Aid & Attendance and Housebound Benefits
Increased payment rates for veterans and survivors who need help with daily activities or are confined to their home — four distinct programs under the A&A/HB umbrella.
Overview — Four Distinct Programs
Aid & Attendance (A&A) and Housebound (HB) are increased payment rates — not separate benefits. They are add-ons that increase an existing VA benefit (pension, compensation, or DIC) when the veteran or survivor meets additional need-based criteria.
Do not confuse these four programs
The term "Aid and Attendance" applies to four different programs with different eligibility rules, different rates, and different statutes:
- Pension A&A / Pension HB — increased pension rates for wartime veterans (38 USC 1521(d)/(e))
- Compensation A&A (SMC-L) — Special Monthly Compensation for service-connected disabilities (38 USC 1114(l))
- Compensation HB (SMC-S) — Special Monthly Compensation housebound rate (38 USC 1114(s))
- Survivors A&A / Survivors HB — increased DIC or Survivors Pension for surviving spouses and dependents
You cannot receive A&A and Housebound at the same time. If you qualify for both, VA pays whichever is the higher rate.
Pension Aid & Attendance
An increased Maximum Annual Pension Rate (MAPR) for wartime veterans who already qualify for VA pension AND meet additional need-based criteria. This is income-based and does not require service-connected disabilities.
Eligibility
The veteran must first qualify for VA pension (wartime service, discharge not dishonorable, income/net worth limits, age 65+ or permanently and totally disabled). Then, to receive the A&A increase, they must meet at least one of these criteria:
- Need help with daily activities — "You need another person to help you perform daily activities, like bathing, feeding, and dressing"
- Bedridden — "You have to stay in bed — or spend a large portion of the day in bed — because of illness"
- Nursing home patient — "You're a patient in a nursing home due to the loss of mental or physical abilities related to a disability"
- Limited eyesight — "Your eyesight is limited (even with glasses or contact lenses you have only 5/200 or less in both eyes; or concentric contraction of the visual field to 5 degrees or less)"
Detailed A&A Criteria (38 CFR 3.352(a))
"Need for aid and attendance means helplessness or being so nearly helpless as to require the regular aid and attendance of another person." Qualifying factors include:
- Inability to dress or undress oneself, or to keep ordinarily clean and presentable
- Frequent need of adjustment of prosthetic or orthopedic appliances that cannot be done without aid
- Inability to feed oneself through loss of coordination of upper extremities or extreme weakness
- Inability to attend to the wants of nature
- Physical or mental incapacity requiring care or assistance on a regular basis to protect from hazards or dangers of the daily environment
Important: Not all factors must be present — the veteran's condition is evaluated as a whole. It is only necessary that the evidence establish that the veteran is so helpless as to need regular aid and attendance, not that there be a constant need.
"Bedridden" definition: The condition must actually require that the claimant remain in bed. Voluntary bed rest or physician-prescribed rest for recovery does not qualify. The determination cannot be based solely on a medical opinion that the veteran should stay in bed.
Current Rates (Effective December 1, 2025)
Pension rates are expressed as MAPR. The veteran receives the MAPR minus their countable annual income.
| Status | Annual MAPR | Monthly Equivalent |
|---|---|---|
| A&A, no dependents | $29,093 | $2,424.42 |
| A&A, 1 dependent | $34,488 | $2,874.00 |
| Each additional dependent | +$2,984 | +$248.67 |
| Two veterans married, both A&A | $46,143 | $3,845.25 |
For comparison, basic pension (without A&A or HB):
| Status | Annual MAPR |
|---|---|
| Basic, no dependents | $17,441 |
| Basic, 1 dependent | $22,839 |
Net worth limit: $163,699 (effective December 1, 2025 to November 30, 2026).
Source: VA.gov — Veterans Pension rates | 38 USC 1521(d) | 38 CFR 3.352(a)
Pension Housebound
An increased pension rate between basic pension and A&A for wartime veterans who are substantially confined to their home due to a permanent disability. Governed by 38 USC 1521(e) and 38 CFR 3.351(d).
Eligibility (meet one)
- Single permanent disability rated 100% PLUS additional disability or disabilities independently ratable at 60% or more
- Permanently housebound — "substantially confined to his or her dwelling and the immediate premises" due to disability that is "reasonably certain to persist throughout their lifetime"
Housebound vs. A&A Comparison
| Feature | Housebound | A&A |
|---|---|---|
| Rate (no deps) | $21,313/yr | $29,093/yr |
| Criteria | Confined to home OR 100%+60% | Needs help with ADLs, bedridden, nursing home, or blind |
| Can receive both? | No | No |
| Focus | Where you are (confined to home) | What you can do (functional limitations) |
Current Rates (Effective December 1, 2025)
| Status | Annual MAPR | Monthly Equivalent |
|---|---|---|
| Housebound, no dependents | $21,313 | $1,776.08 |
| Housebound, 1 dependent | $26,710 | $2,225.83 |
| Each additional dependent | +$2,984 | +$248.67 |
Source: VA.gov — Veterans Pension rates | 38 USC 1521(e) | 38 CFR 3.351(d)
Compensation A&A (SMC-L)
Special Monthly Compensation at the L level — a higher compensation rate that replaces the standard disability compensation rate. Unlike Pension A&A, SMC-L is for veterans with service-connected disabilities and is not income-based.
