VA Home Care: Aides, Nursing and Other Help at Home

01Homemaker and home health aides

Aides from VA-contracted agencies help with eating, dressing, grooming, bathing, toileting, moving around and grocery shopping, and services can continue as long as the veteran needs extra help with daily activities¹.

Homemaker and home health aide care is part of VA’s standard medical benefits package, so every enrolled veteran is eligible if VA finds a clinical need and the service is available locally². Not every VA medical center offers every program, so ask a VA social worker what exists near you.

02Other in-home options

Source: VA long-term care overview².

03When VA services aren't enough

Veterans and surviving spouses eligible for pension can get the higher Aid and Attendance rate, and care costs may lower countable income; see Aid and Attendance for home care³.

04Costs

After the first 21 days of extended care in a 12-month period, home-based extended care carries a copay of up to $15 a day in 2026, depending on service-connected status and finances reported on VA Form 10-10EC; many veterans owe nothing⁴⁵. See VA long-term care copays.

1. Enroll in VA health care, if not already enrolled⁶.
2. Ask the primary care team or a VA social worker for a referral to home care².
3. Complete VA Form 10-10EC if VA tells you a copay may apply⁵.

05What an aide does and doesn't do

A homemaker or home health aide is a trained person, not a nurse, who works for an agency under contract with VA and is supervised by a registered nurse who assesses the veteran’s daily living needs¹. Aide care can serve veterans of any age, can be part of an alternative to nursing home care, and can provide respite at home¹. VA’s page says eligibility requires enrollment, community care eligibility, clinical need and availability, and a copay may apply based on service-connected status¹.

06Worked example: building a home plan

An 88-year-old veteran with heart failure lives with his wife. His VA team enrolls him in Home Based Primary Care for home visits, adds an aide three mornings a week for bathing and dressing, and schedules a few days of respite a year⁷¹⁸. Because he’s a wartime veteran with high care costs, his family also applies for pension with Aid and Attendance, whose 2026 ceiling with a spouse is $34,488; the amounts they pay a private aide for the other days can reduce his countable income⁹¹⁰.

07Home Based Primary Care: medical care at home

Home Based Primary Care (HBPC) brings a VA team home for veterans with ongoing illnesses who have trouble making and keeping clinic visits; they’re often homebound, but that isn’t required⁷. The team can include a physician, nurse practitioner or physician assistant for primary care visits, plus nursing care management, social work, rehabilitation, psychology, nutrition and pharmacy⁷. A basic copay may be charged for each medical visit, as at a clinic⁷; the 2026 primary care copay is $15, and veterans rated 10% or more service-connected pay no outpatient copay⁵.

08Veteran-Directed Care: hire your own helpers

Veteran-Directed Care gives a flexible budget, managed by the veteran or family caregiver, to choose the mix of services, hire personal care aides (which may include a family member or neighbor) and buy items and services that support independent living¹¹. It’s for veterans who need help with daily activities, are isolated, or whose caregiver is under strain, and it’s only offered in certain locations; a copay may apply¹¹.

09Medical foster homes: a home instead of a nursing home

A medical foster home is a private home where a trained caregiver looks after a few residents around the clock, with help with daily activities and medications, some nursing assistance, all meals and planned activities¹². VA inspects and approves these homes but doesn’t provide or pay for them; the veteran must be enrolled in HBPC, and VA says the charge is about $1,500 to $3,000 a month based on income and care level, agreed in advance with the caregiver¹².

10Which in-home service fits?

Source: VA Geriatrics and Extended Care program pages.

11Step by step

1. Enroll in VA health care with Form 10-10EZ⁶.
2. Ask the primary care team for a home and community care assessment².
3. Complete VA Form 10-10EC for extended care copays⁵.
4. Ask about Veteran-Directed Care if you want to hire your own helpers¹¹.
5. Apply for pension or A&A with Form 21P-527EZ if eligible¹³.

12Common mistakes

• Expecting 24-hour care. VA aide hours are based on assessed need¹.
• Not keeping receipts for private care, which may count as medical expenses for pension¹⁰.
• Assuming homebound is required for Home Based Primary Care; it isn't⁷.

13Getting help