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How Veterans Can Use VA Benefits for Alzheimer’s & Memory Care in Texas

The Veterans’ Administration (VA) provides multiple benefits to individuals who have served in the United States military. Some of the most important revolve around healthcare and include inpatient hospital care and outpatient services.

It’s also important to know that VA benefits include more than the traditional healthcare services most Americans think about when they consider their health. It also includes services for mature adults dealing with memory impairments, such as various forms of dementia. In Texas, and throughout the United States, veterans can use their VA benefits to help pay for Alzheimer’s care and memory care services.

However, as many veterans know, the VA system can be challenging to navigate. Even those that have been using VA benefits for years may find it difficult to access memory care coverage. The goal of this guide is to help veterans and their families better understand and navigate the VA process to receive the Alzheimer’s and memory care benefits they need. While anyone can use this guide, special emphasis will be given to resources for Texas residents and retirees.

Table of Contents

FAQs about VA Aid & Attendance

What is Aid & Attendance(A&A)?

Aid & Attendance is a pension benefit program provided by the VA to help veterans and their spouses pay for care. Daily care provided in the veteran’s home, an assisted living, skilled nursing or other supportive living community are all potential candidates for A&A pension benefits.

Do spouses of veterans get nursing home benefits?

Yes. Spouses of veterans get nursing home benefits, including surviving spouses. Spouses are generally eligible for both a basic pension and the Aid and Attendance benefits, which provides nursing home benefits. Some conditions and eligibility requirements may apply.

How much is the monthly A&A benefit?

Monthly benefits vary, with different amounts awarded based on circumstances and who needs benefits. In most cases, A&A applicants can receive up to:

  • $1,830/mo for a veteran
  • $2,903/mo for two veterans who are married
  • $2,169/mo for a veteran with a nonveteran spouse
  • $1,176/mo for a veteran’s surviving spouse

How can I or my family apply for A&A from the VA?

To apply for A&A, you need to obtain all the necessary documents, complete required forms and mail a completed application to the VA with your documents. There are more details on the documents and application process below.

What documents should you include in your A&A application package?

  • Discharge/Separation Papers (DD-214): These are part of your military records. You can request a copy here.
  • Marriage Certificate: Include a copy if you are a surviving spouse or you are a family member or friend applying for benefits for both the veteran and their spouse
  • Social Security Award Letter: You need a copy of your most recent annual award letter that notifies you of your monthly award for the following year
  • Net Worth Documents: This will include documents on your bank accounts, stocks and bonds, CDs, trusts, annuities and other assets that affect your net worth
  • Proof of Income: For retirees and those that are still working part time, this will include documents on all your income from your retirement funds and pensions, as well as income from investments, annuities and other assets
  • Medical Documents: Include proof of medications, any medical bills you have, insurance premiums and other medical expenses that are not reimbursed by Medicare or insurance policies
  • Alzheimer’s or Dementia Diagnosis: When applying for memory care benefits, you’ll need a statement from your physician that includes a current diagnosis. The statement should also detail the current medical status of the individual, their prognosis, the level of self care ability they have, whether or not they can travel unattended and any other information about the individual’s Alzheimer’s disease that the physician deems necessary. The physician statement should include the individual’s name and address.
  • Nursing Home Status Form and Statement of Occupancy: You’ll only need to submit this if the individual is currently in a supportive living environment, such as an assisted living community
  • Banking Information: Bank information is used for direct deposit of monthly payments. In most cases, you’ll need to include a voided check to ensure the VA has all the necessary information for direct deposit.
  • Doctor and Hospital List: Include a full list of all doctors and/or hospitals the individual has visited in the past year

Can I start the benefit application process before I have all the documents?

Yes. While you cannot file the full application, you can submit VA Form 21-0966, which is an intent to file form. VA Form 21-0966 will get your claim into the system early to save you time later.

When will I hear back about my application? How long will it take the VA to process and approve my application?

Once you submit your application, the VA needs to process and approve it. That timeline will depend on the VA regional office serving your part of Texas. VA regional offices with higher workloads may take up to 12 months to approve your application after you file. VA regional offices with lower workloads could be as fast as six weeks, but for most people the approval process is somewhere in the middle – usually between six and eight months.

I get disability compensation from the VA. Can I still apply for the A&A pension?

