This guide compares VA benefits like Aid and Attendance, Housebound Allowance, and VA Pension and explains how they help pay for senior care.
The U.S. Department of Veteran Affairs (VA) offers benefits that provide additional income to wartime Veterans and spouses with low-income and long-term care needs: Aid and Attendance, Housebound Allowance, and VA Pension. If you’ve heard of these VA benefits, you may know they’re complex, and you might have questions about qualifying and applying for them. Understanding the basics can be challenging. This guide explains how these benefits compare to each other so you can learn what VA benefits may help you pay for senior care.
Similarities among the benefits
First, know that many of the details about these benefits are similar, from how you receive the funds to some qualifying factors. The main differences among them are the maximum monthly benefit amounts and the level of care a beneficiary needs to demonstrate in order to qualify.
In the sections below, we’ll explore how Aid and Attendance, Housebound Allowance, and the VA Pension are similar. Later, we’ll explain how they’re different.
How benefit amounts are determined
All three benefits have different maximum monthly benefit amounts that recipients can receive. The VA reviews the maximum amounts annually, considering the cost of living adjustment set by the Social Security Administration. Based on the review, the increases happen on December 1st every year for the following 12 months.
How recipients receive and can use the money
Recipients of all three benefits receive the monthly payments directly to their bank accounts from VA. Money from all three benefits is considered income so that recipients may use it for household or personal expenses. Because most recipients have health-related qualifying factors for these benefits, recipients often have extensive medical or long-term care services expenses to pay for, so the income helps offset those costs.
Can spouses qualify for VA benefits?
The short answer is yes, spouses of Veterans can also qualify. To qualify as a spouse, the Veteran to whom the spouse is or was married must meet the military service criteria. The spouse’s household must meet the net worth criteria. And the spouse must also meet the health criteria.
Another critical factor determining whether Veterans’ spouses qualify for these benefits is their marital status with the Veteran. A spouse must be currently married to the Veteran or was married to the Veteran at the time of their passing. And, with few rare exceptions, the spouse cannot be divorced from the Veteran or have remarried after the Veteran’s death.
Spouses can only apply directly if the Veteran is deceased. If the Veteran is still living but only the spouse is in need of care, the Veteran applies at the married rate based on household medical expenses.
Combining the benefits
You can combine some of these benefits with each other, but not all. There are three ways to get the benefits:
- VA Pension alone (if you don’t also qualify for Housebound or Aid and Attendance).
- VA Pension with Housebound Allowance (if you also qualify for it).
- VA Pension with Aid and Attendance (if you also qualify for it).
Notice how you cannot combine the Housebound Allowance with Aid and Attendance. That’s because the health-related qualifying factors are two different types of health situations. Depending on the applicant’s needs, they qualify for one or the other. The VA will award the benefit based on their assessment of the applicant’s health.
We’ll discuss those health criteria differences later. First, let’s go over the qualification criteria that are the same among all three benefits.
Qualification criteria
There are three areas of criteria that applicants must meet to qualify for any of these benefits. Military service and net worth requirements are the same for all three benefits.
Qualification criteria that are the same for all three benefits
Military service requirements and net worth criteria are the same for VA Pension, Housebound Allowance, and Aid and Attendance and are as follows:
Military service
The Veteran served during an approved wartime period, such as World War II, the Korean conflict, the Vietnam War era, and the Gulf War. The Veteran’s service time must fall within specific dates for each wartime period. The length of qualifying service varies during some wartime periods.
A common misperception about qualifying military service is that the Veteran must have served in a combat zone, which is not the case.
Another aspect of the military service criteria is that the Veteran must not have had a dishonorable discharge.
Income and net worth
While the VA looks at income and assets as two different areas of qualification, they are intertwined due to overlapping complexities built into the code.
