Aid and Attendance is a federal add-on payment layered onto an eligible veteran's or survivor's VA pension, according to the U.S. Department of Veterans Affairs. Eligibility can be established several ways: needing help with everyday activities, being bedridden, residing in a nursing home because of a disability-related loss of function, or meeting the VA's specific visual-impairment standard. Someone applying from within a nursing home also needs to submit VA Form 21-0779 alongside the rest of the claim.
It's important to keep VA eligibility and Iowa Medicaid eligibility in separate mental buckets, because Iowa treats Aid and Attendance differently than income for Medicaid purposes. Iowa's Medicaid income manual classifies the payment as a third-party medical payment rather than countable income. But when it's paying for the same nursing-facility or in-home health-related need Medicaid is also covering, Iowa folds it into the client-participation calculation — it isn't set aside or diverted to help a community spouse.
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