Veterans Benefits for Home and Long-Term-Care: The VA Improved Pension for Aid & Attendance and Housebound Benefits.

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To help you meet the challenges of aging, the VA offers a wide variety of benefits and services.

What According to the U.S. Census Bureau, there are more than 9.2 million veterans ages 65 or older in the United States. These Veterans, like you, served in conflicts around the world including World War II, the Korean War, the Vietnam War, and even in the Persian Gulf War.

To help you meet the challenges of aging, the VA offers a wide variety of benefits and services. While some are income-based, many programs aren’t. As the son of a veteran, I’m happy to provide this article (and others in the series) to VA Benefits for Home and Long-Term Care in recognition and honor of your service to our country.

The VA Improved Pension for Aid & Attendance and Housebound Benefits

If you have met the requirements for the Veterans Pension and find that you need care in your home or within a care facility, the VA can also help pay for that care. This would be in addition to the money you receive from the Veterans Pension through either the Aid & Attendance or Housebound pensions.

As this is a “pension benefit,” neither the Aid & Attendance or the Housebound pensions are dependent upon service-related injuries for compensation. Although Aid & Attendance is primarily for older veterans, you may also qualify if you are under 65 or are totally disabled.

If you are not already receiving a pension, you must submit a basic pension application first in order to qualify. Since the Aid & Attendance and Housebound allowances increase the pension amount, you may be eligible for basic pension if you have not previously qualified due to excessive income.

Aid & Attendance (A&A)

The Aid & Attendance (A&A) 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, attending to the wants of nature, adjusting prosthetic devices, or protecting themselves from the hazards of their daily environment
  • You are bedridden, in that their disability or disabilities requires that they remain in bed apart from any prescribed course of convalescence or treatment
  • You are a patient in a nursing home 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
  • A surviving spouse (marriage must have ended due to death of veteran) of a wartime veteran may also apply

2019 Basic Pension with Aid & Attendance Benefits (As of December 1, 2018)

While, again, the amount of the award depends on your income, assets and the actual costs of care you pay monthly, it may be helpful for you to know the Maximum Annual Pension Rate (MAPR) payable to a veteran, spouse or child.

  • Applicant MAPR Monthly Rate Veteran with A&A $22,577
  • Veteran with spouse (One A&A) $26,766
  • Two married veterans (Both qualifying for A&A) $35,813
  • Add for each additional child $2,313

Housebound Benefits

If you wish to remain in either your own home or that of a family member, you can also apply for Housebound Benefits. If, for whatever reason, you do not fully qualify for Aid and Attendance, the VA will automatically consider this level.

You may be eligible for the Housebound benefits if:

  • You have a single permanent disability evaluated as 100-percent disabling AND due to such disability, are permanently and substantially confined to your immediate premises OR
  • You have a single permanent disability evaluated as 100-percent disabling AND another disability OR disabilities evaluated as 60 percent or more disabling.
  • In addition, your income must be less than $14,978 without dependents or $18,773 with dependents.

2019 Basic Pension with Housebound Benefits (As of December 1, 2018)

As with the Veteran Pension and/or Aid & Attendance, the amount of the award depends on your income, assets and the actual costs of care you pay monthly, but the Maximum Annual Pension Rates (MAPR) currently allowed are:

  • Applicant MAPR Monthly Rate Housebound veteran $16,540.
  • Housebound with spouse or one dependent $20,731.
  • Two vets married to each other, one HB $20,731
  • Two vets married to each other, one A/A, one H/B $29,764
  • Two vets married to each other, both H/B $23,734
  • Add for each additional child $2,313

How to Apply

You may apply for Aid and Attendance or Housebound benefits by writing to the Pension Management Center (PMC) that serves your state. You may also visit your local regional benefit office to file your request. You can locate your local regional benefit office using the VA Facility Locator.

You should start the process by submitting Intent to File a Claim for Compensation (21-0966). This will get your claim into the system before you send in the completed application. This is an optional step, but it will help establish a date for retroactive payments once any benefit is approved.

Then, before you can apply for the Improved Pension for Aid & Attendance, you will need the following documents:

  • Authorization for Consent to Release Information to the VA (one for each physician (21-4142)
  • Authorization to Disclose Information to a Third Party (daughter, son, in-law) (21-0845)
  • Banking information for direct deposit of A&A monthly payments (include a voided check).
  • Basic Pension Form for veterans (21-527EZ) or a surviving spouse (21-534EZ-ARE)
  • Copy of current Social Security award letter (the letter that Social Security sends at the beginning of the year stating what your monthly amount will be for the following year).
  • Copy of marriage certificate and all marital information (unless applying for veteran only)
  • Copy of the death certificate (surviving spouses only).
  • ORIGINAL Discharge/Separation Papers (DD-214) (Do NOT send a photocopy). If you need to request military records, you can either fill out Standard Form 180 or, you can visit the National Archives website for further instructions on how to request military records.
  • Employment history (does not apply if applicant is over 65).
  • If you are a court-appointed guardian of the veteran or surviving spouse, a certified copy of the court order of the appointment is required.
  • Medical Expense Report (21p-8416) listing all doctors and hospitals visited in the last year.
  • Net worth information, including bank accounts, CDs, trusts, stocks, bonds, annuities, etc.
  • Nursing Home Status Statement (21-0779) (If veteran and/or spouse is in nursing home or assisted living facility) and Statement of Occupancy from the facility listing monthly rate and daily assistance required (Not required for Housebound)
  • Physician Statement (21-2680) that includes current diagnosis, medical status, prognosis, name and address, ability to care for self, ability to travel unattended, etc.
  • Proof of all income from pensions, retirement, interest income from investments, annuities, etc.
  • Proof of insurance premiums, medical bills, medications, or any other medical expenses that are not reimbursed by Medicare, Medicaid or private insurance.

For professional advice on filing a benefits claim, please consult a VA Accredited Attorney, Claims Agent of your Veterans Service Organization (VSO) Representative to assist you with your application. They can be found by visiting the United States Department of Veterans Affairs Accreditation Search webpage.

If you would like to have an accredited consultant or service organization assist you with your claim, you may file Appointment of Individual as Claimant’s Representative (21-22a) or Appointment of Veterans Service Organization as Claimant’s Representative (21-22).

You should never use unaccredited consultants. In fact, Federal law prohibits unaccredited consultants from assisting with applications in any way. Regulations also prohibit consultants from charging a fee for assistance with the actual application unless the applicant has already been denied once

Please be aware that it may take as long as 6 to 8 months to get approved, depending on the VA’s workload, but benefits are paid retroactively to the date of application. Applicants who are age 90 or older may request an expedited review in a cover letter with their application.

Mailing Your Claim

In mailing your application, it’s highly recommended that you send your package via Certified Mail “Return Receipt” to ensure that the application was received. Make sure that you keep a copy of the entire application for your own records as well as any other correspondence to and from the VA.

The VA has established Pension Management Centers that are dedicated to processing applications for the Improved Pension for Aid & Attendance. When mailing your application, you need to make certain that you send it to the appropriate center assigned for the state where the veteran or spouse resides (as noted above).


If you are a veteran, or are helping someone who is, there are a wide variety of benefits and service available to you. While some are income-based, many programs aren’t. By becoming familiar with all of the benefits in this article and the other four in the series, you can take full advantage of everything you’re entitled to—making your journey along the gray mile easier and more affordable.

Tom Text


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