A home care quote only means something next to the other place Dad would be paid for. The VA award is a fixed monthly amount tied to the tier it is paid under, so it does not move when an aide's rate goes up. The family's gap is the difference between the award and the full monthly bill, and the benchmark is the bill for the setting you would otherwise choose.[1]
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Write the task list first
Before you compare any two numbers, write down what Dad needs each day and each night in plain terms: hours of hands-on help, how many times he needs someone to get up, whether anyone must be present overnight, and what household work is involved. Both prices have to be quoted against that same list. A facility quote for a level of care Dad does not need, or a home quote for fewer hours than he actually uses, tells you nothing.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
Read the facility bill as a list of lines
Ask for a written, itemized monthly statement, not a brochure rate. Check for the base room or unit charge, meals, the level-of-care assessment and what each level costs, any move-in or community fee, deposits and whether they are refundable, charges for a second person, incontinence supplies, transportation, and any separately billed charges for medication handling. Ask what happens at the next reassessment. A first-month number is often not the typical month.
Read the home bill the same way
Ask the agency how it counts hours, whether there is a minimum shift, what the overnight and holiday rates are, how travel time is billed, what happens on the aide's days off, and whether supplies or equipment are added. Ask for the total for a typical week and a typical month, written out against your task list. Use the agency's own paperwork, not a verbal estimate.
Put both into one monthly figure
Turn each option into one number: the full monthly cost, plus any one-time costs spread across twelve months. Then set that figure against the monthly VA amount, if the claim is granted, and against the family's own money. Keep the pending claim separate. The award is not paid until it is granted, so compare the bill against the private-pay months you expect to cover, not against a check you do not yet have.
What the benchmark does not settle
A lower monthly bill is not automatically the better choice. The number does not show whether a setting can meet Dad's needs as they grow, whether the family can stay in the home, or whether the exit terms are fair. The benchmark also does not decide eligibility. VA sets the aid and attendance rules, and the amount can differ by where the veteran lives, so confirm the rate that applies to the setting Dad will actually use.[2]
Where to check the numbers
Confirm the current rate tables and setting rules on VA.gov under the Veterans Pension and Aid and Attendance benefit pages.[1][2] The filing forms are VA Form 21P-527EZ for pension and VA Form 21-2680 for the medical exam. For free local help with the paperwork, see Local Help: St. Louis Offices. For the source list behind these claims, see Sources.
[1] VA.gov, Veterans Pension benefits. [2] VA.gov, Aid and Attendance and Housebound benefits.
This briefing is general information, not legal, medical, or financial advice. This site is not affiliated with the U.S. Department of Veterans Affairs.