Unfortunately, veterans cannot be awarded disability compensation and A&A at the same time. If you’re in a situation where you feel you need or qualify for both, you may want to consider applying for an Improved Pension. Improved Pension may be granted based on health issues that aren’t connected to your time in the service. If your filing is accepted, the VA provides whichever benefit is of the greatest financial value to you.

VA Benefits for Alzheimer’s and Memory Care

The Veterans’ Administration A&A program encompasses Alzheimer’s care and memory care support. It’s part of the VA’s program to help veterans and their families cover the cost of care during their senior years. Both veterans and their surviving spouses may be covered by benefits. The type of care and benefit amount covered will depend on each individual’s needs. Some of the most common services that may be included are:

  • Home-based primary care or home health aide
  • Homemaker services
  • Respite care and adult day care
  • Outpatient care from clinics
  • Inpatient care at hospitals
  • Residential and supportive living care
  • Hospice or palliative care

The care options above help veterans get regular assistance with the activities of daily living, such as getting dressed, eating, bathing and going to the bathroom. A&A pension benefits reduce the financial burden of that assistance.

If you have questions about the care available to you, you can get assistance from Veterans Service Offices located throughout Texas. Assistance is free and can be found through your county website. In the Plano, Texas, area, you can visit Collin County’s website to find benefits, services and assistance available for veteran residents.

Veterans can expect their A&A pension to be similar to the benefits provided by Social Security – it’s a reliable source of financial assistance. Once accepted, you will get your benefit payment from the Department of Treasury. Apply the funds to the care services you need, such as paying assisted living or memory care community fees.

A&A Eligibility

Since A&A benefits are added to your usual pension benefits from the VA, not every veteran will qualify for the additional funds. The VA has medical and financial qualifications that will affect who is accepted and what they receive in monthly benefits. Specific requirements can be found on the VA website.

Generally, veterans who have more than 90 days of active duty with at least one day during a period of war may apply. Spouses may also be eligible for benefits, and a surviving spouse can begin the application process if the marriage ended only due to the veteran’s death.

Medical Requirements for A&A Benefits

To medically qualify for A&A pension awards, the veteran or their spouse must not be able to perform the normal activities of daily living on their own. They will need the assistance of another person to perform common tasks including eating meals, getting dressed in the morning and undressed in the evening or maintaining proper hygiene. Veterans will likely have the medical qualifications for A&A benefits if:

  • They have lost their eyesight and need regular assistance
  • They are mentally or physically incapacitated and live in an assisted living community or other supportive living residence
  • They have a memory impairment such as Alzheimer’s disease or another form of dementia and require in-home care or memory care services

Medical qualifications are established through a medical evaluation. Applicants will need a physician to verify their condition as part of the application process. 

Appointment as Fiduciary

It’s common for veterans with Alzheimer’s or dementia to give Power of Attorney to a relative or friend who can handle issues such as A&A applications and benefits. While common for civilians, the VA does not recognize Power of Attorney. If Power of Attorney abilities are something you or a relative need, you must have the VA approve a relative or friend to act as a fiduciary instead.

To become a fiduciary, applications must complete VA Form 21-0845, also known as the Authorization to Disclose Personal Information to a Third Party. VA Form 21-0845 gives the chosen fiduciary the ability to work with the VA on behalf of the veteran or their spouse. Fiduciary applications must also attend an appointment with a field agent.

If you need help with the fiduciary application process, you can complete VA Form 21-22, or Appointment of Veterans Service Organization as Claimant’s Representative. This will help you get the assistance you need.

Financial Qualifications for A&A Benefits

Aid and Attendance applicants must demonstrate financial need in order to qualify for benefits. In most cases, they show a limited income and net worth along with a certain amount of medical expenses. There is no standardized income or asset level, but typically the VA accepts applications with less than $80,000 in assets on average. Personal vehicles and homes are excluded from asset value. To determine what income and assets are included in the estimate, use this worksheet.

Step by Step Guide for Applying for Benefits

Texas veterans who are interested in adding A&A benefits to their regular pension can use the following steps to apply.

Step 1: Determine eligibility.

The best way to determine your eligibility for Aid and Attendance benefits is by using the VA’s online form. The form is maintained by the VeteranAid.org website and can be filled out by veterans, their surviving spouses, friends and relatives. VeteranAid.org also helps applicants find local assisted living options. For more help in this area, you can call (866) 584-7191.

Step 2: File VA Form 21-0966.

