How can Aid and Attendance Pension Pay for Nursing Home Care?

If a potential claimant for the Aid and Attendance Pension benefit is residing in a nursing home as a patient, VA will pay towards out-of-pocket costs for that nursing home if the income test is met.

There is no way that a Pension income could cover the entire cost of any nursing home. If the claimant is also eligible for Medicaid assistance in a nursing home, special rules apply. We discuss these special Medicaid rules in the section on Medicaid in the table of contents to the right.

Payments to hospitals, nursing homes, medical foster homes, and inpatient treatment centers – including inpatient treatment centers for drug or alcohol addiction and including the cost of meals and lodging charged by such facilities – are medical expenses.

If it is established that a claimant or relative in a governmental institution is participating in a program of therapy or rehabilitation supervised by a physician, or a physician, physician assistant, certified nurse practitioner, or clinical nurse and that specialist states in writing that the claimant or relative has a medical condition that makes such a level of care necessary, the entire amount paid is a deductible expense for Pension. A physician, physician assistant, certified nurse practitioner, or clinical nurse specialist's statement specifically addressing the issue of whether an individual who is not entitled to aid and attendance or housebound needs to be in a protected environment must be of record, even if the individual's diagnosis is known.

A medical expense deduction for Pension for nursing home fees is allowed if a responsible official of the nursing home certifies that the claimant or relative is a patient – as opposed to only being a resident – of the nursing home. The claimant must also earn a medical rating for aid and attendance via Form 21-2680.

VA will also verify nursing home fees if or when one of the following situations exists:


Examples of verification include:


It should be noted that VA Form 21-0779 is for a veteran claimant only. If the claimant is a spouse of a living veteran or a single surviving spouse of a veteran, one of the other means of verification must be used to substantiate patient status and payments. The spouse must also submit VA Form 21-2680.

There is also a restriction for paying benefits if a single beneficiary for Pension is in a nursing home and is eligible for Medicaid. Please see the section on Medicaid and Pension from the table of contents.


Please refer to the table of contents in the top right column of this page for more topics on Pension with Aid and Attendance.