Spouses of veterans may have access to nursing home benefits through the Department of Veterans Affairs, but may be able to access depends on the veteran's service record and disability rating, not on being married alone.
The main program is Aid and Attendance (A&A), a monthly payment that can help cover nursing home costs if the veteran meets specific criteria. A spouse cannot receive A&A based on their own military service — only as a dependent of a veteran who qualifies. If the veteran has already passed away, a surviving spouse may be able to receive Dependency and Indemnity Compensation (DIC), which can also help with long-term care costs.
The amount paid varies widely depending on the veteran's disability rating, whether they are in a nursing home or assisted living, and their household income. There is no single dollar figure that applies to all spouses. The VA also runs Aid and Attendance at a Nursing Home, which is a separate benefit from standard VA health care and requires a separate request.
Key Takeaways
- A spouse can receive Aid and Attendance benefits only if the veteran they are married to has a service-connected disability rated at 50 percent or higher, or meets medical criteria for housebound status.
- The veteran must have served on active duty and received a discharge other than dishonorable; the length of service varies by era.
- A surviving spouse of a deceased veteran may receive Dependency and Indemnity Compensation, which can be used toward nursing home care.
- The VA pays the benefit to the veteran or surviving spouse, not directly to the nursing home, so you manage the payment yourself.
- You will need to submit medical evidence that the veteran or surviving spouse requires nursing home-level care, along with proof of income and assets.
How Aid and Attendance Works for Spouses in Nursing Homes
Aid and Attendance is a monthly stipend designed to help pay for personal care in a nursing home, assisted living facility, or at home. The veteran must be the one with the service-connected disability, but the payment can be used by the household to cover the spouse's care if the spouse is the one who needs it.
To receive this benefit, the veteran must have a disability rating of at least 50 percent from the VA, or meet the criteria for "housebound" status (essentially unable to leave home without help). The veteran does not have to be in a nursing home themselves — they can be living at home while the spouse is in the facility. The VA sends the monthly payment to the veteran or their representative, and that person decides how to use it.
The amount changes each year. The VA publishes new rates in December for the following year, and rates are higher if the veteran is in a nursing home than if they are at home. You can find current rates on the VA website, but the exact amount your household receives also depends on your countable income and assets, which the VA calculates using specific rules.
Income and Asset Limits That Affect Your Benefit
The VA uses a means test for Aid and Attendance, meaning your household income and assets determine whether you receive the full amount, a reduced amount, or nothing. The income limit changes each year and varies by family size and whether you are in a nursing home.
Not all income counts the same way. The VA excludes certain types of income, such as Supplemental Security Income (SSI) and some veterans' benefits. Medical expenses, including nursing home costs themselves, can reduce your countable income. This is one reason it helps to have a detailed list of all household expenses when you explore.
Assets are also counted, but the VA does not count your home, one vehicle, or certain other items. There is a threshold above which you become ineligible, but that threshold is higher than many people expect. The exact rules are complex, and the VA has published a guide called "Understanding Aid and Attendance" that walks through the calculation. If your income is close to the limit, it is worth submitting an process anyway, because the VA's calculation of countable income may be different from what you estimate.
Surviving Spouses and Dependency and Indemnity Compensation
If the veteran has passed away, a surviving spouse may receive Dependency and Indemnity Compensation (DIC) based on the veteran's service-connected death. DIC is a monthly payment that does not have the same income limits as Aid and Attendance, though there is a maximum household income above which you become ineligible.
DIC rates are set by Congress and are the same for all surviving spouses whose veteran died from a service-connected cause. The amount is higher than many Aid and Attendance payments, but it is not specifically earmarked for nursing home care — it is a general benefit that can be used for any household expense, including long-term care.
To receive DIC, you must have been married to the veteran at the time of death, and the marriage must have lasted at least one year (with some exceptions for deaths in service). You do not have to be a U.S. citizen, but you do have to report your income and assets to the VA each year.
How to Request These Benefits From the VA
To explore for Aid and Attendance, you submit VA Form 21-2680 (Statement in Support of Claim for Aid and Attendance) along with a completed VA Form 21-526EZ (process for Disability Compensation and Related Compensation Benefits) if the veteran does not already have a rating. If the veteran already receives VA disability benefits, you can submit just the 21-2680 and a letter explaining that you are requesting Aid and Attendance.