Once you know you or a relative is eligible for A&A benefits, you should submit VA Form 21-0966, a one-page document known as the  Intent To File A Claim For Compensation And/Or Pension, Or Survivors Pension And/Or Dic. This document enters your claim into the VA’s system before you complete your application, giving you a jumpstart on the process. The form is entirely optional but will help you determine a date from which you can receive retroactive payments (if awarded) after the VA approves your application. Once you file, you have one year to complete and submit your full application. If you file more than a year after submitting VA Form 21-0966, then it may no longer be valid.

Step 3: Gather all your required documentation.

Discharge/Separation Papers (DD-214)

Marriage Certificate copy

  •  A marriage certificate is not required if you are the veteran and you are only applying for benefits for yourself

Death Certificate copy

  • A copy of the veteran’s death certificate is only required for surviving spouses

Social Security award letter copy

  • You will need the most recent award letter detailing benefits for the upcoming or current year

Net worth information

  • To establish net worth you may need information such as bank account statements, annuities documents, trust information, stocks, bonds and other financial documents

Proof of income

  • Include all income information such as that from retirement accounts, pensions, investment income and other sources

Medical statement from a physician

  • Your physician’s statement should include you or your relative’s name and address along with their diagnosis, prognosis, medical status and ability to provide self-care. You may also want to include other health information, such as the individual’s ability to travel with or without assistance.

Senior Care Residence Status Statement

  • Often called a “nursing home status statement,” veterans or spouses in supportive living residences such as assisted living must submit a Nursing Home Status Statement and a Statement of Occupancy from the residence. The Statement of Occupancy will be supplied directly from the residence.

Proof of out-of-pocket medical expenses

  • Out-of-pocket medical expenses include those that are not covered or reimbursed by Medicare, Medicaid or insurance. They often include information on medication expenses, insurance premiums and other medical bills.

VA Form 21P-8416, also known as a medical expense report

  • Documents assigning a court-appointed guardian
  • If the applying veteran or their surviving spouse has a court-appointed guardian, you need to submit a certified copy of the court order granting guardianship

Employment history

  • Employment history is only required if the applicant is less than 65 years old

You should also provide a detailed list of the physicians, practitioners, specialists and hospitals the applicant visited over the last 12 months. Include billing statements that explain any medical expenses the applicant incurred. Dementia and Alzheimer’s medical expenses include, but are not limited to:

  • Transportation from an ambulance
  • Home health services and visits for medical treatment
  • Hospital and nursing service expenses
  • Medical insurance premiums covering medical insurance
  • Lab tests
  • Neurology care
  • Occupational, physical and speech therapy
  • Physical exams and physician care
  • Prescriptions and medications
  • Psychiatric care
  • Transportation to doctor appointments and for medical purposes; A&A will cover 20 cents per mile plus tolls and parking for the drivers and it will cover the actual fares for buses, taxi or other modes of transportation

Step 4: Complete the VA Application Form.

Fill out VA Form 21-527EZ and/or VA Form 21-534EZ. These are the main forms used to apply for Special Improved Benefits with Aid & Attendance.

Step 5: Make a copy of your application and mail the original.

Making a copy of your completed application and its supporting documents is a due diligence step that helps you be better prepared for any problems with the mail or VA processing. Once you have a copy, mail your completed application to the Pension Management Center for your state. Texas applicants should send applications to:

Department of Veterans Affairs
Claims Intake Center
Attention: St. Paul Pension Center
PO Box 5365
Janesville, WI 53547-5365

What Veterans and Their Families Can Expect after Applying for Aid & Attendance

Aid and Attendance applications typically take six to eight months to process. The timeline can be extended up to 12 months depending on processing backlogs. Once the application is processed, the VA will provide a determination letter that informs applicants if they have been awarded A&A benefits.

You will need to fund your Alzheimer’s and memory care until the Veterans’ Administration approves your A&A benefits. Payments from your original A&A filing date may be reimbursed – up to your monthly benefit amount – by the VA after your application is approved.

The Veterans’ Administration prioritizing applicants who are 90 years old or better. Veterans and surviving spouses who are 90 or older can include a cover letter in their application that requests expedited processing.

Financing Supportive Care

Financing daily care such as assisted living, Alzheimer’s or memory care is easier when you have all the information in front of you, including the services and amenities offered in each option. Download our guides today to finding the right assisted living or memory care community for you or those in your care.

Download the Assisted Living Guide              Download the Memory Care Guide

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