month of income paying $5,500 a month for an adult care home in Winston-Salem has negative countable income and could receive the full surviving-spouse rate. Keep receipts and the home's statements, because the VA will ask for them.

What are the VA's net worth and service rules?

The claimant's net worth, assets plus annual income, must be at or below $163,699 for the period from December 1, 2025, the veteran must have served at least one day during a wartime period with 90 days of active duty in most cases, and the discharge must not be dishonorable.

The primary home and a reasonable lot are excluded, and a vehicle generally is too. The VA also looks back three years for assets transferred below fair value to meet the net worth limit, and can impose a penalty period. Do not reposition assets based on advice from someone selling a product.

Where do Winston-Salem veterans apply, and does it cost anything?

Applications can be filed free through a county veterans services officer, a VA-accredited service organization or directly with the VA; nobody is allowed to charge a fee to prepare or file an initial pension claim.

Each of our five counties has a veterans services office. Bring the DD-214, marriage and death certificates for a surviving spouse, income records, bank statements and a physician's statement of the need for help. Claims often take several months, but benefits are generally paid back to the month after the claim was filed.

Does the North Carolina State Veterans Home in Kernersville take residents from the five counties?

Yes. The North Carolina State Veterans Home in Kernersville is a 120-bed licensed and CMS-certified nursing home, with a dementia special care unit, that admits eligible veterans; admission depends on VA eligibility and nursing need, not on county.

The home is one of the state's veterans nursing homes, and the VA pays part of the daily cost for eligible veterans, sometimes all of it for veterans with high service-connected disability ratings. Its CMS ratings, survey results and staffing are on its directory listing. Ask about the waiting list early.