A Veteran’s Guide To Long-Term Care

Discover VA long-term care benefits for veterans, including nursing homes, home care, caregiver support, and insurance options to plan ahead.
Updated: October 13th, 2025
Holly Ellison

Contributor

Holly Ellison

Veterans are among our nation’s most valued citizens. They dedicated their lives to protecting our freedoms, yet many face significant challenges once their service comes to an end. Veterans remain one of the most underserved populations, often struggling to access the care and support they deserve.

The good news is that help is available. From federal programs to community-based initiatives, there are resources designed to support veterans and their families.

This article breaks down what long-term care for veterans really looks like, exploring the unique options available. We’ll cover VA long-term care benefits, Long-Term Care Insurance, and resources for family caregivers, who play a vital role in supporting their loved ones.

Disclaimer: The information provided in this article is for educational purposes only and should not be interpreted as legal or financial advice. For personalized assistance, contact your VA Medical Center or a VA-accredited representative.

What Is Long-Term Care and Why Do Veterans Need It?

Long-term care refers to assistance with daily living activities such as bathing, grooming, dressing, toileting, eating, or transferring. It can also include support with household tasks, transportation, and companionship.

According to HHS, about 56% of Americans 65 and older will require long-term care that meets the federal definition. Veterans may be more likely to need long-term care due to service-related injuries, PTSD, and chronic conditions.

This higher likelihood makes sense. Many veterans live with service-related injuries or lifelong disabilities. Others may face challenges with mental health, post-traumatic stress, or the difficulty of transitioning from military to civilian life. These unique experiences often place veterans at higher risk of needing long-term support.

Due to these factors, planning for long-term care is particularly important for veterans and their families. Fortunately, the VA offers programs designed explicitly with veterans in mind. 

The Cost of Long-Term Care for Veterans

So, why should you care about long-term care? The answer is simple: long-term care is expensive. Neither traditional employer-sponsored health insurance nor Medicare pays for long-term care services.

Veterans do have an advantage; the VA offers several programs designed to help with long-term care needs. 

However, these programs are not all-inclusive. Coverage often comes with limitations; some services may not be included, and others may require co-pays based on income, disability rating, or priority group.

In the next section, we’ll break down exactly what services are covered, which programs are available, and how veterans and their families can plan for the additional costs that fall outside of VA benefits.

VA Long-Term Care Benefits Explained

VA Health Care benefits are a vital resource for many veterans, providing access to a wide range of affordable medical services and support. But when it comes to long-term care, things can look a little different.

Unlike traditional health insurance, including Medicare, which generally does not cover most long-term care needs, the VA offers specific programs designed to fill some of these gaps.

These programs can help veterans remain at home longer, support family caregivers, or provide residential options when more advanced care is needed.

Long-term care under the VA Medical Benefits package is split into two categories:

  • VA Home and Community-Based Services

  • VA Residential Settings and Nursing Homes

In the next sections, we’ll explain more about what each category covers, how coverage works, and what you can expect to pay and access.

Who Is Eligible for VA Long-Term Care Benefits?

Long-term care benefits through Veterans Affairs are available only to veterans who meet all of the following requirements:

  • Enrolled in VA Health Care: You must already be enrolled and actively receiving care through the VA Health Care system.

  • Clinical need for long-term care: A VA provider must determine that you require long-term care services.

  • Services available in your location: The specific services or facilities must be offered in your local area.

You must already be enrolled in VA Health Care before you can access long-term care services. Enrollment in VA Disability Compensation does not automatically make you eligible for VA Health Care. 

These are two separate benefits: disability compensation provides financial payments, while VA Health Care provides medical care and services.

If you are not currently enrolled in VA Health Care, you will not yet qualify for long-term care benefits. 

How To Apply for VA Health Care and Long-Term Care Benefits

The first step to getting VA long-term care benefits is to apply for VA Health Care. Here’s a step-by-step guide to applying: 

  1. Gather necessary documentation.

    • Social security information of you and any dependent, spouse, or other individual connected to your future VA health benefits. 

    • Discharge papers (DD214) and other information related to your time in the military. 

    • Gross household income from the previous calendar year. (This may be optional, check with a VA representative.)

    • Deductible expenses from last year, including medical and education. 

