VA Long Term Care Benefits
Veterans can receive long-term care at home or through community-based programs through the Department of Veterans Affairs. The VA covers some long-term care costs for veterans enrolled in VA Health care if it determines such care is medically necessary. The types of long-term care you qualify for will vary based on how close you are to services, your disability status, and your individual needs and preferences.
- Veterans can receive a variety of long-term care benefits from the VA, including nursing home care, assisted living, and home health services.
- Eligibility for VA long-term care benefits depends on factors such as service-connected disabilities, income level, and current medical needs.
- The VA offers several programs to support veterans’ long-term care, such as the Aid and Attendance benefit and the Housebound benefit.
- Veterans and their families can explore different VA long-term care options by contacting a VA social worker or visiting their local VA medical center.
- Long-term care benefits from the VA aim to provide veterans with the necessary support to maintain their quality of life and independence.
Veterans may qualify for long-term care assistance through the VA if they need skilled nursing care or assistance with daily needs. It is not necessary to have a service-connected disability to qualify, but having a service-connected disability can increase VA coverage for your care. To qualify for this VA benefit program, you must be enrolled in VA health care and complete an application for long-term care.
Types of VA Long-Term Care Benefits
VA long-term care is available in your home and numerous community-based settings. The VA will determine where you receive care based on the community settings available near your home, your preferences, and your needs.
Community-Based Services
Community-based long-term care services are services you receive outside your home, including the following:
- Community Living Centers – These are skilled nursing facilities the VA owns. There are over 100 Community Living Centers in the United States.
- State Veterans Homes – These are skilled nursing facilities owned by state governments and certified by the VA. Every state has at least one, and some have several.
- Community nursing homes – These are private nursing homes that contract with the VA. Most communities in the United States have multiple community nursing homes.
- Adult Day Health Care – These are supervised facilities veterans can go to during the day for socialization and activities, often in conjunction with other long-term care options. Adult Day Health Care facilities are located within State Veterans Homes, VA medical centers, and community organizations.
- Nursing home respite care – These short-term nursing home stays aim to relieve family caregivers when they need a multi-day break, such as for out-of-town trips.
Home-Based Services
Long-term home-based services are available to veterans who need skilled care but prefer to stay in their homes or do not live near community-based facilities. The VA provides the following home-based services to veterans:
- Skilled home health care
- In-home respite care for families who need a break for a few hours
- Homemaker Home Health Aide Care for veterans who need help with activities of daily living
- Home-Based Primary Care for veterans who cannot easily get to the doctor due to the severity of their health conditions or isolation
- Palliative care for veterans who require comfort measures in addition to medical treatment
- Hospice care for veterans with terminal illnesses and a life expectancy of six months or less who no longer receive curative treatment but require comfort measures
VA Long-Term Care Eligibility Requirements
You may qualify for VA health care if you meet all the following criteria:
- You have signed up for the VA’s standard benefits package, also known as VA health care.
- The VA determines you need a specific long-term care service.
- The service is available near you.
Your specific circumstances will determine the types of care for which you qualify. If you need skilled nursing care, you may qualify for residential care in a Community Living Center, State Veterans Home, or community nursing home that has a contract with the VA. However, the VA may provide home-based skilled nursing care if you do not live near such a facility or want to receive care at home.
Does the VA Provide Long-Term Care to Spouses or Dependent Children?
All VA health care, including long-term care, is only available to veterans. Family members may be eligible for TRICARE or CHAMPVA, but these programs generally do not cover long-term care.
100 Percent VA Disability Rating and Long-Term Care
A 100 percent disability rating provides access to long-term care benefits without copays or deductibles. Thus, most veterans with a service-connected condition are eligible for long-term care benefits for their service-connected and non-service-connected illnesses. Even if you have a 0 percent rating, you can still receive long-term care coverage without copays for that condition as long as the VA acknowledges the condition is service-connected.
Do I Have to Pay for VA Long-Term Care?
The VA bears most of the cost of eligible long-term care services. You may be required to pay a copay for services. However, you may be able to access long-term care without a copay if you have any of the following:
- A compensable service-connected disability
- Limited income
- A service-connected disability rated at least 0 percent when that condition is the reason for your long-term care
- A residential care stay that began on or before November 30, 1999
- A condition caused by herbicide exposure in Vietnam that requires care
- A condition caused by radiation exposure that requires care
- Service during the Persian Gulf War
- Post-Persian Gulf War combat service
- A condition requiring care due to sexual trauma
- Cancer affecting the head or neck
How Much Are the VA Long-Term Care Copays?
There are no copays for the first 21 days of care during any 12-month period. If the VA requires you to pay copays, they will begin on the 22nd day of service. The copay is assessed for each day or half-day of service in residential facilities, except the discharge date. As of 2024, the maximum copay rates vary based on the type of care you receive, as follows:
- Adult day health care – Up to $15
- Institutional respite care – Up to $97
- Non-institutional respite care – Up to $15
- Nursing home care – Up to $97
- Hospice care – $0
The VA will calculate your copays based on your income. The amounts listed above are the maximum rates, so the amount you pay could be significantly lower. Additionally, if you receive coverage for long-term care through other forms of insurance, such as private insurance or Medicaid, the VA will bill those carriers for care related to non-service-connected conditions. If the VA receives insurance payments, your copays may be reduced.
The VA does not pay for the cost of room and board in non-medical facilities, such as assisted living facilities. However, it may cover the cost of some services at such facilities.
Financial Aid Options
You may qualify for a VA pension if you served during wartime and have limited resources. If your income is low enough to qualify for this program, you will also meet the criteria for long-term care without copays.
VA Pension
To qualify for a VA Pension, you cannot have income that exceeds the Maximum Annual Pension Rate, or MAPR, and your net worth must be lower than the limit set by Congress. The MAPR varies based on the number of dependents you have and whether you need assistance with activities of daily living or are housebound. These amounts are adjusted annually for inflation. The 2024 net worth limit is $155,356, and the 2024 MAPR is as follows:
- Single veteran with no dependents – $16,551
- Veteran with a spouse or child – $21,674
The MAPR increases by $2,831 for each additional dependent. Once the VA determines your MAPR, it deducts your annual income from your MAPR. The difference is your annual benefit amount. The VA divides the difference by 12 to determine your monthly payment amount.
Qualifying for a VA Pension provides potential access to additional assistance for in-home long-term care. Depending on the nature of your disability, you may be eligible for the Aid and Attendance or a Housebound Allowance programs. You can only receive one of these benefits. The VA awards these benefits as an increase to the MAPR, resulting in a higher monthly pension payment.
Aid and Attendance
Aid and Attendance is available to veterans who receive pensions and need assistance with activities of daily living, such as dressing, bathing, and toileting. The MAPR for a single veteran with Aid and Attendance and no dependents is $27,609 or $32,729 if you have a spouse or dependent child.
Housebound Allowance
The Housebound Allowance is awarded to veterans who receive pensions and are mostly confined to their homes due to a disability. The Housebound Allowance increases the MAPR to $20,226 if you have no dependents or $25,348 if you have a spouse or dependent child.
How to Apply for VA Long-Term Care
To apply for long-term care through the VA, you must be enrolled in VA health care and complete the Extended Care Services form. When submitting the form, you must include detailed information about your income, assets, insurance, dependents, and monthly expenses. The VA will use this information to determine whether you will have a copay and the amount.
Veterans Guide Can Answer Your Questions About VA Long-Term Care
If you have further questions about eligibility or need assistance filing a claim for VA benefits, contact us online today or call (888) 982-1009 for a free consultation.
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