Pension A&A vs. Compensation A&A (SMC-L)
These are commonly conflated but are entirely different programs. Pension A&A is income-based and does not require service-connected disabilities. SMC-L requires service-connected disabilities and pays a flat rate regardless of income. The rates, eligibility rules, and governing statutes are all different.
Eligibility (any one of the following)
- Anatomical loss or loss of use of both feet
- Anatomical loss or loss of use of one hand and one foot
- Blindness in both eyes with visual acuity of 5/200 or less (concentric field contraction to 5 degrees or less is equivalent)
- Permanently bedridden due to service-connected disabilities
- So helpless as to be in need of regular aid and attendance due to service-connected disabilities (same 38 CFR 3.352(a) criteria as Pension A&A)
Key Differences from Pension A&A
| Feature | Pension A&A | SMC-L |
|---|---|---|
| Service connection | Not required | Required |
| Income-based | Yes — MAPR minus income | No — flat rate |
| Wartime service | Required | Not required |
| Rate (no deps) | $29,093/yr MAPR | $4,900.83/mo ($58,809.96/yr) |
| Form | 21-2680 | 21-2680 (same form) |
Current Rates (Effective December 1, 2025)
| Dependent Status | Monthly Rate |
|---|---|
| Veteran alone | $4,900.83 |
| With spouse (no children) | $5,120.42 |
| With spouse + 1 parent | $5,296.66 |
| With spouse + 2 parents | $5,472.90 |
| With 1 parent (no spouse) | $5,077.07 |
| With 2 parents (no spouse) | $5,253.31 |
| With 1 child (no spouse) | $5,047.68 |
| With 1 child + spouse | $5,281.24 |
- Additional child under 18: +$109.11/month
- Child over 18 in school: +$352.45/month
- Spouse receiving A&A: +$201.41/month
How SMC-L Is Awarded
- Often automatic: VA raters have a duty to consider SMC entitlement whenever evidence in the record suggests qualifying conditions
- VA Form 21-2680 may be required to establish the need for A&A
- SMC-L is not requested separately — it is part of the disability compensation claim and rating process
- SMC-K ($139.87/month) can be added on top of SMC-L for qualifying anatomical losses
Higher SMC Levels
SMC-L is the entry level. Veterans with more severe combinations can qualify for higher rates:
- SMC-L 1/2: $5,154.00/month (intermediate between L and M)
- SMC-M: $5,408.55/month (loss of both hands, both legs at knee, etc.)
- SMC-N through O/P: $6,152.64–$6,877.12/month
- SMC-R.1: $9,826.88/month (needs regular non-professional caregiver)
- SMC-R.2/T: $11,271.67/month (needs licensed healthcare professional daily)
Source: VA.gov — SMC rate table | 38 USC 1114(l) | 38 CFR 3.350(b)
Compensation Housebound (SMC-S)
Special Monthly Compensation at the S level — an increased compensation rate for veterans who are housebound due to service-connected disabilities or who have the "math" (100% + separate 60%+). Governed by 38 USC 1114(s) and 38 CFR 3.350(i).
Eligibility (two pathways)
Pathway 1 — The Math: A service-connected disability rated as total (100% schedular or TDIU) PLUS additional service-connected disabilities independently ratable at 60% or more, separately affecting different body systems.
Pathway 2 — Actual Confinement: Permanently housebound — "substantially confined to such veteran's house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability" expected to persist throughout the veteran's lifetime.
Key Points
- Pathway 1 is most common and is frequently granted automatically when the rating math works out
- TDIU counts as "total" for Pathway 1 — a veteran with TDIU based on one condition plus separate conditions combining to 60%+ qualifies
- The 60% must be for separate disabilities from the one(s) establishing the 100% or TDIU
- SMC-S is structured as the 100% rate plus a housebound differential
- A veteran cannot receive SMC-S and SMC-L simultaneously — if both are met, they receive whichever is higher
Current Rate (Effective December 1, 2025)
| Dependent Status | Monthly Rate |
|---|---|
| Veteran alone | $4,408.53 |
The SMC-S rate includes the 100% disability rate ($3,938.58 for veteran alone) plus the housebound differential. Dependent additions apply per standard rules.
Source: VA.gov — SMC rate table | 38 USC 1114(s)
Survivors A&A and Housebound
Surviving spouses and dependent parents receiving DIC or Survivors Pension can receive increased payments when they need the aid and attendance of another person or are housebound.
DIC with A&A or Housebound
For surviving spouses receiving Dependency and Indemnity Compensation (service-connected death). Governed by 38 USC 1311(c) (A&A) and 38 USC 1311(d) (housebound).
