Aid and Attendance (A&A) is an enhanced VA pension benefit providing additional monthly payments to veterans and surviving spouses who need help with daily activities, are bedridden, have severe vision impairment, or reside in a nursing home. It is not a standalone benefit but an addition to the VA Veterans Pension or Survivors Pension.
10 steps across 1 sections
1. Steps Process
- Verify basic pension eligibility first — You must qualify for the VA Veterans Pension (wartime service, 65+ or disabled, income/net worth limits) or the VA Survivors Pension before A&A can be added
- Determine if you meet A&A clinical criteria — You qualify if you meet at least one:
- Need help with activities of daily living (bathing, dressing, eating, toileting, transferring)
- Are bedridden (bed-confined except for medical appointments)
- Have corrected visual acuity of 5/200 or less in both eyes, or concentric contraction of the visual field to 5 degrees or less
- Reside in a nursing home due to physical or mental incapacity
- Obtain a physician's statement — Have your attending physician complete VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), documenting your functi...
- Gather financial documentation — Income from all sources, net worth (limit $159,240 as of 2024-2025), and unreimbursed medical expenses (crucial for reducing countable income)
- Complete the pension application:
- Veterans: VA Form 21P-527EZ (Application for Pension) with A&A indicated
Common Mistakes
- Not applying because income seems too high
- Confusing A&A with VA disability compensation
- Transferring assets to reduce net worth
- Missing the physician's form
- Not including the Housebound alternative
Pro Tips
- Track every unreimbursed medical expense
- A&A rates are significantly higher than basic pension:
- Single veteran basic pension: ~$1,209/month; with A&A: ~$2,020/month
- Veteran with one dependent: ~$1,584/month; with A&A: ~$2,394/month
- Surviving spouse: ~$812/month; with A&A: ~$1,296/month (approximate 2025 rates)