When an older veteran’s care needs grow, VA can be a much bigger help than many families expect, but its long-term care runs through VA health care, not the benefits office.
Here’s a map of what VA offers, the rules for getting it and what it costs.
What VA long-term care includes
VA’s long-term care services include 24-hour nursing and medical care, physical therapy, help with daily tasks like bathing, dressing, meals and medicines, comfort care, and support for family caregivers1.
| Setting | What it is | Guide |
|---|---|---|
| Community Living Centers | VA-run nursing homes, usually near a VA medical center | [[va:nursing-home-care|Nursing home care]] |
| Community nursing homes | Private nursing homes under VA contract | [[va:nursing-home-care|Nursing home care]] |
| State veterans homes | State-run homes that VA inspects and helps pay for | [[va:state-veterans-homes|State veterans homes]] |
| Medical foster homes | Private homes where a caregiver looks after a few people | [[va:medical-foster-homes|Medical foster homes]] |
| Home Based Primary Care | A VA medical team that visits the home | [[va:home-based-primary-care|Home Based Primary Care]] |
| Homemaker and home health aides | Aides from VA-contracted agencies | [[va:home-care|VA home care]] |
| Adult day health care | Daytime program with care and activities | [[va:adult-day-care|Adult day care]] |
| Respite care | Short breaks for family caregivers | [[va:respite-care|Respite care]] |
| Hospice and palliative care | Comfort-focused care for serious illness | [[va:hospice-care|Hospice]] |
Source: VA long-term care overview1.
Who is eligible
Most VA long-term care follows the same three tests: the veteran is enrolled in VA health care, VA finds the service is needed for their ongoing treatment and personal care, and the service is available nearby. VA may also consider service-connected status and other insurance1. Services bought from community providers also require community care eligibility2.
Nursing home care has extra rules: VA provides Community Living Center care and pays for community nursing home care when a veteran meets criteria tied to service-connected status, disability level and income34. Start by enrolling; see VA health care enrollment and priority groups.
What VA doesn't pay for
Assisted living facilities, adult family homes and medical foster homes aren’t run, staffed or paid for by VA, though VA inspects and approves the ones it works with, and VA benefits may pay for extra services like visits from a VA provider1. For services VA health care doesn’t cover, families may use Medicaid, Medicare or private insurance1, or the cash benefit Aid and Attendance.
What it costs
Copays depend on service-connected status and finances. There’s no copay for the first 21 days of extended care in a 12-month period; after that, VA’s 2026 maximums are $97 a day for nursing home and overnight respite care and $15 a day for adult day health care and daytime respite56. VA Form 10-10EC, Application for Extended Care Services, sets the amount5.
Some veterans owe no extended care copays, including those with a compensable service-connected disability and those whose income is below the basic pension rate6. Details in VA long-term care copays.
How to get started
- Enroll in VA health care. Apply online, by phone or in person7.
- Ask for a social worker. A VA social worker assesses needs and explains local options1.
- Complete VA Form 10-10EC. It determines extended care copays5.
- Check cash benefits too. Pension with Aid and Attendance can pay for care VA doesn't provide8.
When VA must provide nursing home care
Federal law requires VA to provide needed nursing home care to any veteran who needs it for a service-connected disability, and to any veteran who needs it and has a service-connected rating of 70% or more10. Once placed in a VA nursing home, those veterans can’t be transferred out without their consent or their representative’s10. For other veterans, nursing home care depends on clinical need, available beds and finances3.
Worked example: three families, three paths
- A veteran rated 70% who needs nursing care. VA must provide it, there's no extended care copay because the rating is compensable, and VA pays for state veterans home care under a contract or agreement10611.
- A wartime veteran with no rating, income of $1,900 a month, who needs help bathing and dressing at home. He can use VA homemaker and home health aide care and respite if VA finds a clinical need, and may also qualify for pension with Aid and Attendance, whose 2026 ceiling for a single veteran is $29,0931213.
- A surviving spouse who isn't a veteran. She isn't eligible for VA health care or VA nursing homes, but may qualify for Survivors Pension with Aid and Attendance, $18,697 a year in 202614.
How VA care fits with Medicare and Medicaid
Medicare covers skilled nursing facility care only after a qualifying hospital stay and only up to 100 days per benefit period; in 2026 days 21 to 100 cost $217 a day and Medicare pays nothing after day 10015. VA doesn’t bill Medicare or Medicaid16. If a veteran doesn’t qualify for VA-paid nursing home care, VA directs families to their own resources, Medicare and Medicaid4.
Common mistakes
- Waiting for a crisis to enroll. Enrollment comes first for every VA long-term care service1.
- Assuming VA pays for assisted living. It doesn't; Aid and Attendance is the usual VA help for assisted living18.
- Skipping VA Form 10-10EC. Without it VA can't figure a reduced copay5.
- Not asking about a rating increase. A rating that reaches 70% changes nursing home eligibility completely10.