ALW guide
VA Aid and Attendance and ALW: can you use both?
Aid and Attendance is a monthly addition to a VA pension. ALW is Medi-Cal paying an assisted-living home for care. They come from different agencies; the county decides how VA money counts for Medi-Cal.
They are different things from different agencies. Aid and Attendance is a monthly amount the U.S. Department of Veterans Affairs (VA) adds to a VA pension for a veteran or survivor who needs help with daily activities. The Assisted Living Waiver (ALW) is Medi-Cal paying an assisted-living home for care. Whether VA money affects the Medi-Cal that ALW needs is the county's decision, so ask before counting on both. Beta ALW can tell you what to ask.
Important: The VA decides Aid and Attendance. The county decides Medi-Cal, and it decides how any income, including a VA payment, counts. The California Department of Health Care Services (DHCS) decides ALW eligibility after a nurse assessment. Beta's ALW team cannot promise any of the three, and this page states no dollar amounts; the VA publishes its rates and the county applies Medi-Cal's rules to the person's own income.
What each one is
| Question | VA Aid and Attendance | ALW |
|---|---|---|
| Who runs it | The U.S. Department of Veterans Affairs. | DHCS, through Medi-Cal. |
| What it is | Monthly payments added to a VA pension. | Medi-Cal paying a licensed assisted-living home for care, plus care coordination. The resident pays room and board. |
| Who may get it | A person who gets a VA pension and meets at least one of the VA's conditions, among them needing another person's help with daily activities such as bathing, feeding and dressing, or being a patient in a nursing home because of a disability. | Adults 21 or older with full-scope Medi-Cal and no monthly share of cost, who need the level of care a nursing home gives and can live safely in an assisted-living home in an ALW county. |
| What it pays for | The VA adds the amount to the pension; the family decides what it goes toward, often the assisted-living fee. | The home's care, by care tier, and the Care Coordination Agency's work. Never room and board. |
| Where to apply | Online with the VA, by mail with VA Form 21-2680 (a medical examiner fills in the examination section; VA Form 21-0779 is added for a nursing home patient), or at a VA regional office. A county Veterans Service Officer helps at no cost. | Through a Care Coordination Agency, the state-listed organization that sends the waitlist request to DHCS. Beta is one. |
The VA also pays a Housebound allowance to a pensioner who spends most of the time at home because of a permanent disability. The VA says a person cannot get Aid and Attendance and Housebound at the same time. The VA's page on both.
Can you use both?
Nothing on the VA's page or DHCS's ALW pages says a person cannot hold a VA pension with Aid and Attendance and be enrolled in ALW. The question is the Medi-Cal in between. ALW needs full-scope Medi-Cal with no monthly share of cost, and the county decides Medi-Cal by looking at the person's income and assets. A VA payment is income the county will ask about. How the county treats it is the county's decision, and this page does not state that rule. Ask the county eligibility worker, in writing, how the VA payment will be counted, and keep the answer with the Medi-Cal notice. The 2026 income and asset limits, and what counts.
Where VA money fits under ALW
ALW never pays room and board, the room and the meals. The resident pays that from income. A veteran or survivor whose pension includes Aid and Attendance may put it toward room and board, as long as the county has counted it for Medi-Cal and the person still has the Medi-Cal that ALW needs. What ALW pays, and what you pay. Other ways to pay for assisted living in California.
Veterans on hospice
Beta's hospice side has its own page for veterans and their families: Veterans at betahospice.com. It is a separate service line; ALW care coordination and hospice are coordinated, never combined. How hospice and ALW work together.
What people ask
Does Aid and Attendance stop someone from getting ALW?
Not by itself. ALW's six requirements say nothing about VA benefits. What matters is whether the person has full-scope Medi-Cal with no monthly share of cost after the county counts the VA payment as income. The county decides that.
Does ALW pay room and board for a veteran?
No. ALW never pays room and board, for anyone. The resident pays it from income, which for a veteran or survivor may include the VA pension and Aid and Attendance.
Who helps with the VA claim?
The VA takes the application online, by mail or at a regional office, and a county Veterans Service Officer helps with the claim at no cost. Beta's ALW team does not file VA claims; it can tell you what the ALW side needs while the VA claim is in.
About this informationReviewed October 26, 2026. Program details may change. View official sources and page limitations.
Written by Beta's ALW team and reviewed by Sergio B., Program Coordinator, against the official sources this page lists; facts checked through October 26, 2026. Where this page and an official source differ, the source controls.
This page gives general California ALW information. DHCS decides eligibility after the nurse assessment and releases openings. Each home decides its own admissions. Nothing here is an eligibility decision or a promise of enrollment, and it does not guarantee a place in a home. You may choose any Care Coordination Agency listed by DHCS and any participating home.
Something out of date? Tell Beta's ALW team.