Home care in Tennessee costs less per hour than the national average, which means Aid and Attendance can stretch further here.
This page shows how the pension and TennCare CHOICES work together for a veteran at home.
What home care costs in Tennessee
The Bureau of Labor Statistics put Tennessee’s median aide wage at $15.45 an hour in May 2025, against $17.21 nationally12. That’s the worker’s pay, not an agency rate. At the wage alone, 25 hours a week comes to about $20,085 a year before agency overhead. Compare that with the $29,093 single-veteran ceiling3. Find agencies in Tennessee home care.
2026 Aid and Attendance rates
These are the national ceilings VA set for December 1, 2025 onward. They’re the same in every state; what you actually receive is the ceiling minus your countable income34.
| Household | Basic pension | With Housebound | With Aid and Attendance |
|---|---|---|---|
| Veteran, no dependents | $17,441 | $21,313 | $29,093 |
| Veteran with a spouse or child | $22,839 | $26,710 | $34,488 |
| Surviving spouse, no dependents | $11,699 | $14,298 | $18,697 |
These are yearly ceilings, not what everyone gets. VA subtracts your countable income from the ceiling and pays the difference in monthly installments.
Source: VA pension rate tables35, 2.8% cost-of-living increase effective December 1, 2025.
How aide bills raise the pension
Payments to an agency or a hired caregiver count as medical expenses when the person needs help with daily activities6. Keep invoices, or a written agreement and pay records for a private caregiver.
A Vietnam veteran in Cookeville who lives alone has $21,600 a year of income and expects $24,600 a year in care and other unreimbursed medical costs. VA subtracts only the part of those costs above 5% of the basic rate, which is $872 for this household in 20264. So countable income is $21,600 − ($24,600 − $872) = $0. The yearly pension is the $29,093 ceiling minus $0, which is $29,093, or about $2,424 a month35. Because the care costs wipe out all countable income, the full ceiling is paid. His aide bill tops his income, so he receives the full single-veteran ceiling, about $2,424 a month.
TennCare CHOICES at home
CHOICES Group 2 serves people 65 and older, and adults 21 and older with physical disabilities, who qualify for nursing home care but choose home care instead. Group 3 serves people at risk of needing nursing home care, though non-SSI enrollment is capped (3,750 as of July 1, 2025)7. Services include personal care visits of up to 2,580 hours a year, adult day care of up to 2,080 hours a year, in-home respite of up to 216 hours a year and inpatient respite of up to nine days a year8.
Consumer direction
In consumer direction, the member becomes the employer and can hire, train and schedule workers, including family members, friends or neighbors, though there may be some limits. Consumer Direct Care Network Tennessee is the fiscal employer agent7. Companion care, a live-in helper, is available only to some Group 2 members in consumer direction8.
VA programs at home
VA Tennessee Valley and VA Mountain Home both provide home-based primary care, medical foster home support, and hospice and palliative care; VA Memphis supports medical foster homes too91011. Ask about Homemaker and Home Health Aide care and Veteran-Directed Care, which come through VA health care rather than the pension1213.
Who qualifies, including edge cases
The veteran needs 90 days of active duty with at least one day in a wartime period (24 months or the full call-up period for most people who entered after Sept. 7, 1980), a discharge other than dishonorable, and net worth under $163,699, counting assets plus yearly income, with a 36-month look-back on transfers1415163. For home care, the medical test is needing another person’s help with daily activities, being bedridden, needing protection from everyday hazards, or living in a nursing home because of incapacity1718. The full rules are in our national Aid and Attendance guide.
- Surviving spouses. A wartime veteran's surviving spouse can qualify on their own care needs, using VA Form 21P-534EZ19.
- Under 65. A claimant under 65 must also be permanently and totally disabled20.
- The home. A primary residence on up to two acres is left out of net worth21.
- Housebound instead. A veteran mostly confined to home who doesn't need daily help may get the lower Housebound rate; see Housebound vs. A&A.
TennCare rules at home
TennCare CHOICES pays for nursing home care (Group 1) and for home and community services for people 65 and older, or adults 21 and older with physical disabilities, who qualify for nursing home care but choose to stay in the community (Group 2). In 2026, income can’t exceed $2,982 a month, countable resources can’t exceed $2,000 (the home you live in doesn’t count), and transfers in the last five years are reviewed. People over the income limit may set up a Qualifying Income Trust722. VA’s $90 pension limit doesn’t apply to people getting home and community-based services23.
Mistakes to avoid
How to apply
- Have the doctor complete VA Form 21-2680. Or, for a nursing home resident, ask the business office for Form 21-07792425.
- File the pension claim. Veterans use VA Form 21P-527EZ and surviving spouses use 21P-534EZ, with income, asset and care-cost records2619.
- Lock in the start date. An intent to file (VA Form 21-0966) holds your effective date for a year while you gather papers2728.
- Add caregiver records. Agency invoices or a signed caregiver agreement and pay records.
- Call 1-866-836-6678. Your Area Agency on Aging and Disability starts CHOICES7.
- Work with a TDVS service officer. Free29.
More for Tennessee families: Aid and Attendance in Tennessee, Tennessee State Veterans’ Homes, VA senior care in Tennessee and disabled veteran property tax relief.