Guides · Updated September 27, 2026
Aid and Attendance and medical expenses
Aid and Attendance is an added amount on VA Pension or Survivors Pension for someone who needs help with daily activities, lives in a nursing home, or has limited eyesight. It raises the pension limit. For many families, care costs are what make it pay.
This guide is general information, not legal advice. VetCareLog is not affiliated with the U.S. Department of Veterans Affairs. Confirm your situation with an accredited representative.
How it works with medical costs
The VA sets a yearly maximum for each situation, then subtracts the income it counts. Medical costs the family paid and was not paid back for come off that income, after a small deductible of 5% of the basic yearly rate. With Aid and Attendance, the maximum is higher. For example, for a veteran with no spouse or dependents:
| Basic pension | $17,441 a year |
|---|---|
| With Aid and Attendance | $29,093 a year |
| Medical cost deductible | $872 a year |
Because people who need daily help often pay a lot for care, their medical costs can bring their counted income down a long way. That is why Aid and Attendance families have the most to gain from keeping every record.
Costs that often apply
- In-home aides and home health care
- Assisted living or adult day care. In many cases the VA can count more of the facility's cost when the resident needs help with daily activities; ask a VSO about your situation.
- Nursing home costs
- Medicare and other insurance premiums, prescriptions, and equipment
- Drives to medical care
How it is reported
In-home care and care facilities go in Section IV of VA Form 21P‑8416, and the provider completes a worksheet in the form. Other medical costs go in Section V, and mileage in Section VI. For a nursing home listed on Medicare's Care Compare, the form asks for VA Form 21‑0779 instead.
See the math for your family
The calculator on our homepage shows the VA's formula with this year's rates, including Aid and Attendance, for your own income and costs.
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More guides
- What counts as a medical expense for VA Pension
- Does the Medicare premium count for VA Pension?
- VA Pension mileage: how drives to the doctor count
- Paying a family caregiver and VA Pension
Rates in this guide are the VA’s maximum annual pension rates effective December 1, 2025. They change every December. Source: VA pension rates.