FAMILYVA program

Aid and Attendance / Housebound Allowance

Increased pension rate for veterans who need the regular aid of another person for daily activities, or who are substantially confined to the home due to a permanent disability.

Available to veterans getting or applying for VA pension who need personal care assistance or are substantially housebound

View on VA.gov

Example value

Up to $29,093/yrVeteran pension with A&A, no dependents

Step-by-step guide

What VA looks for: Aid and Attendance for a veteran on pension

Veterans Pension, or a claim for itThe add-on raises a Veterans Pension. It is not paid on its own. Your pension is your household's MAPR minus countable income, and care costs you pay can lower that income.
A need for regular aid and attendanceHelplessness, or being so nearly helpless that you need the regular help of another person. VA finds this one of three ways: corrected vision of 5/200 or less in both eyes or a visual field of 5 degrees or less; being a nursing home patient because of mental or physical incapacity; or a factual need under the daily living factors.

Source: 38 CFR 3.351(a) (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab); VA.gov: current pension rates (opens in new tab); 38 CFR 3.351(b) (opens in new tab); 38 CFR 3.351(c) (opens in new tab); 38 CFR 3.352(a) (opens in new tab)

Which kind of claim is this?

Aid and Attendance for a veteran on pension
A higher Veterans Pension rate for a veteran who needs another person's regular help. VA looks for a pension award, or a pension claim, and one of three things: the vision loss the rule describes, being a nursing home patient because of mental or physical incapacity, or a factual need for help with daily life.
Source: 38 CFR 3.351(a) (opens in new tab); 38 CFR 3.351(b) (opens in new tab); 38 CFR 3.351(c) (opens in new tab); 38 CFR 3.352(a) (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
Housebound for a veteran on pension
A higher Veterans Pension rate for a veteran who does not need aid and attendance but has one permanent disability rated 100 percent, plus either other disabilities rated 60 percent or more or a lifelong confinement to home. A total rating based on unemployability does not count as the 100 percent disability.
1. Veterans Pension, without the aid and attendance rateThe Housebound rate applies to a veteran on pension who is not in need of regular aid and attendance. VA does not pay Housebound and Aid and Attendance at the same time.
2. One permanent disability rated 100 percentA single permanent disability rated 100 percent under the rating schedule. A rating based on unemployability under 38 CFR 4.17 does not count here.
3. More disability rated 60 percent, or confined to home for lifeEither other disabilities rated 60 percent or more on their own, involving different body parts or systems. Or being substantially confined to your home and its grounds, or to a ward if you live in an institution, when it is reasonably certain to last for life.
Source: 38 CFR 3.351(d) (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab); VA Form 21-2680 (opens in new tab)
Aid and Attendance or Housebound for a surviving spouse on Survivors Pension
A higher Survivors Pension rate for a surviving spouse who needs aid and attendance under the same criteria as a veteran, or, if not, who is permanently housebound. The surviving spouse Housebound rule has no 100 percent rating step. A surviving spouse on DIC instead has separate DIC add-ons, covered in the DIC chapter.
1. Survivors Pension, or a claim for itThe add-on raises Survivors Pension for a surviving spouse. Countable income is figured the same way, and care costs you pay can lower it.
2. A need for aid and attendance, or being permanently houseboundThe same three aid and attendance criteria that apply to a veteran. Or, without that need, being substantially confined to your home and its grounds, or to a ward if you live in an institution, because of disability reasonably certain to last for life.
Source: 38 CFR 3.351(a)(5) (opens in new tab); 38 CFR 3.351(c) (opens in new tab); 38 CFR 3.351(f) (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab); VA Form 21P-534EZ (opens in new tab); VA.gov: Survivors Pension rates (opens in new tab); 38 CFR 3.352(a) (opens in new tab)

