10 Things You Should Know About Pension with Aid & Attendance

Applying for The Pension with Aid and Attendance benefit can be cumbersome and time-consuming.  In addition, it can be confusing as it involves many rules and detailed criteria.  Home care agencies may avoid promoting this benefit simply because they do not understand it. Unfortunately, this leaves many Veterans without the option of home care.  To put it in perspective, Veterans 70 and older will account for 34% of the total Veteran population by 2045*, and this does not include surviving spouses.  Approximately one out of ten of that 34% will be eligible for Pension with Aid and Attendance.  Home Care agencies should include a Veteran focus in their marketing plan and have a basic understanding of the benefit, so this Veteran population can be reached.

Here are 10 things you should know about promoting Pension with Aid and Attendance.

  1. Military Service:

A Veteran must not have received a dishonorable discharge.  For those who served before September 8, 1980, they must have served at least 90 days of active duty with at least one day during war period.  Those who served September 8, 1980, and after, must have served at least 24 months or a full period for which they were called or ordered to active duty with at least one day during a war period. Note:  A Veteran does not have to have served in a combat zone to qualify.

                Wartime periods:

    • World War II (December 7, 1941, to December 31, 1946)
    • Korean conflict (June 27, 1950, to January 31, 1955)
    • Vietnam War era (February 28, 1961, to May 7, 1975, for Veterans who served in the Republic of Vietnam during that period. August 5, 1964, to May 7, 1975, for Veterans who served outside the Republic of Vietnam.)
    • Gulf War (August 2, 1990, to a date yet declared)
  1. Surviving Spouses:

Surviving spouses of eligible Veterans may qualify for the Pension with Aid and Attendance if:

    • They were married to the Veteran at the time of their death
    • The spouse must have been married to the Veteran for at least one year
    • Did not remarry
    • Has a medical condition which requires assistance
    • Meets the income requirements
  1. Medical Eligibility Requirements:

At least one of the following needs to be present in order to meet the medical eligibility:

    • Assistance with Activities of Daily Living (ADLs), such as bathing, grooming, dressing, meal preparation, feeding, maintaining continence, etc.
    • The need for care must not be service related, such as heart disease, Parkinson’s, Alzheimer’s, Stroke, etc.
    • Impaired eyesight which requires support for ADLs
  1. Look Back Period:

The VA instituted a 3-year look back period effective October 18, 2018.  The look back period begins the date of the application dating back 36 months.

  1. Annuities:

Any transfer of assets into an annuity to “spend down” one’s net worth to meet the asset requirement will now be in violation of the VA look back period if the annuity cannot be liquidated (cashed out). In addition, if it cannot be cashed out, while it will not be counted towards one’s net worth, the monthly payments will be counted towards one’s income. If the annuity can be liquidated, the annuity will count towards one’s net worth but will not violate the look back period.  This only applies to those who have an excessive net worth. Said another way, if a veteran or surviving spouse created an annuity but never had assets in excess of $138,489, this new rule does not apply to him/her. Another exception to this rule is the requirement of annuities upon retirement from employment. While this type of annuity will not violate the look back rule, the monthly income from the annuity will still be counted as income.**

  1.  Income:

To qualify for VA Pension with Aid and Attendance, the Veteran or surviving spouse’s income minus predictable recurring medical expenses must be less than the pension amount. Income is the combined household gross income, which includes a spouse and, in some circumstances, a dependent child.  The following is considered countable income:

    • Earnings
    • Retirement or survivor’s programs
    • Interest
    • Dividends
    • Unemployment compensation
    • Net income or owner’s draw from a business
    • IRA or 401K disbursements

If submitted properly, the following is not counted as income:

    • Temporary Assistance for Needy Families (TANF), also known as welfare
    • Supplemental Security Income (SSA)
    • Tax refunds
    • Food Stamps
    • Energy Assistance Programs
    • Interest on IRAs
    • Funds received from a reverse mortgage
  1. Assets:

To be eligible, a veteran or surviving spouses’ net worth (assets) must be limited to less than $138,489 (until November 30, 2022).  The asset limit changes on December 1 each year based on inflation. The increase is established on the same percentage as Social Security cost-of-living increases. The VA excludes one home, one vehicle, and up to two acres of land. Anything over and above is counted as an asset.

  1. Other VA Benefits:

Veterans can receive both the Veterans Directed Home and Community Based Services (formerly Chore Maker) and Pension with Aid & Attendance in all states.

Veterans cannot receive both VA Disability compensation and VA Pension with Aid and Attendance.

NOTE:  Veterans and surviving spouses can receive Medicaid and Pension with Aid and Attendance in most states.

  1. CareAdvance™

Many Veterans and surviving spouses cannot take advantage of the benefit because of an inability to pay for care during the VA processing period. For those clients, we have the CareAdvance™ program.  This program will pick up some or all the cost of care prior to reimbursement through a no-interest loan program.  The CareAdvance™ loan makes homecare possible for more than 78% of our customers that would otherwise go without the help they need.

  1. The VCC Difference:
    • Our services do not end once the client is approved for the benefit.
    • Our online Partner Portal provides real-time status of each client or referral, which provides faster communication, maximum visibility, and better service.
    • Our Client Care team monitors the quality and utilization of care, ensures the proper paperwork is in order, and answers any questions or concerns for the clients and providers. They ensure eligibility is maintained, and home care services are available and in place as long as needed.
    • VCC publishes monthly educational materials for our Partner Providers to share with potential clients from all walks of life – not just Veterans and their families who may be eligible for VA Pension funds.



*Pewresearch.org, The changing face of America’s veteran population, by Kristen Bialik, November 10, 2017

**American Council on Aging, VA Look Back & Net Income Rules for Aid and Attendance, Housebound and Basic

Eligibility, October 11, 2019

Department of Veteran Affairs, VA Aid and Attendance benefits and Housebound Allowance, www.va.gov


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About Cheryl Hammons CFE, CSA

Cheryl Hammons is an experienced home care professional, published author, and frequent speaker. She has held several roles throughout her 12 years in the home care industry, including training, support, and operations. She currently serves as Strategic Partnership Director at Veterans Care Coordination where she focuses on building value-driven relationships, developing revenue-generating programs, and creating educational materials for home care partner companies. Cheryl is the author of "Embracing a New Normal: Dealing with Grief" and "Respecting Religious Differences in Home Care."