- DIC A&A eligibility: Surviving spouse is a patient in a nursing home, blind, or so nearly blind or significantly disabled as to need regular aid and attendance
- DIC Housebound eligibility: Surviving spouse is substantially confined to home by disability but does not qualify for A&A
DIC Rates (Effective December 1, 2025)
| Component | Monthly Amount |
|---|---|
| Base DIC (death on/after Jan 1, 1993) | $1,699.36 |
| A&A add-on | +$421.00 |
| Housebound add-on | +$197.22 |
| 8-year marriage add-on | +$360.85 |
| Per child under 18 | +$421.00 |
| Transitional benefit (first 2 years) | +$359.00 |
Parents' DIC A&A: Dependent parents receiving Parents' DIC can receive an A&A supplement of $458.00/month on top of their income-based Parents' DIC rate.
Survivors Pension with A&A or Housebound
For surviving spouses receiving Survivors Pension (wartime veteran, non-service-connected death, income-based). Same A&A/HB criteria as veteran pension. Governed by 38 USC 1541 and 38 CFR 3.351.
Survivors Pension Rates (Effective December 1, 2025)
| Status | Annual MAPR | Monthly Equivalent |
|---|---|---|
| Basic, no dependents | $11,699 | $974.92 |
| A&A, no dependents | $18,697 | $1,558.08 |
| Housebound, no dependents | $14,298 | $1,191.50 |
| Basic, 1 dependent child | $15,311 | $1,275.92 |
| A&A, 1 dependent child | $22,304 | $1,858.67 |
| Housebound, 1 dependent child | $17,902 | $1,491.83 |
| Each additional child | +$2,984 | +$248.67 |
| A&A (Spanish-American War), no dep | $19,453 | $1,621.08 |
Net worth limit: $163,699 (same as Veterans Pension).
How to Apply (Survivors)
- DIC with A&A/HB: File with VA and submit VA Form 21-2680
- Survivors Pension with A&A/HB: File VA Form 21P-534EZ (Application for DIC, Survivors Pension, and/or Accrued Benefits) plus VA Form 21-2680
- If in a nursing home or assisted living: also submit VA Form 21-0779
Source: VA.gov — DIC survivor rates | Survivors Pension rates | Parents' DIC rates
How to Apply
Pension A&A / Housebound
- If already receiving VA pension: file a claim for increased pension based on A&A
- If not yet receiving pension: apply for pension and A&A simultaneously using VA Form 21P-527EZ (Application for Pension)
- Submit VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) — this must be completed by a physician
- If in a nursing home or assisted living: also submit VA Form 21-0779 (Request for Nursing Home Information in Connection with Claim for Aid and Attendance)
- Submit relevant private medical records and treatment documentation
What Physicians Document on Form 21-2680
- The veteran's ability (or inability) to perform activities of daily living
- Whether the veteran is bedridden and why
- Diagnoses contributing to the need for assistance
- Whether the veteran can leave the home and under what circumstances
- Vision status if claiming A&A based on eyesight
Compensation A&A (SMC-L)
SMC-L is typically awarded automatically during the disability rating process when evidence suggests qualifying conditions. VA raters have a duty to consider SMC entitlement. VA Form 21-2680 may be submitted to support a claim.
Mailing address (Pension claims): Department of Veterans Affairs, Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365
Source: VA.gov — Aid & Attendance and Housebound | VA.gov — Evidence for A&A claims
Common Mistakes to Avoid
Conflating Pension A&A with SMC-L
These are different programs with different eligibility, rates, and statutes. Pension A&A is income-based for wartime veterans regardless of service connection. SMC-L requires service-connected disabilities and pays a flat rate. If your disabilities are service-connected, you likely need to pursue SMC-L through the disability compensation system — not Pension A&A.
Not submitting VA Form 21-2680
The 21-2680 is the physician's examination that documents your need for A&A or housebound status. Without it, VA has no medical evidence to evaluate your claim. Have your doctor complete this form thoroughly — vague or incomplete entries lead to denials.
Pension poaching scams
Criminals target elderly veterans by offering to "help" them qualify for Pension A&A. These schemes typically involve moving assets into trusts or annuity products to appear to meet the net worth limit. These arrangements can trigger penalty periods under the 3-year lookback rule, result in loss of assets, and lead to denial of pension claims. Apply directly through VA.gov or with an accredited representative — verify accreditation using the VA accreditation search tool. Never pay upfront fees for initial VA claims assistance.
Forms for This Topic
The official VA forms relevant to this page, in one place. Select a form to view, download, or add it to your report.
- VA Form 21-2680 — Examination for Housebound Status or Permanent Need for Regular Aid and AttendanceUse VA Form 21-2680 to apply for Aid and Attendance benefits that will be added to your monthly compensation or pension benefits.
- VA Form 21P-534EZ — Application for DIC, Survivors Pension, and/or Accrued BenefitsUse VA Form 21P-534EZ if you want to submit evidence along with your claim, using the Fully Developed Claim (FDC) program to get a decision on your claim faster.
- VA Form 21-0779 — Request for Nursing Home Information in Connection with Claim for Aid and AttendanceUse VA Form 21-0779 if you’re a resident of a nursing home and you're providing supporting information for your claim application for VA Aid and Attendance benefits.
- VA Form 21P-527EZ — Application for Veterans PensionUse VA Form 21P-527EZ if you’re a wartime Veteran and want to file a pension claim.