You will also need to submit medical evidence. This can be a letter from the veteran's doctor, a nursing home assessment, or a VA medical exam. The evidence should describe why the veteran or spouse needs nursing home-level care — for example, inability to bathe, dress, or eat without help, or a diagnosis that requires 24-hour supervision.
You can submit these forms online through VA.gov, by mail to your regional VA office, or in person at a VA office. The VA also allows you to work with a Veterans Service Officer (VSO), who is a trained representative who can help you gather documents and submit the process at no cost. VSOs work for organizations like the American Legion, Veterans of Foreign Wars (VFW), and Disabled American Veterans (DAV), and they know the local VA office and the current processing times.
What Happens After You Submit Your process
The VA typically takes several weeks to several months to process an Aid and Attendance claim. If the veteran already has a disability rating, the process is usually faster because the VA only needs to review the medical evidence for Aid and Attendance level of care. If the veteran does not yet have a rating, the VA must first rate the disability, which takes longer.
The VA will send you a letter explaining the decision. If approved, the payment begins the month after approval (or sometimes the month of approval, depending on timing). If denied, the letter will explain the reason — for example, the disability rating is not high enough, or the medical evidence does not show nursing home-level need. You can request reconsideration or file an appeal if you disagree.
While you wait, you can ask the VA to make a payment on account if you are facing when ready financial hardship. This is not automatic, but the VA can sometimes provide emergency funds while the claim is being reviewed.
Other VA Programs That May Help With Nursing Home Costs
Aid and Attendance and DIC are the main programs, but the VA also offers other options depending on your situation. If the veteran is enrolled in VA health care, the VA may cover some or all of the cost of nursing home care through its own facilities or through contracted community nursing homes. This is different from Aid and Attendance — it is direct care rather than a monthly payment.
The veteran must meet the VA's criteria for nursing home admission, which includes having a service-connected disability or being unable to afford care elsewhere. The VA prioritizes veterans with higher disability ratings and lower income. Wait times vary by region.
Some states also offer programs that work alongside VA benefits. For example, Medicaid can pay for nursing home care if the veteran or spouse meets income and asset limits, and some states allow you to combine Medicaid with VA benefits. A Veterans Service Officer or your state's Medicaid office can explain how these programs work together in your state.
Frequently Asked Questions
Can a spouse receive Aid and Attendance if the veteran is still living at home?
Yes. The veteran does not have to be in a nursing home to receive Aid and Attendance. The benefit is based on the veteran's disability rating and the spouse's need for care, not on where the veteran lives. If the spouse is in a nursing home and the veteran is at home, the veteran can still receive the payment and use it to help cover the spouse's costs.
What if the veteran's disability rating is less than 50 percent?
The veteran is not may be able to access for Aid and Attendance unless they meet the housebound criteria, which means they are unable to leave home without help due to a service-connected condition. If the veteran does not meet either threshold, Aid and Attendance is not available. Other programs, such as Medicaid or state-specific veteran benefits, may still help.
Do I have to spend down my savings to receive Aid and Attendance?
The VA counts assets, but there is a threshold, and certain assets do not count at all — such as your home and one vehicle. If your assets are above the limit, you may need to reduce them to become may be able to access, but the VA can explain the exact calculation before you make any decisions. Some people work with an elder law attorney to understand their options.
What if the veteran received a dishonorable discharge?
A dishonorable discharge disqualifies the veteran from VA benefits, including Aid and Attendance. Other types of discharge — honorable, general, or other than dishonorable — may allow benefits depending on the circumstances. If you are unsure about the discharge status, you can request a copy of the veteran's discharge papers (DD Form 214) from the National Archives.
Can a divorced spouse receive these benefits?
A divorced spouse cannot receive Aid and Attendance based on an ex-veteran's service. However, a surviving ex-spouse may receive DIC if the marriage lasted at least 20 years and the ex-veteran died from a service-connected cause. State law and the length of the marriage affect may be able to access.