First, the VA looks at net income, including Social Security, pensions, IRA distributions, rental income, dividends, interest, etc. Then, they subtract anticipated medical expenses over the next 12 months, such as health insurance premiums and long-term care costs, including home care services, adult day care, assisted living, nursing home, or similar expenses. Any remaining annual income is then added to net worth, which cannot exceed $150,538 for 2023. “Net worth” includes all available assets except a home on 2 acres or less. This includes savings, investments, IRAs, vacation homes, rental or investment property, etc.
Here’s an example of how the net worth and income rules work: A Veteran has Social Security and a pension of $3,000 per month. He also draws $500 per month from his IRA. Each month, he pays $2,500 of his $3,500 monthly income for home care services to help with his activities of daily living. The VA would assume he has a net income of $1,000 per month or $12,000 per year. The Veteran has total savings, IRAs, and investments of $130,000. In the net worth calculation, the VA would add the $130,000 in savings to the $12,000 in excess income to give him a total net worth of $142,000. This amount is below the $150,538 limit. So, the Veteran would meet the net worth and income eligibility requirement criteria.
Differences among the benefits
The health requirements for each benefit differ, ranging from a lower level of care needed to the highest level of care. Based on what health requirements an applicant meets, the VA determines which benefit they would receive.
VA Pension health criteria
To meet the health requirements for the VA Pension, you require the lowest level of care of the three. The general requirements are that you are at least 65 years old or under 65 and have a long-term or permanent disability.
Housebound Allowance health criteria
To meet the health requirements for this benefit, the general requirement for the Housebound Allowance is that you have a disability that keeps you in your home the majority of the time. But, you can manage your own care, so you do not need help with any activities of daily living (ADLs). This means you can bathe, dress, eat, and ambulate (move around, walk) by yourself.
Aid and Attendance health criteria
To meet the health requirements for Aid and Attendance, you need the highest level of care of the three benefits’ requirements. The general requirement is that at least one of the following applies to the applicant:
- You need help with at least two ADLs, such as bathing, dressing, eating, toileting, or ambulating.
and/or
- You have a cognitive disability that requires a protective environment for your safety.
and/or
- You have macular degeneration or are legally blind in both eyes.
Now that we’ve covered how the health-related criteria differ, let’s explore the maximum monthly benefit amounts for each benefit.
Maximum benefit amounts
The maximum monthly benefit amounts differ for VA Pension, Housebound, and Aid and Attendance. Because the VA Pension has the lowest health need requirement, it pays the lowest of the three; Aid and Attendance’s health need requirements are the greatest, so it pays the most. The concept is that the higher level of care you require, the greater your medical and long-term care expenses. VA helps offset these expenses with these benefits based on the level of care needed.
The actual amount a beneficiary receives is based on three factors: household net worth, the marital status of the person who needs care, and whether the person who needs care is the Veteran or the spouse. Here are the maximum monthly benefit amounts for 2023, which are subject to change for 2024 in December:
- Aid and Attendance: A married Veteran who needs care can receive up to $2,642 monthly.
- Housebound Allowance: A married Veteran can receive up to $2,046 monthly.
- VA Pension: A married Veteran can receive up to $1,750 monthly.
The maximum amounts decrease for each benefit if the recipient is a single Veteran who needs care, a married spouse who needs care, or a surviving spouse who needs care.
The bottom line
Paying for long-term care can be a challenge. The VA Pension, Housebound Allowance, and Aid and Attendance benefit can help wartime Veterans and their spouses, widows, or widowers cover the costs of the long-term care they need.
Qualifying and applying for any of the three benefits are complex processes. There are exceptions to certain rules and particular requirements for each criteria area. You may also need to submit supporting documentation with the application, and the application can be lengthy in itself.
If you or your spouse needs care and could use extra cash to pay for it, don’t let the complexity of these benefits prevent you from applying — if you qualify, you may add over $2,000 to your monthly income.
If you think you meet the criteria for any of these benefits, professionals can help guide you through the process so you can submit a complete application the first time and start getting more funding to pay for your care.
