Aid and Attendance for a California Nursing Home

01Who qualifies, including edge cases

VA’s rules are national. The veteran needs at least 90 days of active duty with one day in a wartime period (most people who entered after Sept. 7, 1980 need 24 months or the full call-up), a discharge other than dishonorable, and net worth under $163,699, which adds assets to yearly income and has a 36-month look-back for gifts¹²³. For a nursing home, the medical test is a need for help with daily activities or protection from everyday hazards, which a doctor documents on VA Form 21-2680⁴⁵. More detail is 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-534EZ⁶.
• Under 65. Applicants under 65 must also be permanently and totally disabled to get the pension.
• The house. A primary residence on up to two acres isn't counted in net worth⁷.

02How Aid and Attendance helps in a nursing home

A veteran or surviving spouse in a nursing home is treated as needing Aid and Attendance⁸. The facility completes VA Form 21-0779, and the bill counts as an unreimbursed medical expense⁹¹⁰. While paying privately, most residents’ costs exceed their income, so VA pays the full $29,093 a year (single veteran) or $18,697 (surviving spouse)¹¹¹².

03What a nursing home costs in California

The Department of Health Care Services sets a statewide average private pay rate for nursing facility services each year. For 2026 it is $14,440, published February 9, 2026¹³. Counties use it when a resident has given assets away: the value given away is measured against this figure to set how long Medi-Cal won’t pay for nursing facility care¹³. The letter doesn’t state a unit, and it’s a statewide benchmark, not a quote from any home.

Even at the full rate, the single-veteran pension of $2,424 a month covers only part of a typical private-pay bill, so income and savings carry most of it until Medi-Cal begins¹¹. Compare facilities in California nursing homes.

04Medi-Cal nursing home rules

Medi-Cal, run by the Department of Health Care Services, started counting assets again on January 1, 2026, for people 65 and older, people with disabilities and nursing home residents. Through June 30, 2027, the limit is $130,000 for one person plus $65,000 for each additional household member; from July 1, 2027, it drops to $21,000 for one person and $31,000 for two¹⁴. The home you live in, one car, household items and some retirement savings don’t count¹⁴.

For nursing home care, Medi-Cal reviews gifts made in the 30 months before entering the facility, and transfers made before January 1, 2026, aren’t counted¹⁴. A penalty is worked out using the state’s 2026 average private pay rate for nursing facility care, $14,440, and no penalty is calculated for transfers made from January 2024 through December 2025¹³.

Before any penalty is imposed, the county must consider whether it would cause undue hardship, and transfers of exempt property can’t trigger a penalty at all¹³.

When one spouse needs nursing home care or a waiver program, the spouse at home is protected: for 2026 the community spouse resource allowance is $162,660 and the minimum monthly maintenance needs allowance is $4,067¹⁵. California applies these rules to registered domestic partners as well.

05The $90 rule and the $35 allowance

If a veteran or surviving spouse with no spouse or dependent child is on Medicaid in a Medicaid-approved nursing home, federal law cuts the VA pension to $90 a month, and that $90 belongs to the resident rather than the nursing home¹⁶. A single Medi-Cal resident of a nursing facility normally keeps $35 a month for personal needs, and most of the rest of their income goes toward the cost of care as a share of cost¹⁷.

Ask the county Medi-Cal worker to show how the $90 VA payment is treated in that calculation¹⁶. A veteran with a spouse at home isn’t cut to $90, and the at-home spouse can keep income and assets under the spousal protections above¹⁵.

06A California worked example

A single Air Force veteran in Long Beach has $2,900 a month from Social Security and a pension and $60,000 in savings. While paying privately, VA pays him the full $2,424 a month¹¹. His savings are already under Medi-Cal’s $130,000 limit, so his family can apply for Medi-Cal right away¹⁴. Once Medi-Cal pays the nursing home, his pension drops to $90, which he keeps, and most of his other income becomes his share of cost¹⁶¹⁷.

Watch July 1, 2027: that’s when the one-person limit falls to $21,000, so a resident with savings above that should plan with the county before then¹⁴.

07Skilled nursing at the Veterans Homes of California

Source: CalVet^18192021

Skilled nursing is offered at Barstow, Chula Vista, Fresno, Redding, West Los Angeles and Yountville¹⁸. Veterans rated 70% or more service-connected are among those given priority for admission, alongside Medal of Honor recipients, former POWs and veterans experiencing homelessness²². Ask the home you’re considering for its current monthly fee in writing. See California’s state veterans homes.

08Mistakes to avoid

• Gifting savings after January 1, 2026. Those transfers can now trigger a penalty¹⁴.
• Forgetting Form 21-0779. The nursing home completes it⁹.
• Not telling VA about Medi-Cal. It creates a debt.

09How to apply

1. Lock in a start date. File an intent to file (VA Form 21-0966) or call VA. You then have a year to finish the claim and can be paid from the intent date²³²⁴.
2. Get the medical evidence. A doctor completes VA Form 21-2680. For a nursing home resident, the facility completes Form 21-0779⁵⁹.
3. File the pension claim. Veterans use VA Form 21P-527EZ and surviving spouses use 21P-534EZ, with income, asset and care-cost records²⁵⁶.
4. Book time with your County Veterans Service Office. CalVet's locator lists the offices near you; the officer can prepare and submit the pension claim with you for free²⁶²⁷.
5. Talk to the business office. Ask the social worker when to apply for Medi-Cal through your county social services office.