VA Aid and Attendance: Net Worth Limit and Look-Back

Two numbers sit on the same line of the 2026 pension rate page at VA.gov, and families usually read only one of them.

The first is $163,699. That is the net worth limit for Veterans Pension and Survivors Pension from 1 December 2025 through 30 November 2026. The second is the definition underneath it, which says the calculation "includes your and your dependent's assets and income for VA purposes." VA's own worked example on that page adds $121,000 in assets to $14,000 of annual income and gets $135,000. Savings plus a year of Social Security, pension checks and interest, all on one line, measured against one ceiling.

That addition is the reason a widow with $150,000 in a money market account and $1,800 a month from Social Security is over the limit on paper, and the reason she may still qualify once the assisted living invoice has been entered on the right form. The rest of this page is about how the arithmetic runs, what the 36-month look-back does to it, and which of six VA forms carries which piece.

Aid and Attendance is not a benefit. It is a higher ceiling on one

There is no application called "Aid and Attendance." What exists is a needs-based pension for wartime veterans and their surviving spouses, and a set of Maximum Annual Pension Rates (MAPR) that go up when the claimant needs regular help from another person. The payment is the gap between the MAPR and the claimant's income for VA purposes after deductions. Nothing more.

The rates below took effect 1 December 2025 with a 2.8% cost-of-living increase. They were read from VA.gov on 30 August 2026; the veteran page shows a last update of 18 December 2025 and the survivor page 17 August 2026.

Each additional dependent child adds $2,984 to the MAPR. Two veterans married to each other who both need Aid and Attendance share a MAPR of $46,143.

The medical test for the higher rate is in 38 CFR 3.352(a), read from the eCFR on 30 August 2026 against a title 38 issue date of 27 August 2026. The regulation lists what the rater weighs: inability to dress or undress, or to keep oneself "ordinarily clean and presentable"; inability to feed oneself through loss of coordination or extreme weakness; inability to attend to the wants of nature; or a physical or mental incapacity "which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment." Being bedridden qualifies on its own, but the regulation is specific that a physician prescribing bed rest does not make someone bedridden. And it adds the sentence that matters most at the examination: it is not required that all of the listed conditions exist, only that "the veteran is so helpless as to need regular aid and attendance, not that there be a constant need." VA.gov's plain-language version lists a fourth route, eyesight of 5/200 or less in both eyes even with correction.

Housebound is the middle tier and cannot be paid at the same time as Aid and Attendance.

Who the underlying pension is open to

The service requirement is older than most people expect. For a veteran who entered active duty on or before 7 September 1980, VA.gov requires at least 90 days of active service with at least 1 day during a covered wartime period. The periods that matter for a parent in their eighties or nineties are World War II (7 December 1941 to 31 December 1946), the Korean conflict (27 June 1950 to 31 January 1955), and the Vietnam era, which runs from 1 November 1955 for those who served in the Republic of Vietnam and from 5 August 1964 for everyone else, both ending 7 May 1975. A clerk who spent 1953 at Fort Dix served during wartime. Service after 7 September 1980 needs 24 months or the full period called, again with a wartime day inside it; the Gulf War period opened 2 August 1990 and has not been closed.

The veteran also has to be 65 or older, permanently and totally disabled, in a nursing home for long-term care, or receiving SSDI or SSI. At 65 no medical records are required for the pension itself; the 21-2680 covers the Aid and Attendance question separately.

A surviving spouse qualifies on the veteran's service, provided they have not remarried since the veteran's death and the discharge was not dishonorable. The veteran did not need to have applied for, or received, anything from VA while alive.

The net worth test adds income to assets

38 CFR 3.274 sets the rule. Paragraph (a) fixed the limit at $123,600 on 18 October 2018 and ties every later increase to the Social Security cost-of-living adjustment; the $163,699 figure is that number after seven Decembers. Paragraph (b)(1) is the sentence to keep: "Net worth means the sum of a claimant's or beneficiary's assets and annual income."

Whose assets get added depends on who is filing. Under paragraph (c)(1), a veteran's assets include the spouse's. Under (c)(2), a surviving spouse's assets "include only the assets of the surviving spouse." A veteran with a spouse who has a separate retirement account is measured against the combined figure. That same account, after the veteran's death, belongs to the survivor alone and is measured once.

What counts as an asset is in 38 CFR 3.275: the fair market value of all real and personal property, less the mortgage or lien specific to each piece. The exclusions in paragraph (b) are short. The primary residence, with a lot of up to 2 acres (87,120 square feet), unless the extra acreage cannot be sold separately. Personal effects "suitable to and consistent with a reasonable mode of life," which the regulation illustrates with appliances and family vehicles. And the residence stays excluded even when the claimant is living in a nursing home, an assisted living facility, or a family member's house for care, under (b)(1)(ii).

