For many aging or disabled veterans who need help with activities of daily living, finding the funds to pay for the care they need is a common concern.

Many veterans aren’t aware of the Aid & Attendance pension they have earned for themselves and their surviving spouses through their service to their country.

The Aid and Attendance pension provides benefits that reduce the cost of care for wartime veterans and surviving spouses who require assisted living/personal care.

Veterans and surviving spouses who are eligible for a VA pension and require the aid and attendance of another person, or are housebound, may be eligible for additional monetary payment.

“Aid & Attendance is most often used [to pay] for a personal care home and/or home care,” Daniel Tooth, director of the Lancaster County Department of Veterans Affairs, said.

Tooth added that a common misconception about the benefit is “that all veterans can receive this benefit. Only wartime veterans and their surviving spouses are eligible.”

When a veteran turns 65, the VA automatically classifies them as disabled, and if they meet income and asset criteria, they are eligible for a basic pension.

Because Aid and Attendance and Housebound allowances increase the pension amount, people who are not eligible for a basic pension due to excessive income may be eligible for pension at these increased rates.

A&A and Housebound benefits are non-service-connected benefits (disability need not be a result of service).

A veteran or surviving spouse may not receive Aid and Attendance benefits and Housebound benefits at the same time, nor may they receive non-service and service-connected compensation at the same time.

If a veteran is currently receiving disability compensation from the VA, they cannot receive both the disability compensation and the A&A pension, but they can file for the increased pension based on non-service-connected health issues.

If the application is approved, the VA will pay whichever benefit has the highest dollar amount. If the veteran is receiving compensation for a service-connected injury, that compensation would not be counted as income.


Aid & Attendance (A&A)

The Aid & Attendance increased monthly pension amount may be added to your monthly pension amount if you meet one of the following conditions:


You require the aid of another person in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices, or protecting yourself from the hazards of your daily environment (e.g., using a stove or other household appliances).

You are bedridden, in that your disability or disabilities require that you remain in bed apart from any prescribed course of convalescence or treatment.

You are a patient in an assisted living or personal care facility due to mental or physical incapacity.

Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes or concentric contraction of the visual field to 5 degrees or less.



This increased monthly pension amount may be added to your monthly pension amount when you are substantially confined to your immediate premises because of permanent disability.


How to Apply

In eastern Pennsylvania, you may apply for Aid and Attendance or Housebound benefits by writing to the Philadelphia VA Regional Office, P.O. Box 8079, Philadelphia, PA 19101. Call the office toll-free at (800) 827-1000 for more information.

When considering a move to a personal care home or nursing facility, the community’s administration will often assist in making sure you have the necessary information collected and that it is complete prior to submission.


What You Need

You must have military discharge or DD 214.

You should include copies of the Aid & Attendance Form 10 or VA 21, signed by a doctor, M.D., or D.O., validating the need for Aid and Attendance or Housebound-type care. The VA does not accept physician assistant, nurse, or social worker signatures.

Eligibility requirements include (canceled checks or statements are required for documentation of expenses):


1. Ninety continuous days of service in the U.S. military with at least one day during a wartime period as established by the U.S. Congress, e.g., World War II, Korea, Vietnam.


2. A medical diagnosis or condition that required the assistance of another person to meet the daily necessities of life, such as hygiene, eating, bathing, etc. Example: Alzheimer’s disease or other dementia, stroke, blindness, etc.


3. Household income that is below the established limits. Authorized out-of-pocket household medical expenses can be deducted from income. These expenses can include:


• Medicare and health insurance premiums

• Prescription drugs

• Co-payments for doctors and prescriptions

• Skilled nursing care or home care

• Assisted living (personal care in Pennsylvania) and nursing care expenses when required by medical conditions

• Funeral expenses

• Incontinence supplies


Household income and medical expenses include both veteran and spouse. The household asset limit is $80,000, not including the home and/or auto.

The objective is to use medical expenses to reduce income. Income can be verified through SS 1099, tax returns, bank statements, etc.

Although there is not currently a look-back period and penalty on asset transfers to reduce wealth, as is the case with Medicaid applications, Tooth warned changes are on the horizon for 2018.

“There is a two-year look-back on asset transfers coming next year,” Tooth said.

Even if you don’t qualify for the Aid & Attendance benefit, you may still qualify for the Basic Pension based on age and income or Pension with Housebound Benefits if you are housebound.

For more information, check out the Aid and Attendance page on the Department of Veterans Affairs’ website (,, or call the Philadelphia VA Regional Office toll-free at (800) 827-1000.

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