VA Aid and Attendance in El Paso: A Worked Example for Assisted Living

The basic mechanism

VA pension pays the difference between countable income and the maximum annual pension rate. Unreimbursed medical expenses, including assisted living care charges, are subtracted from income, so high care costs can bring countable income below the maximum.

A worked example

Take a veteran with $24,000 a year in income who pays $5,666 a month, the Texas median, for assisted living. Annual care costs of about $68,000 exceed income, so countable income after deductions can fall to zero, subject to VA's rules on which costs count. The pension could then approach the $29,093 maximum, about $2,424 a month.

Actual results depend on VA's calculation; this example is illustrative.

Net worth and look-back

Net worth, assets plus annual income, must be at or below $163,699 through November 30, 2026, and VA reviews transfers in the prior three years.

El Paso resources

The El Paso County veterans service office and accredited veterans service organizations help file claims at no cost. The El Paso VA Health Care System serves enrolled veterans, and the Ambrosio Guillen Texas State Veterans Home offers nursing care for eligible veterans.

Who counts as a wartime veteran

Pension requires wartime service: at least one day of active duty during a recognized wartime period, including World War II, the Korean conflict, the Vietnam era and the Gulf War period that began in August 1990 and has not ended. Veterans who entered service after September 7, 1980 generally need 24 months of service or the full period for which they were called. Discharge must be other than dishonorable.

Many El Paso veterans served in the Gulf War era, so younger veterans with disabilities may also qualify, along with older veterans.

Documenting care costs

VA needs proof of the care being paid for. For assisted living, the facility completes a form describing the care provided, and the family supplies receipts. For home care, invoices from a licensed agency or records of payments to a caregiver are needed. A physician's statement of the need for help with daily activities supports the Aid and Attendance level.

Keep copies of everything and track monthly totals; VA may ask for updated expenses.

Combining pension with other help

Pension can be combined with savings, family support and long-term care insurance to pay for assisted living. Medicaid counts VA pension as income, and when a veteran on Medicaid enters a nursing facility, the pension may be reduced. Ask a veterans service officer before applying for Medicaid.

Avoiding pension scams

Some companies charge fees to help veterans qualify or suggest moving assets into products. VA penalizes transfers made in the three years before applying, and accredited representatives help for free. Never sign over assets on the advice of a salesperson.

After approval

VA may pay retroactively to the date of the claim. Report changes in income, care costs or living situation promptly to avoid overpayments that VA will later recover.

A home care version of the example

The same mechanism works at home. A veteran paying a licensed agency for 20 hours a week of personal care at the Texas median of about $30 an hour spends roughly $2,600 a month, or about $31,000 a year. Those payments count as unreimbursed care expenses, reducing countable income and often producing a monthly pension that helps pay for the care.

Families sometimes assume the benefit is only for people in facilities. It is not, and in El Paso, where home care is so common, the home care version may help more families than the assisted living one.

How long the claim takes

Processing times vary. Filing an intent to file first preserves the effective date while you gather documents, and VA can pay back to that date if the claim is approved. A complete claim, with the care provider's form, receipts and medical evidence, moves faster than one VA has to develop.

While the claim is pending, many families pay for care from savings and treat the pension as reimbursement. Ask the facility or agency whether it will wait for part of the payment; some will, if they know a claim has been filed.

Where the numbers come from

The rates in this guide are VA's published maximum annual pension rates effective December 1, 2025, and the net worth limit for December 1, 2025 through November 30, 2026. VA adjusts them each year with Social Security's cost-of-living increase, so check VA.gov for the current figures before you apply.

Surviving spouses

Surviving spouses of wartime veterans can qualify too, at a lower maximum, $18,697 a year with no dependents. Many El Paso widows of Fort Bliss veterans never apply.