What to gather, and what it shows VA

Documents for this benefit: what each is, what it shows VA, and how VA gets it
Document	What it shows	How VA gets it	Have it?
Physician exam for Aid and Attendance or Housebound VA Form 21-2680. A medical examiner completes the examination section about your daily functioning and confinement.	The daily help or confinement VA looks for	Download the form from VA.gov and give it to your physician or other medical examiner. The completed form goes to VA by mail to the Pension Intake Center, online, or at a regional office. BeneVets does not ask for its contents.
Nursing home information VA Form 21-0779, completed by a nursing home official to confirm you are a patient there.	Nursing home patient status	An official of the nursing home completes VA's form and submits it to VA online or by mail. VA.gov says a claimant in a nursing home also needs this form.
Nursing home and care facility records Records from a nursing home, assisted living, or similar facility showing that you live there, the care you get, and why.	Care because of mental or physical incapacity	The facility keeps these. You can send copies with the claim, or name the facility and sign a release so VA can request them; VA makes reasonable efforts to get private records it is told about. BeneVets does not collect them.
Written statement that you need the care A signed statement from a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist that you need the in-home care, or need to live in a protected setting, because of a physical, mental, developmental, or cognitive disorder.	That unlicensed in-home or facility care counts as a medical expense	Your provider writes and signs it, and it goes to VA with your medical expense report. It matters most before VA has found a need for aid and attendance or housebound status. BeneVets does not collect it.
Medical expense report VA Form 21P-8416, where you list medical and care expenses you paid for yourself or a family member in your household and were not paid back for.	Care costs that lower countable income	You fill it out from your own bills and receipts and send it to VA, online or by mail. BeneVets does not collect expense details.
Care bills and expense receipts Invoices and receipts for an in-home attendant, assisted living, a nursing home, insurance premiums, and other medical costs, showing what you paid and when.	What you paid for care in the 12-month period	The provider, facility, or insurer sends these. The totals go on your medical expense report to VA, and VA may ask for copies. In-home care payments should match the hours the attendant works.	Yes
Your pension award letter The VA letter that awarded Veterans Pension or Survivors Pension.	That the add-on has a pension to raise	VA mailed it when it decided the pension claim. If you are not on pension yet, the pension application and the add-on can go in together.	Yes

Records and statements go to VA. BeneVets never asks you to upload or type them here.

Steps, in order

Get free help from a VSO
Free help: an accredited VSO can file this with you. Find one near you in the BeneVets VSO directory at Find an accredited VSO near you. VA also accredits attorneys and claims agents.
Source: VA.gov: accredited representatives (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
Set your start date
If you are not on pension yet, submit an intent to file on VA Form 21-0966, or start the online pension application while signed in. VA treats a complete claim filed within 1 year as filed on the intent to file date.
Source: 38 CFR 3.155(b) (opens in new tab); VA.gov: your intent to file (opens in new tab); VA Form 21-0966 (opens in new tab)
Find which benefit the add-on raises
Aid and Attendance and Housebound raise Veterans Pension or Survivors Pension. A surviving spouse on DIC has separate DIC add-ons instead.
Source: 38 CFR 3.351(a) (opens in new tab); 38 CFR 3.351(a)(5) (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
Check the criteria
Compare your situation with the rules: the vision loss, nursing home, or daily living criteria for Aid and Attendance, and for Housebound, the 100 percent rule for veterans or the lifelong confinement rule for surviving spouses.
Source: 38 CFR 3.351(c) (opens in new tab); 38 CFR 3.351(d) (opens in new tab); 38 CFR 3.351(f) (opens in new tab); 38 CFR 3.352(a) (opens in new tab)
Have the physician exam completed
Download VA Form 21-2680 and have your physician or other medical examiner complete the examination section.
Source: VA Form 21-2680 (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
Ask the nursing home for its form
If you live in a nursing home, ask an official there to complete VA Form 21-0779 and send it to VA.
Source: VA Form 21-0779 (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
Gather what you pay for care
Collect bills and receipts for an in-home attendant, assisted living, a nursing home, insurance premiums including Medicare, and other medical costs paid in the 12-month period and not paid back.
Source: 38 CFR 3.272(g) (opens in new tab); 38 CFR 3.278(c)(5) (opens in new tab); 38 CFR 3.278(d)(1) (opens in new tab); 38 CFR 3.278(d)(2) (opens in new tab); 38 CFR 3.278(d)(3) (opens in new tab)
Get a written statement for unlicensed care
If your in-home attendant is not a licensed provider, or your facility care is help with daily activities, ask your physician, physician assistant, certified nurse practitioner, or clinical nurse specialist for a written statement that you need that care.
Source: 38 CFR 3.278(d)(2) (opens in new tab); 38 CFR 3.278(d)(3) (opens in new tab)
Report care costs on the medical expense report
List the costs on VA Form 21P-8416. Only the part above 5 percent of the MAPR without the add-on lowers countable income.
Source: VA Form 21P-8416 (opens in new tab); 38 CFR 3.272(g) (opens in new tab); 38 CFR 3.272(g)(1)(iii) (opens in new tab); 38 CFR 3.272(g)(2)(iii) (opens in new tab)
File as a veteran
Not on pension yet: file VA Form 21P-527EZ with the physician exam. Already on pension: send VA Form 21-2680 online, by mail to the Pension Intake Center, or at a VA regional office.
Source: VA Form 21P-527EZ (opens in new tab); VA Form 21-2680 (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
File as a surviving spouse
Not on Survivors Pension yet: file VA Form 21P-534EZ with the physician exam. Already on it: send VA Form 21-2680 online, by mail to the Pension Intake Center, or at a VA regional office.
Source: VA Form 21P-534EZ (opens in new tab); VA Form 21-2680 (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)
Report changes after an award
After an award, tell VA promptly about changes in income, net worth, marital status, or nursing home patient status.
Source: 38 CFR 3.277(b) (opens in new tab)

