What Are These Benefits?
Aid and Attendance (A&A) and Housebound are enhanced pension rates for veterans (and survivors) who receive VA Pension and have additional care needs. They significantly increase the monthly pension payment.
These are not disability compensation — they're enhancements to the VA Pension program.
Who Qualifies
Basic Pension Eligibility First
You must first qualify for VA Pension:
- Wartime veteran (or survivor) with limited income
- Permanent and total disability (non-service-connected) OR age 65+
- Discharge under other than dishonorable conditions
- Meet service requirements (90 days active, at least 1 during a wartime period)
See our VA Pension guide for full eligibility details.
Aid and Attendance Criteria
On top of pension eligibility, you qualify for A&A if you:
- Need help with daily activities (bathing, dressing, eating, toileting, adjusting prosthetics)
- Are bedridden (spend a significant portion of the day in bed)
- Are a patient in a nursing home due to physical or mental incapacity
- Have corrected visual acuity of 5/200 or less in both eyes, or concentric contraction of the visual field to 5 degrees or less
Housebound Criteria
You qualify for housebound if you:
- Have a single permanent disability rated at 100% AND are substantially confined to your home, OR
- Have a single permanent disability rated at 100% AND have additional separate disabilities independently rated at 60% or more
Note: Aid and Attendance and Housebound are mutually exclusive — you receive whichever rate is higher, not both.
Rates (Approximate 2025 Annual Rates)
Veterans
| Category | Annual Rate |
|---|---|
| Basic pension (with dependents) | ~$21,001 |
| Housebound (with dependents) | ~$25,672 |
| Aid and Attendance (with dependents) | ~$35,083 |
Surviving Spouses
| Category | Annual Rate |
|---|---|
| Basic pension | ~$14,089 |
| Housebound | ~$17,241 |
| Aid and Attendance | ~$22,513 |
Rates are adjusted annually. These are approximate — verify current rates at VA.gov.
How the VA Calculates Your Payment
VA Pension (including A&A/Housebound) is income-based. The VA calculates:
Maximum Annual Pension Rate (MAPR) − Countable Income = Annual Pension Benefit
Divided by 12 for your monthly payment.
What Counts as Income
- Social Security benefits
- Retirement income
- Investment income
- Wages/salary
- Most other income sources
What Reduces Countable Income
Unreimbursed medical expenses (UME) can be deducted from your income, including:
- Assisted living or nursing home costs
- In-home caregiver expenses
- Medicare premiums
- Prescription and medical costs
- Medical equipment and supplies
- Transportation to medical appointments
This is where A&A becomes especially valuable: if you're in an assisted living facility paying $5,000+/month, that expense can dramatically reduce your countable income, potentially qualifying you for the full pension rate.
How to Apply
Step 1: Apply for VA Pension (if not already receiving)
File VA Form 21P-527EZ (Application for Pension).
Step 2: Apply for A&A or Housebound
Include VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) with your pension application, or submit it separately if already receiving pension.
This form must be completed by your physician — it documents:
- Your specific care needs
- Your ability (or inability) to perform daily activities
- Whether you're bedridden
- Whether you're restricted to your home
Step 3: Provide Income and Asset Information
The VA needs documentation of:
- All income sources
- Net worth (assets) — there is an asset limit
- Unreimbursed medical expenses
- Dependent information
Asset Limit
As of 2025, the net worth limit for VA Pension is approximately $155,356 (adjusted annually). This includes assets minus debts, excluding your primary home and personal possessions.
A 3-year look-back period applies — the VA reviews transfers of assets made within 3 years of application to prevent people from giving away assets to qualify.
Common Situations
Veteran in Assisted Living
A veteran in an assisted living facility often qualifies for A&A. The facility costs count as unreimbursed medical expenses, reducing countable income and potentially qualifying the veteran for the maximum rate. This can help offset the cost of care.
Veteran Cared for at Home
If a family member provides care, the care costs can be documented as unreimbursed medical expenses. This requires a caregiver agreement — a written record of services provided and their fair market value.
Surviving Spouse
Surviving spouses of wartime veterans can receive A&A or Housebound pension rates too, even if the veteran never applied for pension. This is particularly common among elderly surviving spouses who need assisted living or in-home care.
Important Warnings
Fraud alert: Some companies and financial advisors market "pension poiching" or "asset sheltering" schemes — helping veterans or survivors restructure assets (often through trusts or annuities) to artificially qualify for pension benefits. The VA's 3-year look-back period was specifically created to combat this. These schemes can result in: denial of benefits, having to repay benefits received, and potential legal consequences. If someone is telling you to move your money to qualify for VA pension — be very cautious and consult an accredited VA attorney.
Important: Only VA-accredited attorneys, claims agents, or VSOs can legally assist you with VA pension claims. Unaccredited advisors who charge fees for pension assistance are violating federal law.