Harold Simmons came home from Vietnam in 1971 with a Purple Heart, a permanent limp, and a quiet determination to never ask anyone for help. For decades, he kept his word. He built a business, raised a family in Plano, and lived independently until he was 77. Then his balance started going. Then his memory. By late 2024, his daughter Linda was driving from Frisco to Plano three times a week to help him shower, dress, and manage his medications. By spring of 2025, the family had moved him into an assisted living community near McKinney — a clean, caring facility that charged $7,200 a month.
Harold had saved carefully. But $86,400 a year has a way of clarifying the math. Within eighteen months, the family had burned through more than $130,000. Linda started researching Medicaid. Her brothers started discussing whether they should sell their father's house. Nobody was sleeping well.
Then an elder law attorney asked a question that stopped the family in its tracks: "Has your father applied for Aid and Attendance?"
They had never heard of it.
The Most Underused Benefit in Texas Elder Law
If Harold's story sounds familiar, it should. Texas is home to an estimated 1.5 million veterans — among the largest veteran populations of any state in the country. Thousands of them, and thousands of their surviving spouses, are sitting in nursing homes, memory care units, and assisted living communities right now, quietly depleting savings they spent a lifetime building, unaware that the federal government set aside a benefit specifically for them — and they haven't claimed it.
The VA's Aid and Attendance benefit is, without question, one of the most underutilized financial resources in Texas elder law. It pays up to $2,874 per month to a married veteran who needs help with daily activities. It pays up to $2,424 per month to a single veteran. And for surviving spouses of wartime veterans — widows and widowers who have never served a day themselves — it pays up to $1,558 per month. These are the 2026 rates, reflecting a 2.8% cost-of-living adjustment effective December 2025.
For a family paying $7,200 a month for assisted living, a benefit that offsets nearly $2,900 of that cost is not a small thing. It is a lifeline. And for a surviving spouse struggling to afford in-home care on Social Security alone, $1,558 a month can be the difference between staying home and moving to a facility.
What Aid and Attendance Actually Is
Aid and Attendance (A&A) is an enhanced pension benefit paid by the Department of Veterans Affairs on top of the standard VA pension. It is not the same as disability compensation. It is not based on service-connected injuries. It does not require that the veteran's need for care has anything to do with their military service. It is specifically designed for wartime veterans — and their surviving spouses — who need assistance with the activities of daily living: bathing, dressing, eating, toileting, moving from bed to chair.
A Vietnam veteran who needs help dressing because of Parkinson's disease — a condition with no connection to his military service — still qualifies. A surviving spouse of a Korean War veteran who has never been inside a VA facility in her life may qualify. The benefit follows the person, not the diagnosis.
To qualify, the veteran or surviving spouse must meet three separate criteria: medical, service, and financial.
The Three Tests for Eligibility
The Medical Test
At least one of the following must be true:
- The veteran needs assistance from another person to perform activities of daily living such as bathing, dressing, feeding, and toileting
- The veteran is bedridden due to mental or physical incapacity
- The veteran resides in a nursing home facility due to mental or physical disability
- The veteran has significant visual impairment (corrected visual acuity of 5/200 or less in both eyes, or concentric contraction of the visual field to 5 degrees or less)
In practical terms: if your parent or spouse needs help with two or more daily activities — and most people in assisted living do — the medical threshold is almost certainly met. The VA requires a physician to complete Form 21-2680, the Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. The family doctor can complete this form.
The Service Test
The veteran must have served at least 90 days of active duty, with at least one day during a congressionally recognized wartime period:
- World War II: December 7, 1941 – December 31, 1946
- Korean War: June 27, 1950 – January 31, 1955
- Vietnam War: August 5, 1964 – May 7, 1975
- Gulf War: August 2, 1990 – present (this period remains open)
That last category is one that surprises many families. The Gulf War period is still legally "open," which means veterans who served during Desert Storm, Operation Iraqi Freedom, Operation Enduring Freedom in Afghanistan, or any other conflict since August 2, 1990 may qualify — even if they are in their 50s and 60s and years away from thinking of themselves as candidates for long-term care planning. If a Gulf War veteran develops a serious illness that requires daily assistance, the benefit is available.
The veteran must also have been discharged under conditions other than dishonorable.
The Financial Test
Net worth cannot exceed $163,699 in 2026. Here is where many families assume they don't qualify — and where they are often wrong.
What does not count toward the net worth limit: the primary residence, regardless of its value. One personal vehicle, regardless of its value. Household goods and personal effects. The cost of future care can also be deducted from net worth under a formula that considers the veteran's life expectancy and projected medical expenses — a calculation that can bring many families who appear to be above the limit back into eligibility.
What does count: bank accounts, investment accounts, a second home, most other financial assets. If the combined value of those countable assets is under $163,699, the financial test is met.