Good to know

Care costs you pay can lower countable income

Pension is the MAPR for your household minus your countable income. Medical expenses you paid in the 12-month period and were not paid back for are taken out of that income, but only the part above 5 percent of the MAPR without the Aid and Attendance or Housebound increase. Care costs count as medical expenses: an in-home attendant, care in an assisted living or similar facility, nursing home care including meals and lodging, and health and long-term care insurance premiums, including Medicare Parts A, B, and D.

Source: 38 CFR 3.272(g) (opens in new tab); 38 CFR 3.272(g)(1)(iii) (opens in new tab); 38 CFR 3.272(g)(2)(iii) (opens in new tab); 38 CFR 3.278(c)(5) (opens in new tab); 38 CFR 3.278(d)(1) (opens in new tab); 38 CFR 3.278(d)(2) (opens in new tab); 38 CFR 3.278(d)(3) (opens in new tab); VA.gov: current pension rates (opens in new tab)

Who gives the care matters for some costs

An in-home attendant must be a licensed health care provider unless VA finds you need aid and attendance or are housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist states in writing that you need that care. In an assisted living or similar facility where you get health or custodial care, help with daily activities from someone who is not a licensed provider counts after the same finding, or a written statement from one of those providers that you need a protected setting. Meals and lodging there count when the facility provides or contracts for your care, or when one of those providers states in writing that you must live in that kind of facility to get care from someone else.

Source: 38 CFR 3.278(d)(2) (opens in new tab); 38 CFR 3.278(d)(3) (opens in new tab)

What VA weighs for the need for help

VA weighs the ability to dress, keep clean, eat, and use the toilet without help, adjusting a prosthetic or orthopedic device, and whether regular care is needed for protection from daily hazards. Not every factor has to be present, and the need has to be regular, not constant. A condition that actually requires staying in bed is also a basis, but being told to rest in bed to recover is not. Help from a relative or someone in your home still counts.

Source: 38 CFR 3.352(a) (opens in new tab); 38 CFR 3.352(c) (opens in new tab); 38 CFR 3.351(b) (opens in new tab)

One rate at a time

VA pays either the Aid and Attendance rate or the Housebound rate, not both. Housebound applies when the aid and attendance need is not found.

Source: 38 CFR 3.351(d) (opens in new tab); 38 CFR 3.351(f) (opens in new tab); VA.gov: Aid and Attendance and Housebound (opens in new tab)

Surviving spouses on DIC

DIC has its own Aid and Attendance and Housebound added amounts for a surviving spouse, with a separate housebound rule. Those are part of a DIC claim, covered in the DIC chapter.

Source: 38 CFR 3.351(a) (opens in new tab); 38 CFR 3.351(e) (opens in new tab); VA.gov: DIC rates for spouses and children (opens in new tab)

The higher level allowance is a compensation rule

The higher level aid and attendance allowance for daily skilled care at home applies to veterans paid certain top rates of disability compensation. It is not part of pension.

Source: 38 CFR 3.352(b) (opens in new tab)

Report changes, including nursing home status

Anyone who applies for or gets pension must promptly tell VA about changes in income, net worth, marital status, and nursing home patient status.

Source: 38 CFR 3.277(b) (opens in new tab)

BeneVets is informational and is not an accredited representative. Free help: an accredited VSO can work through VA benefits with you at no cost. Find an accredited VSO near you