Aid and Attendance STL
Subject
VA Aid and Attendance and help at home
As of
September 12, 2026
Status
Ask a VSO
An older man in a plaid shirt smiles at the camera in a bright room at home.
Exhibit A. Photo: Pexels.
  • Net worth limit$163,699
  • MAPR, A&A, no dependents$29,093 a year
  • Asset look-back3 years
  • Cost to file with a VSOFree

Benefit briefing, St. Louis metro

Dad served. Somebody at the post said the VA pays for help at home. Here is the file.

Aid and Attendance is real, and narrower than the pitch. Here are the three gates, the forms by number, the free filing doors in St. Louis, and what the pitch leaves out: a claim puts nobody in the house tonight.

Bottom line up front
  1. It is cash added to a VA pension, not a caregiver.
  2. An accredited VSO files it, and VA says that is always free.
  3. Help at home can start on private pay while the claim is pending.

Not affiliated with the U.S. Department of Veterans Affairs.

Section 01

Orders for tonight, before anyone signs anything

Six moves that cost nothing.

  1. Do not move money.VA reviews transfers in the 3 years before filing; penalties run up to 5 years.
  2. Find the discharge papers.Gate one is dates of service.
  3. Call a service officer.Missouri Veterans Commission, St. Louis County: (314) 421-8654.
  4. Protect the start date.An intent to file sets a potential effective date; an identity-verified online application sets it automatically.
  5. Book the exam page.Take a blank Form 21-2680 to his next appointment.
  6. Cover the hours separately.The claim is paperwork. The nights at home are another job.
A caregiver's hands pass a warm mug to an older person wrapped in a knit blanket.
Photo: New Plan Care Solutions.
Section 02

The three gates, in the order the file clears them

All three must clear. This desk grades no one's file; it shows where each line is printed.

Three gates in sequence 1 SERVICE 2 MEDICAL NEED 3 MONEY
  1. Gate 1

    Wartime service

    • Active duty before September 8, 1980: at least 90 days, with at least 1 day during wartime.
    • Enlisted after September 7, 1980: generally 24 months, with 1 day during wartime.
    • Korea: June 27, 1950 to January 31, 1955. Vietnam: November 1, 1955 (in country) or August 5, 1964 (elsewhere) to May 7, 1975.
    • No dishonorable discharge, plus age 65, a permanent and total disability, a nursing home stay, or SSDI or SSI.

    VA.gov, updated September 3, 2026

    The wartime dates brief

  2. Gate 2

    Need for aid

    • He needs another person for bathing, feeding and dressing, or
    • illness keeps him in bed much of the day, or a disability put him in a nursing home, or
    • eyesight of 5/200 or less in both eyes.
    • Housebound is the other add-on; never both at once.

    VA.gov, updated May 8, 2026

    Who fills out 21-2680

  3. Gate 3

    Income and net worth

    • Net worth limit $163,699 through November 30, 2026. The house, car and most furnishings do not count; a spouse's net worth does.
    • Payment is the gap between income for VA purposes and the MAPR.
    • Unreimbursed medical expenses may reduce income for VA purposes.

    VA.gov, updated December 18, 2025

    The net worth brief

Section 03

Briefing index: every read on this desk

Grouped the way a file gets built.