The Three-Year Look-Back: Why Timing Matters
Here is where many Texas families make a costly mistake — one that is entirely avoidable with advance planning.
In October 2018, the VA implemented a three-year look-back period for asset transfers made to reduce net worth before applying for Aid and Attendance. If a veteran or spouse transferred assets for less than fair market value within three years of the application date — gifted money to children, transferred the house without adequate consideration — the VA will impose a penalty period during which no benefits are payable. The maximum penalty period is five years.
This is shorter than the five-year look-back period that governs Texas Medicaid eligibility — but it is real, and families who transfer assets without understanding this rule can find themselves in a penalty period precisely when they need the benefit most. The solution is not to avoid planning; it is to plan with someone who understands both programs.
An elder law attorney who is VA-accredited can help structure assets and income to qualify for Aid and Attendance without triggering the look-back rule — and without jeopardizing future Medicaid eligibility. These two programs are not mutually exclusive. With careful planning, many Texas veterans and their families can coordinate both.
Aid and Attendance and Medicaid: Using Both
One important interaction to understand: if a veteran qualifies for both Aid and Attendance and Medicaid-covered nursing home care simultaneously, the VA reduces the maximum pension to $90 per month for any month after the month of nursing home admission — because Medicaid is covering the bulk of care costs. The Aid and Attendance benefit at full rates is most valuable for veterans who are in assisted living, memory care, or receiving in-home care — settings that Medicaid typically does not fully fund.
For families navigating the transition from private-pay assisted living toward eventual Medicaid eligibility, Aid and Attendance can bridge a critical financial gap during the years of private-pay spending before the five-year look-back period has run. Understanding how to sequence these benefits — and when to apply for each — is the core of what Medicaid planning and VA benefits planning looks like in practice.
How to Apply in Texas — and Why Free Help Is Available
This is where Texas veterans have a genuine advantage.
The Texas Veterans Commission operates county veterans service officers at more than 294 locations across the state, available at no charge to help veterans and families navigate the VA claims process. In North Texas, service offices are available in Collin County (serving Plano, McKinney, Frisco, and Allen), Dallas County, Denton County, and Tarrant County. These officers are trained and accredited; they can help gather documentation, complete forms, and submit a complete application.
The application itself requires more than a single form. The VA will need:
- The veteran's discharge papers (DD-214) confirming wartime service and honorable discharge
- Form 21-2680 completed by a physician confirming the medical need
- Financial documentation: bank statements, asset valuations, and evidence of care costs
- For surviving spouses: the veteran's death certificate and marriage certificate
An incomplete application results in delays — often significant ones. An application that is denied requires a formal appeal, and re-filing after a denial means starting the clock over. Getting it right the first time matters.
One caution worth stating plainly: the Aid and Attendance benefit has attracted a cottage industry of financial advisors and insurance agents who charge fees — sometimes thousands of dollars — to "help" veterans apply. The VA does not authorize fees for filing VA benefit claims. The Texas Veterans Commission provides the same assistance at no cost. Any third party charging a fee to file a VA pension claim is not authorized to do so and should be avoided.
What the Benefit Meant for Harold
With help from an elder law attorney and the Collin County Veterans Service Office, Harold Simmons's family filed a complete Aid and Attendance application in the summer of 2025. Processing took approximately four months — typical for the program. The benefit was approved retroactively to the date of application.
Harold's family now receives $2,874 per month — $34,488 per year — applied directly toward his care costs. His savings are no longer in freefall. His house doesn't need to be sold. And Harold, who spent his entire adult life refusing to ask for help, has finally accepted something the government has been holding for him since the day he landed back in the United States in 1971.
He earned it. He just didn't know it was there.
The Bottom Line
If you have a parent, spouse, or family member who is a wartime veteran — or a surviving spouse of one — and they need help with daily activities, the VA Aid and Attendance benefit should be on your radar immediately. Not after savings are depleted. Not after Medicaid is the only option left. Now, while there is still time to plan.
Texas has more veterans than almost any other state, and it has the infrastructure to help them. But the benefit will not find you. You have to find it — and ideally, you find it before you need it urgently.
The elder law attorneys at WG Law serve veterans and their families throughout McKinney, Frisco, Plano, Allen, and the greater DFW Metroplex. We can evaluate whether your family member qualifies for Aid and Attendance, coordinate the benefit with long-term Medicaid planning, and help you build a strategy that makes your family's resources go as far as possible. Contact us to schedule a consultation.
This article provides general legal information about VA Aid and Attendance benefits and is not legal advice. Benefit rates and eligibility requirements are subject to change. Individual circumstances vary, and qualification depends on facts specific to each veteran and family. Consult a VA-accredited elder law attorney for guidance tailored to your situation.