Two things in that section trip families up. The mortgage on the excluded house is not subtracted from the other assets, per (b)(1)(i); an excluded asset carries no deductible debt. And selling the house turns it from an excluded asset into a counted one. The regulation is explicit that after entitlement is established, net sale proceeds are an asset unless spent on another residence "within the same calendar year as the year in which the sale occurred." Families sometimes list the house for sale to fund the move and, in doing so, move $300,000 from the excluded column to the counted one. The fees that money is meant to pay do bring the number back down, which is the next section, but the order of operations deserves a pause before the listing agreement is signed.

Facility fees shrink the number, and this is where most cases are decided

Annual income for VA purposes is gross income minus deductible expenses. Under 38 CFR 3.272(g), unreimbursed medical expenses are deducted to the extent they exceed 5 percent of the basic MAPR: $872 a year for a veteran with no dependents in the current rate year, $584 for a surviving spouse with no dependent child. Paragraph (b)(3) of 3.274 says VA subtracts these expenses, including "appropriate prospective medical expenses," when it calculates net worth, not just when it calculates the monthly payment.

The regulation supplies its own example, and the example is the whole strategy in four sentences. In 3.274(f)(3), a claimant has $115,000 in assets and $9,000 in income, so $124,000 in net worth against a $123,600 limit. The claimant is in a nursing home paying $29,000 a year. VA subtracts the portion above 5 percent of the MAPR, $28,400, from income, which "decreases annual income to zero." Net worth is now $115,000 and the claim is within the limit. Example (f)(4) runs the same arithmetic with $9,000 of expenses instead of $29,000 and ends in a denial.

What makes assisted living rent a medical expense is 38 CFR 3.278, and specifically paragraph (d)(3), which covers a "care facility other than a nursing home." Payments for help with activities of daily living in such a facility are medical expenses if the resident is receiving health care or custodial care there and either needs Aid and Attendance or has a physician, physician assistant, certified nurse practitioner or clinical nurse specialist state in writing that the person "needs to be in a protected environment." Meals and lodging become medical expenses under (d)(3)(iv) when the facility provides or contracts for that care. Custodial care, defined at (b)(4), is regular assistance with two or more ADLs, or regular supervision because of a physical, mental, developmental or cognitive disorder. The facility must be licensed if the state licenses that kind of facility and, if residential, staffed 24 hours a day.

In-home care follows the same logic under (d)(2): an aide who is not a licensed health care provider still generates a deductible expense if the claimant needs Aid and Attendance or a clinician states in writing that the care is required. Payments have to be "commensurate with the number of hours" the aide actually works, which is why a home care agency invoice showing hours belongs in the packet, and why a lump sum paid to a relative without a timesheet is a weak claim.

Medicare Part B premiums, Part D premiums and long-term care insurance premiums are all medical expenses under 3.278(c)(5). A widow's $202.90 Part B deduction is a small number, but it is one VA lets her keep.

The 36-month look-back and the $2,874 penalty rate

Since 18 October 2018 VA has had its own transfer penalty, and it works differently from Medicaid's. 38 CFR 3.276 defines the look-back at (a)(7) as "the 36-month period immediately preceding the date on which VA receives" an original pension claim or a new one after a period of non-entitlement. It never includes a date before 18 October 2018. Medicaid's look-back, by contrast, is 60 months, and the two programs count different things; the payer-by-payer comparison on this site covers the Medicaid side.

The VA penalty only attaches to a covered asset, defined at (a)(2) as one that was part of net worth, was transferred for less than fair market value, and "if not transferred, would have caused or partially caused" net worth to exceed the limit. A gift that leaves the claimant under the limit even if it were added back is not covered at all. Example 1 in (a)(3) makes the point: assets of $115,900, no income, a $30,000 gift to a friend. Adding it back gives $145,900 against a $123,600 limit, so the covered asset amount is $22,300, the overage, not the $30,000.

Then the division. Paragraph (e) sets the penalty at the covered asset amount divided by the monthly penalty rate, "rounding the quotient down to the nearest whole number," and caps it at 5 years. The monthly rate under (e)(1) is the Aid and Attendance MAPR for a veteran with one dependent divided by 12, rounded down to the dollar: $34,488 / 12 = $2,874 for claims filed in the current rate year, which is the figure VA.gov prints. A $22,300 covered amount is 7 months. A $100,000 covered amount is 34 months. The penalty period starts under (e)(2) on the first day of the month after the transfer, or after the last transfer if there were several, which means part of a penalty may already have run by the time anyone applies.

Two features of the regulation cut in the claimant's favour and are easy to miss. Under (e)(5)(ii), if the assets are returned to the claimant before the claim date or within 60 days after VA's decision notice on the penalty, VA recalculates or eliminates the penalty, provided the evidence reaches VA within 90 days of that notice. And under (c), an asset transferred as a result of fraud or an unfair business practice in the sale of financial products is not a covered asset at all, with a contemporaneous complaint to state or federal authorities offered as supporting evidence.

Annuities and trusts are called out by name at (a)(5)(ii). Moving money into either is a transfer for less than fair market value "unless the claimant establishes that he or she has the ability to liquidate the entire balance of the asset for the claimant's own benefit." If it can be liquidated, it is simply still an asset. A product sold as a way to "qualify for Aid and Attendance" is, under this paragraph, either counted or penalised. There is no third outcome.