No.ReadWhat it settles
01 The three gates
1.1What is the difference between Aid and Attendance and Housebound, and can Dad get both?Two add-ons on a VA pension. You cannot receive both at the same time. The examining physician completes Form 21-2680. This desk does not decide need.
1.2Aid and Attendance eligibility wartime dates: the three gates Dad has to passService, need, and money, in that order, with the VA wartime period table linked rather than restated from memory.
1.3What is the VA Aid and Attendance income limit and net worth cap for this rate year?There is no secret income number besides MAPR versus countable income. Net worth is $163,699 this rate year. Look-back is three years. Do not move money tonight.
02 The forms
2.1VA Form 21-2680: who fills it out, and the other forms in the same stackThe examining physician attests on 21-2680. The pension application, survivors form, expense report, and intent to file sit next to it.
03 How long
3.1How long does Aid and Attendance take to get approved, and can care start before the check?VA processes claims in the order received unless a claim needs priority processing. The status tool is how you check. Care at home can start on private pay while the claim is pending.
04 Who files it free
4.1What does a Missouri Veterans Commission service officer actually do on an Aid and Attendance file?MVC's public page names Veterans Service Officers who provide counseling and assistance and who complete and submit claims. People search benefits counselor. This is the job, statewide.
4.2Does the St. Louis VA Regional Office on Page Avenue take a pension claim if I walk in?Page Avenue is a benefits office and one listed apply door. Health care is a different campus. Mail often goes to Janesville. A VSO is usually the first practical door.
4.3How do you file VA Aid and Attendance in Missouri without paying a consultant?Missouri Veterans Commission VSOs file pension claims at no charge. The three gates, the form stack, and MO HealthNet as a separate door.
4.4Dad lives in St. Charles County. Where do I file Aid and Attendance from here?The free St. Charles claim door, the county programs that are not his, and the VA offices that handle benefits and health care as separate jobs.
4.5Veteran service officer, St. Louis County: who files Aid and Attendance for freeThe free accredited doors by name, and the tells of a paid pitch.
05 Two VA doors
5.1Can VA Aid and Attendance pay a family member who is already doing the care?The pension is cash paid to the Veteran or surviving spouse. They decide how to spend it. Whether a relative's hours count as unreimbursed medical expenses is a VSO documentation question.
5.2Does Aid and Attendance cover non-medical home care? Pension vs the Homemaker Aide programTwo VA doors: a cash pension you spend on care you hire, and VA-arranged Homemaker and Home Health Aide hours.
5.3Is VA Home Based Primary Care in St. Louis the same thing as Aid and Attendance?Four VA doors that get mixed at the kitchen table: pension cash, Homemaker Aide hours, a home-based clinical team, and PCAFC. Nights are still an hours problem.
5.4If Dad already has VA compensation, is Aid and Attendance still a pension add-on?Form 21-2680 can sit on compensation or pension. This desk covers the pension add-on. Tell a VSO about the existing file before anyone files pension as the only door.
06 Survivors
6.1VA Aid and Attendance for a surviving spouse: home care on Dad's wartime serviceSurvivors Pension with Aid and Attendance, Form 21P-534EZ, evidence, and who files it in St. Louis.
07 Expenses
7.1How much does Aid and Attendance pay in 2026, and which MAPR row is Dad actually on?MAPR is an annual maximum on a VA pension, not a monthly flyer number. This desk quotes the Veteran with no dependents row and sends you to the VA table.
7.2What counts as unreimbursed medical expenses on a VA pension, and why paying for care can change the math38 CFR 3.278 on in-home attendant care, Form 21P-8416, and the net worth limit for the rate year.
08 Medicaid
8.1Can Dad get Aid and Attendance and Medicaid? The Missouri questions to ask before you applyMO HealthNet and VA pension are both needs-based. Order can matter. Take the questions to a VSO and an elder law attorney.

New to this? Start here walks the reads in order.

The service officer takes the paperwork. The hours at home still need someone.

It is not the VA and files no claims. It provides non-medical hours at home, on private pay.

A care planner talks through a plan with a family at a kitchen table.
Photo: New Plan Care Solutions

New Plan Care Solutions is independently owned and operated in St. Louis by Stacie Postol. Non-medical in-home support for St. Louis and St. Charles counties: personal care and daily routines, companionship, homemaking, respite for family caregivers, and help while recovering at home. Support can start with a few hours.

It is the only provider featured here, and the guides on this site are educational, not medical advice.

Call (314) 405-0887orvisit newplancare.com

Phone number is optional. We will contact you only in the way you request.

Goes straight to New Plan Care Solutions, not to a lead broker. See their privacy policy.

Section 04

Who to call in the St. Louis metro

As printed on each office's page, checked September 12, 2026. More on local help.

OfficeNumber or doorSource
Missouri Veterans Commission, St. Louis County(314) 421-8654MVC office list
MVC, St. Louis City(314) 421-8676MVC office list
MVC, St. Charles(314) 421-8622MVC office list
St. Louis VA Regional Benefit Office9700 Page Ave.VA.gov
VA benefits hotline800-827-1000VA.gov
VA Caregiver Support Line1-855-260-3274caregiver.va.gov
Aging Ahead caregiver program(636) 207-0847Aging Ahead
Missouri Adult Abuse and Neglect Hotline1-800-392-0210Missouri DHSS
Section 05

What help at home looks like while the VA decides

A caregiver and an older woman fold towels together at a bedroom table.
Photo: New Plan Care Solutions.

The pension, if granted, is paid to him to spend. Most families spend it on non-medical help at home. None of it is nursing.

  • A few hoursThe morning routine, a shower with someone nearby, lunch, laundry, the ride to the 21-2680 appointment.
  • OvernightSomeone awake in the house for the bathroom trips.
  • RespiteTime off for the family caregiver to work or sleep.

Care before the check. VA says it processes claims in the order it receives them unless a claim needs priority processing. Nobody has to wait. Keep every receipt for the service officer.

Section 06

The questions men actually ask

Does the VA send a caregiver, or does it send money?

Money. VA-arranged aide hours are a separate program, Homemaker and Home Health Aide care, started with a VA social worker.

Who fills out the 21-2680, me or his doctor?

A medical examiner fills out the examination section. You bring the form, not the findings.

A man offered to file it for a fee. Is that normal?

A VSO files free. If anyone says to move assets first, call a service officer before you call him back.

Mom is a widow. Can she get it on Dad's service?

A surviving spouse who has not remarried may be eligible for Survivors Pension on Form 21P-534EZ, with an Aid and Attendance rate. The survivors brief

How long until the first check comes?

VA prints no month count. Protect the start date, then follow the file with VA's claim status tool.

VA.gov and Missouri pages read September 12, 2026. Every source: sources.