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VA Aid & Attendance,
stacked with Medicaid.

Wartime veterans and surviving spouses who need help with activities of daily living qualify for up to $2,727/month from the VA — separate from Medicaid, stackable with it, with its own 3-year lookback and its own application timeline.

By The ElderCareAtlas Editors··Last reviewed

Earned rest and dignity — a vast ochre grassland at first light

What is VA Aid & Attendance?

A tiered enhancement to the VA Improved Pension benefit paid monthly to wartime veterans, their spouses, and surviving spouses who need assistance with activities of daily living. 2026 maximum benefits: $2,727/month (married veteran), $2,300 (single veteran), $1,478 (surviving spouse). Income and net-worth caps apply.

Who this is for

Wartime veterans who served 90+ days active duty with at least 1 day during a defined wartime period (WWII, Korean War, Vietnam, Gulf War onward). Their living spouses qualify through the veteran while the veteran is alive. Surviving spouses qualify independently after the veteran’s death. In all cases the applicant must have a documented medical need for assistance — typically activities-of-daily-living impairment, housebound status, or residency in a nursing home or assisted-living facility.

The 3-year VA lookback

Introduced in October 2018, the VA’s 36-month lookback reviews asset transfers for less than fair market value in the 3 years preceding the application. Uncompensated transfers create a penalty period (up to 5 years) calculated using the MAPR. Practically, this means the same discipline that governs Medicaid planning also governs A&A planning — gifting to children shortly before applying is almost always a mistake.

Stacking with Medicaid

A&A income counts against the Medicaid income cap. In income-cap states, this often requires a Qualified Income Trust (also called a Miller Trust). In most medically-needy states, A&A income can be spent on medical expenses and reduce the "excess" income that would otherwise disqualify the applicant. The details vary enormously by state; the combination of A&A + Medicaid + a nursing-home spouse + a community spouse is the highest-complexity elder-law fact pattern in the American system.

Next

Maximum monthly benefits are approximately $2,727 for a married veteran, $2,300 for a single veteran, $1,478 for a surviving spouse, and $3,612 for two veterans married to each other. These are the MAPR (Maximum Annual Pension Rate) divided by 12 — the VA pays the gap between the veteran's countable income and the MAPR.
A wartime veteran (90+ days of active duty with 1+ day during a defined wartime period), their spouse, or surviving spouse. The applicant must need assistance with at least two activities of daily living, be housebound, or be in a nursing home or assisted-living facility. Income and assets must fall below VA caps ($155,356 net worth in 2026).
Since 2018, the VA applies a 36-month lookback on asset transfers — shorter than Medicaid's 60 months but using similar logic. Transfers for less than fair market value during the window can delay eligibility by up to 5 years of penalty time.
Yes, but the stacking rules require care. Medicaid treats A&A as countable income, which can push the applicant over the Medicaid income cap. In income-cap states, this can require a Qualified Income Trust (Miller Trust). The planning is state-specific and worth engaging an accredited VA attorney or CMP who handles both programs.
Through the VA directly at VA.gov/pension or through a VSO (Veterans Service Organization). Applications take 4-8 months to process in 2026. Most elder-law attorneys who handle Medicaid also handle A&A; about 40% of the US VSO network provides this help free.

Sources

  1. VA Veterans Pension Rates — U.S. Department of Veterans Affairs · 2026 MAPR — married veteran, single veteran
  2. VA Survivors Pension Rates — U.S. Department of Veterans Affairs · 2026 MAPR — surviving spouse
Next step

Match to a VA-accredited planner.

Aid & Attendance applications require VA-accreditation (attorney or claims agent). Unaccredited advisors cannot represent a veteran on a pension claim. We match families to accredited professionals.

Match me to a planner →Read Medicaid basics