The forms, by who files them

Six forms cover almost every Aid and Attendance claim, and the mailing address for all of them is the same:

Department of Veterans Affairs, Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365

The intent to file is the one families skip and later wish they had not. VA.gov states that an intent to file sets a potential effective date and that an approved claim can pay retroactively for the interval between the intent and the decision. It also says that applying online with an identity-verified account sets that date automatically, while a PDF application mailed without a prior 21-0966 gets the date VA receives it. A paper packet that takes four months to assemble, with a doctor's appointment for the 21-2680 and a call to the facility for the 21-0779, costs four months of pension at roughly $1,558 a month for a surviving spouse at the A&A rate if the intent was never lodged.

For a veteran under 65, VA.gov asks for a copy of medical records with the application. Over 65, it does not. What it asks of everyone is the household's gross monthly income, the value of its assets and its unreimbursed medical expenses, which is why the 21P-8416 goes in with the first packet rather than after.

If the claimant cannot sign, the person signing needs authority that VA recognises, and a durable power of attorney is not automatically enough for VA benefits purposes; VA has its own fiduciary process. That question is bigger than this page and starts with which document lets whom act.

After a denial for excessive net worth

Paragraph (g) of 3.274 gives a denied claimant one route back that does not require a new application. If net worth later drops to the limit, the effective date of entitlement is "the day net worth ceases to exceed the limit," provided VA receives a certified statement that net worth has decreased before the decision becomes final, which the regulation defines as within 1 year of the decision notice. Miss that year and the effective date becomes the date of a fresh claim.

Spending down is permitted, and the regulation says how. Under (f)(1), assets decrease when spent "on any item or service for which fair market value is received," as long as the purchase is not itself an asset. Paying the facility, prepaying a funeral, replacing a wheelchair van: all reduce net worth at face value. Giving the same money to a grandchild does not.

For a beneficiary already on pension whose net worth rises above the limit, (h)(1) sets the discontinuance date at the last day of the calendar year in which the excess occurred, and (h)(2) cancels the discontinuance entirely if net worth comes back under the limit before that date. An inheritance in March that is spent on care by December never triggers a reduction.

A parent already on a Medicaid waiver waiting list can hold a VA pension claim at the same time; how a state counts the Aid and Attendance portion as income for Medicaid is a question for the state agency, not for VA.

Sources

Every figure and quoted phrase above was checked on 30 August 2026. Sections of 38 CFR were pulled through the eCFR versioner API at title 38's issue date of 27 August 2026.

• VA.gov, Current pension rates for Veterans (last updated 18 December 2025) and Current Survivors Pension benefit rates (last updated 17 August 2026): the $163,699 net worth limit for 1 December 2025 to 30 November 2026, the 2.8% increase factor, every MAPR figure in the table, the 5 percent deductible thresholds of $872 and $584, the $2,984 additional dependent amount, the $121,000 + $14,000 = $135,000 example, and the $2,874 penalty period rate.
• VA.gov, Aid and Attendance benefits and Housebound allowance (last updated 8 May 2026): the four eligibility routes, the 5/200 vision standard, Form 21-2680 and Form 21-0779, and the Janesville mailing address.
• VA.gov, Eligibility for Veterans Pension, How to apply for a VA pension as a Veteran (last updated 6 August 2026), and Survivors Pension: service and wartime period dates, the age-65 and nursing home routes, the under-65 medical records instruction, the five ways to file, Forms 21P-527EZ and 21P-534EZ, and the intent-to-file effective date language.
• 38 CFR 3.274 (net worth limit and definition, whose assets are included, the two worked examples at (f)(3) and (f)(4), the certified-statement rule at (g), and the calendar-year discontinuance rule at (h)); 3.275 (asset definition, the primary residence and 2-acre exclusion, the sale-proceeds rule, and the non-deductible personal mortgage); 3.276 (covered asset, the 36-month look-back at (a)(7), annuities and trusts at (a)(5)(ii), the penalty formula and 5-year cap at (e), the 60-day return rule at (e)(5), and the fraud exception at (c)); 3.278 (definitions of custodial care and care facility, and the in-home and facility rules at (d)(2) and (d)(3)); 3.352 (criteria for regular aid and attendance).
• VA form pages: 21-0966, 21P-527EZ, 21P-534EZ, 21-2680, 21-0779, 21P-8416.

The monthly figure of roughly $1,558 for a surviving spouse is $18,697 divided by 12 and assumes zero countable income; actual payments are the MAPR less income after deductions. The $202.90 Part B premium is the standard 2026 amount shown on Medicare.gov and is used here only as an example of a deductible premium. On fees: 38 CFR 14.636(b) allows only accredited agents and attorneys to take fees at all, and (c)(1) limits those fees to representation after VA has issued an initial decision on the claim. Recognized organizations and their representatives, whom VA lists through its accreditation search, may not charge. Nobody accredited may charge for preparing the initial claim.

This page is general information, not legal, medical, or financial advice. See the terms.