What VA Aid & Attendance Actually Covers

Aid & Attendance is money, not a care plan

The single most useful thing to understand about Aid & Attendance is that it is not a separate benefit program with its own approved provider list. It's an add-on to a VA pension. If a veteran or a surviving spouse qualifies for pension and also needs regular assistance with everyday tasks, the monthly pension amount goes up.

That money is deposited to the beneficiary. Nobody sends an invoice to the VA. There is no network, no prior authorization, and no VA case manager approving your choice of caregiver. The family decides where the money goes.

This is why the benefit is genuinely useful for non-medical home care. Medicare doesn't pay for someone to help your father shower, cook his meals, and drive him to Lahey. Aid & Attendance can — indirectly, by increasing the household income he uses to pay for it.

What families in Massachusetts actually spend it on

Because the payment is unrestricted cash, there's no official list. But in practice, families in Greater Boston and MetroWest use it for the same handful of things:

• Personal care at home — bathing, dressing, toileting, transfers, help getting safely in and out of bed.
• Companion care and supervision — meals, laundry, light housekeeping, medication reminders, and someone in the house so a parent isn't alone all day.
• Alzheimer's and dementia care — trained caregivers for wandering, sundowning, repetition, and the exhaustion that lands on the spouse who's been doing it alone.
• Overnight coverage so an adult child can sleep, or so a spouse in her eighties isn't the one getting up at 3 a.m.
• Non-medical transportation to appointments, dialysis, adult day programs, church, or the grocery store — including the part most services skip, which is help to the door and back.
• Assisted living or facility costs, when home is no longer realistic.

What it does not cover

Aid & Attendance is not health insurance. It doesn't pay for skilled nursing, wound care, injections, physical therapy, or anything else clinical. Neither do we — Westmark is a non-medical agency, and if your parent needs a nurse, that's a different provider and usually a different funding source.

It also isn't retroactive to whenever you started paying out of pocket. Claims are dated, they take time to process, and the timing matters. If you're six months into paying privately and only now hearing about this benefit, get the claim started before you research anything else.

And a caution worth saying plainly: no legitimate agency can promise you an amount. Rates are adjusted annually and depend on the beneficiary's household, income, and unreimbursed medical expenses. Anyone quoting you a confident monthly number without looking at the current VA tables is guessing.

Who decides eligibility — and it isn't us

Westmark Home Care does not determine eligibility and does not file VA claims. We're a home care company. We're not VA-accredited, we don't interpret the regulations, and we're not going to tell you whether your mother's service period or net worth qualifies. Anyone in this industry who tells you otherwise is stepping outside their lane.

Here's who can actually help, at no cost:

• Your city or town Veterans' Service Officer. Massachusetts municipalities have them, and they know both the federal benefit and the state programs. Billerica, Woburn, Framingham, Quincy — call the town hall and ask for the VSO.
• A VA-accredited representative, agent, or attorney, or an accredited service organization such as the DAV, VFW, or American Legion.
• The VA directly, including its published pension and Aid & Attendance rate tables, which are updated each year. That's the only rate source worth trusting.
• A Massachusetts elder law attorney, particularly if there are asset transfers, a house, or a spouse still living at home in the picture.

How to keep care going while a claim is pending

This is the practical problem most families call us about at 11 p.m. The benefit may eventually help. It doesn't help this week.

A few things that make the gap manageable. Start with the level of care your parent needs right now, not the level you're afraid of. Many families begin with two or three visits a week for bathing and errands rather than daily coverage. Our rates are flat and published — companion, personal, dementia, overnight, and 24-hour care all have posted hourly or daily prices, with no deposits, no enrollment fees, and no long-term contract. Visits have a six-hour standard minimum; transportation has none and is quoted per trip.

If the call is coming right after a hospital or rehab discharge, ask about the 4-hour post-discharge block at $44/hour. Those first two weeks home are when falls and readmissions happen, and a shorter block is often enough to cover mornings.

We also give 48 hours' notice as the standard for changing or canceling a visit — which cuts both ways. If money is tight one month, you can scale back without penalty.

What Westmark can do for a VA claim

We can't file it. We can document it. Care expenses matter in these claims, and the person preparing the paperwork will need clean records.

On request, we'll provide a written service agreement stating the care being delivered, the hourly rate, and the schedule, plus itemized monthly statements showing dates, hours, and services. If your VSO or accredited representative needs something in a particular format, have them tell us what they need.

Our caregivers are insured, bonded, and background-checked. Every one passes a CORI criminal background check, reference verification, an in-person interview, and a skills evaluation. Massachusetts does not license non-medical home care agencies, so screening is the real differentiator — ask any agency you're considering exactly what theirs includes.

More detail on how we work with veteran families is on our veterans page. If you want a free in-home assessment with no obligation, request one here or call (508) 233-8062. A real person answers, including at night.

Common questions