Most older Washingtonians want to stay in their own rowhouse or apartment. When a wartime veteran or surviving spouse needs steady hands-on help to do that, the cost of that help is often what opens the door to Aid and Attendance.
Here’s how the pension works with DC’s Medicaid home care and VA’s own programs.
Who qualifies, including edge cases
Three federal tests apply everywhere: service (90 days on active duty with one day in a wartime period, or 24 months for most later enlistees), character of discharge (anything but dishonorable) and money (net worth, meaning assets plus annual income, under $163,699, with gifts in the past 36 months reviewed)123. The fourth test, for home care, is medical: regular help with daily living or protection from hazards, shown on VA Form 21-268045. See the national Aid and Attendance guide.
How Aid and Attendance pays for home care
The 2026 maximums are $29,093 (veteran alone), $34,488 (veteran and spouse) and $18,697 (surviving spouse) per year89. Few people get the maximum: VA subtracts countable income first, and paying for home care is what shrinks that income.
Once a doctor documents the need, money spent on in-home help with personal care or supervision is deducted from income in VA’s math, whether you pay an agency or a person you hire yourself10. If the helper is a relative, put a signed agreement in place first, with the tasks, the hours and the rate, and pay by check or transfer so every payment leaves a record.
What aides earn in DC
Federal wage data show a median of $20.53 an hour for home health and personal care aides in the District in May 2025, higher than the $17.21 national median1112. That’s the aide’s wage; agencies add employer taxes, insurance and supervision on top.
For scale only: 20 hours a week at that wage is 20 × 52 × $20.53, about $21,351 a year before any agency markup11. Your claim should use what you really pay. Browse DC home care.
A DC worked example
Here is how the numbers work for A widowed Air Force veteran in Congress Heights, who has $25,000 a year in income and spends $21,351 a year on care and medical bills. VA ignores the first $872 of those costs (5% of the basic rate for a veteran alone)138, so $20,479 is deducted and countable income falls to $4,521. Subtracting that from the $29,093 ceiling leaves $24,572 a year, roughly $2,047 a month8. At $25,872 or more in yearly care costs, the full $29,093 is paid.
Medicaid home care in DC: the EPD Waiver
The District’s Elderly and Persons with Physical Disabilities (EPD) Waiver pays for services that help people stay at home instead of moving to a nursing home, including case management, personal care aides, adult day health, chore aides, respite, personal emergency response systems and home adaptations1415. Income up to $2,982 a month and resources up to $4,000 apply for one person in 2026, with spend-down for higher incomes16.
- Services My Way. EPD participants living in their own home can self-direct. The participant or an authorized representative becomes the employer of a Participant-Directed Worker who provides personal care, and can also request goods or services the plan doesn't otherwise cover14.
- Hiring a relative. Ask DHCF in writing which family members can be hired as the worker before anyone starts; rules for spouses and legally responsible relatives are stricter.
- Where to ask. Call the EPD Waiver line at 202-724-562615.
VA home care in DC
The Washington DC VA Medical Center at 50 Irving Street NW is the main VA site, with District clinics at 820 Chesapeake Street SE and a Community Resource and Referral Center at 1500 Franklin Street NE, plus clinics in nearby Maryland and Virginia17. If getting to Irving Street has become hard, ask VA about travel pay and about care closer to home. The Irving Street team can tell you whether your parent qualifies for Home Based Primary Care visits, a homemaker or home health aide, respite for the family, or Veteran-Directed Care, where VA funds a budget to hire your own helpers if the program has space18192021.
Mistakes to avoid
How to apply for home care in DC
- Start with an intent to file. Form 21-0966 (or a call to VA) sets the date benefits can be paid from, and gives you a year to finish2324.
- Collect the medical exam. Form 21-2680 from a doctor, or Form 21-0779 from a nursing home525.
- Send the application. 21P-527EZ (veteran) or 21P-534EZ (surviving spouse), with bank, income and care-cost records266.
- Call MOVA's District Veteran Service Officer. MOVA, at One Judiciary Square, 441 4th Street NW, handles pension claims for District residents; call 202-724-5454 to set up help2722.
- Track the care. Write down hours, tasks and payments each week.