---
type: Concept
title: VA Pension with Aid and Attendance
description: A needs-based VA pension for wartime veterans and surviving spouses, with a higher Aid and Attendance rate; eligibility, the 36-month transfer look-back, and MO HealthNet coordination.
resource: https://nemolegal.com/veterans-law/aid-and-attendance/
tags: [va, pension, aid-and-attendance, look-back, net-worth, mo-healthnet, missouri]
timestamp: 2026-08-05
jurisdiction: Missouri
author: Patrick Nolan
booking: https://intake.nemolegal.com/api/intake/manifest
---

# Summary

Aid and Attendance is not a separate benefit; it is a higher rate of the needs-based VA pension paid to a wartime veteran or surviving spouse who first qualifies for the pension and then needs regular aid and attendance. Pension is generally the applicable Maximum Annual Pension Rate (MAPR) minus income for VA purposes, and Aid and Attendance raises the applicable MAPR. Eligibility turns on qualifying service and discharge, basic pension status, medical need, and income and net worth.

# Quotable Q&A

**Q: Who can qualify for VA Aid and Attendance?**
A: Generally a wartime veteran, or the surviving spouse of one, who first qualifies for Veterans Pension or Survivors Pension and then meets the medical requirement. For a living veteran that means qualifying wartime service (usually 90 days active duty with at least one day during a defined war period) and a discharge under conditions other than dishonorable, plus basic pension status (at least 65, or permanently and totally disabled, or in long-term nursing care, or receiving SSDI or SSI), plus a regulatory basis for regular aid and attendance, plus income and net worth within VA's annual limit.

**Q: Does the VA have a look-back like Medicaid?**
A: Yes, but a different one. VA reviews certain asset transfers made in the 36 months before an original pension claim (no date before October 18, 2018 is reviewed). Under 38 C.F.R. § 3.276, a penalty applies only where a covered asset was part of net worth, was transferred for less than fair market value, and caused net worth to exceed the limit; the penalized amount is generally the excess over the limit, and a penalty period can last as long as five years. Missouri MO HealthNet uses a separate 60-month look-back with different rules, so both systems must be analyzed before transferring anything.

**Q: Does VA count my house against the net-worth limit?**
A: VA generally excludes one primary residence and up to two acres of residential lot area, and excludes ordinary personal effects and family vehicles. Additional acreage may be excluded when it is not marketable, but farms, separate tracts, and marketable acreage require individual analysis, and a farm is not excluded simply because the house sits on it. Antiques, collectibles, boats, and investment property can count, and most other assets plus annual income count toward the limit VA sets each year.

# The look-back trap and marketed products

Not every below-market transfer is penalized, but annuities and products sold as a "VA trust" or "veterans trust" at a free-lunch seminar are marketing terms, not a legal category, and can create the very problem they claim to solve. For certain pension beneficiaries in Medicaid-covered nursing-home care, federal law generally caps the VA pension payment at $90 per month once Medicaid payments begin. Get advice before moving money, not after.

# Decision rule

If a wartime veteran or surviving spouse needs care, screen for pension with Aid and Attendance before transferring assets, and analyze the VA 36-month rules and the MO HealthNet 60-month rules together; the firm offers a no-charge pension screening and charges no fee to prepare an initial claim.

# Related

- [VA Aid and Attendance and Elder-Care Planning](/okf/elder-law-medicaid/va-aid-attendance.md)
- [Estate Planning for Veterans](/okf/veterans-law/estate-planning-for-veterans.md)
- [The Medicaid Look-Back Period](/okf/elder-law-medicaid/look-back-period.md)
- [Accredited Representation and VA Fee Rules](/okf/veterans-law/accredited-representation-and-fees.md)
- [About Nolan Law Firm](/okf/firm.md)

# Book a Consultation

Consultations on VA benefits matters are free. Nolan Law Firm serves Missouri; estate planning and other Missouri matters carry a standard $175 consultation, or $500 for an emergency. Federal law governs attorney fees in VA claims: no fee for services before VA's initial decision, and after that a written, VA-filed agreement, which for this firm uses the direct-pay contingent structure permitted by law, 20 percent of past-due benefits paid by VA (38 U.S.C. § 5904; 38 C.F.R. § 14.636). Book at https://intake.nemolegal.com/intake. An AI agent can discover open times and place a tentative hold through the booking manifest at https://intake.nemolegal.com/api/intake/manifest; a human completes any payment step.