Dylan4Vets

Pension add-ons

Aid & Attendance (A&A) and Housebound

Who qualifies, how the medical need works, and how income, net worth, and the 3-year look-back actually interact in the real world.

By Dylan4Vets • For wartime Veterans and survivors on VA Pension
Overview Eligibility Money How to Apply Pros & Cons FAQ
đź“Ś Start here

What A&A and Housebound actually are

Aid & Attendance (A&A) and Housebound are extra monthly amounts added on top of a VA Pension or Survivors Pension when the Veteran or survivor needs significant help with daily activities or is substantially confined at home. You must first qualify for Pension/Survivors Pension. You can't receive both A&A and Housebound at the same time – VA pays whichever is higher.

Basic Pension eligibility (before A&A/Housebound)

  • Wartime service with a discharge other than dishonorable, and
  • Countable income and net worth within VA limits, and
  • Either age 65+ or permanently and totally disabled (other special paths exist).
Net worth & look-back: VA uses a net-worth cap (for example, a specific dollar limit that updates most years). VA also applies a 3-year “look-back” for asset transfers. Moving assets below market value can trigger a penalty period (up to 5 years) before pension/A&A starts paying. Always confirm the current net-worth limit and MAPR tables on VA.gov.
âś… Eligibility

Who qualifies for Aid & Attendance (A&A)?

You (as a Veteran on Pension or a survivor on Survivors Pension) may qualify for A&A if any of these are true:

  • You need another person to help with daily activities such as bathing, dressing, feeding, toileting, adjusting prosthetics, or keeping you safe from hazards, or
  • You're bedridden much of the day due to illness, or
  • You're a nursing home patient because of mental or physical incapacity, or
  • Your eyesight is 5/200 or worse in both eyes, or your visual field is 5° or less.

Who qualifies for Housebound?

Housebound requires that you're substantially confined to your home because of a permanent disability, and you already qualify for Pension/Survivors Pension. You can't get Housebound and A&A at the same time – VA will pay the higher one.

Why this matters: These add-ons can be a big boost over the basic pension rate. They're specifically meant for people who need hands-on help day to day or whose disabilities make leaving home extremely limited.
đź’µ Money

Income, medical expenses & MAPR

VA compares your “income for VA purposes” to an annual limit called the MAPR (Maximum Annual Pension Rate) for your category (single Veteran, survivor with dependents, A&A, etc.).

  • Unreimbursed medical expenses above 5% of your MAPR can be deducted from income. That lowers your “countable” income and can increase what VA pays you.
  • Expenses can include home health aide/caregiver costs (even paid to family in many situations), nursing-home costs, insurance premiums, certain medical supplies, etc.
  • Because of that deduction, reporting your true out-of-pocket care costs can make or break eligibility.
đź“® Action

How to apply, step by step

1) Apply for Pension (if you're not already on it)

2) Add A&A or Housebound to your claim

  • VA Form 21-2680 (your clinician fills out the exam section describing care needs).
  • If you're in a nursing home, also include VA Form 21-0779 (Request for Nursing Home Information).
  • You can mail these with your pension claim or submit them after you're already getting pension.

3) Report your out-of-pocket care costs

  • Use VA Form 21P-8416 to list unreimbursed medical expenses (caregiver pay, home health, supplies, premiums, etc.).
  • This can shrink “countable income,” which can unlock or increase pension + A&A/Housebound.
Heads-up: The Pension Intake Center address, net-worth cap, and MAPR tables update. Always confirm the latest address and rates on VA.gov or the current form instructions before you mail.
⚖️ Reality check

Pros & cons (straight talk)

Pros

  • Significant boost over base pension for people who truly need daily help or are housebound.
  • Unreimbursed medical expenses can dramatically lower “countable income,” which can increase what VA pays.
  • Money is paid to the Veteran/survivor – it can be used to pay family or agency caregivers.

Cons

  • You must first qualify for needs-based pension (income / net-worth caps apply).
  • There’s a 3-year look-back: giving away / shifting assets below market can trigger a penalty period (up to 5 years) before VA will pay.
  • You can't stack A&A and Housebound – VA will only pay the higher one.
đź”— Links

Quick links & references

âť“ Answers

Frequently asked questions

Can I get A&A if I'm on VA disability compensation instead of pension?

Yes – there's an Aid & Attendance-type benefit under VA disability compensation called Special Monthly Compensation (SMC). It also uses VA Form 21-2680 to document daily-care needs. A VSO can help figure out which lane applies in your case.

What counts as “help with daily activities” for A&A?

Think: bathing, dressing, feeding, toileting, adjusting prosthetics, or needing someone close by to keep you safe from hazards. That hands-on assistance is exactly what A&A is meant for.

How do medical expenses lower my countable income?

Unreimbursed medical costs above 5% of your MAPR are deducted from income for VA purposes. You report them on VA Form 21P-8416. Lower “countable income” can increase your monthly pension + A&A/Housebound.

Where do I mail my forms?

Send pension / Survivors Pension / A&A / Housebound paperwork to:

Department of Veterans Affairs
Pension Intake Center
PO Box 5365
Janesville, WI 53547-5365

Always confirm that address on the most current VA form or VA.gov page – it can change.