    • Insurance information (including Medicare, Medicaid, or private coverage)

  2. Fill out the VA Health Care application.

    • In-person: Fill out VA Form 10-10EZ at a local VA medical center or clinic. A VA representative can help you with the information. 

    • By mail: Print and fill out VA Form 10-10EZ and send it to:

      • Health Eligibility Center

      • PO Box 5207

      • Janesville, WI 53547-5207

    • Over the phone: The VA offers a toll-free hotline for assistance with applications at (877) 222-838. Services are available Monday-Friday from 8:00am - 8:00pm Eastern time. 

  3. After qualifying for VA Health Care, discuss long-term care with your VA care team. Your team can help connect you to services that work for you and your long-term care needs. 

If you need help with any step of the application process, please reach out to any of the following resources: a VA social worker (available at most VA facilities), Veterans Service Officers (VSOs) such as DAV, VFW, or American Legion, or the VA Caregiver Support Line: (855) 260-3274.

Application decisions are usually made in one week. If you’ve applied and are wondering about the status of your application, please call (877) 222-838 to find out more information.

How Much Does VA Long-Term Care Cost?

Although VA Health Care covers many long-term care services, some veterans may still be responsible for co-pays. The amount you pay depends on several factors:

  • Income: Veterans with higher incomes may have higher co-pays.

  • Disability rating: Veterans with lower service-connected disability ratings may pay more for care.

  • Priority group: VA assigns veterans to priority groups 1 through 8. Those in Priority Group 1 typically pay less than those in Priority Group 8.

According to the VA Long Term Care Services website, co-pays are generally charged on the 22nd day of care. However, due dates may vary by service or facility. Veterans should confirm costs directly with their VA Medical Center or billing office.

Additionally, the VA is required to bill any pre-existing health insurance (other than Medicare) for treatments related to non-service-connected conditions. Using other insurance can help reduce your overall co-pay for care services.

VA Home and Community-Based Services (HCBS)

The main way veterans access coverage for long-term care services through the VA is Home and Community-Based Services (HCBS)

This program offers a variety of care settings and services designed to help veterans remain at home, stay engaged in their community, and receive the support they need. Key services include:

  • Community Adult Day Health Care: Adult day health care programs are similar to senior centers but with additional medical and daily living support. Veterans can receive help with activities such as eating, mobility, or medication management while participating in social and recreational activities. This program also provides relief for family caregivers during the day.

  • Contract Nursing Home Care Program (formerly Community Nursing Home Care): This is a program where VA pays for care provided in private facilities.

  • Homemaker and Home Health Aide Care (HHA): Trained professionals come to the veteran’s home to assist with daily living activities, such as bathing, dressing, grooming, and meal preparation. HHAs can also help with light household chores, errands, and grocery or meal delivery, allowing veterans to maintain independence at home.

  • Home Telehealth: This care involves the use of technology to help care providers remotely monitor individuals with chronic conditions.

  • Palliative & Hospice Care: While not exclusively long-term care, these services focus on comfort and quality of life. Palliative care provides support for veterans at any stage of illness, addressing both medical and personal care needs. Hospice care is specifically for end-of-life support and includes assistance with daily activities, symptom management, and emotional care for both veterans and their families.

  • Respite Care: Respite care offers temporary relief for family caregivers. A trained caregiver steps in to provide short-term care, allowing family members to rest or attend to personal matters while ensuring the veteran’s needs are met.

  • Skilled Home Health Care: This is short-term, medically necessary care provided directly in a veteran's home. Skilled care focuses on medical needs like wound care or IV therapy, and typically follows a hospital stay, helping veterans stay at home instead of in a skilled care or rehab facility.

  • Veteran-Directed Care (VDC): This program allows veterans to hire caregivers, including family members, and manage their own care budget. Caregivers can receive compensation for providing care. More details about this program are covered in our section on support for veteran caregivers.

Not all Home and Community-Based Services are completely free. Some services may require co-pays based on the veteran’s income, disability rating, or priority group. However, the services listed above are fully offered through the VA and generally covered for eligible veterans.

VA Nursing Homes and Residential Care Options

The other main type of long-term care for veterans offered through VA Health Care is Residential Settings and Nursing Homes. Unlike Home and Community-Based Services, these programs focus on veterans who need more intensive or round-the-clock care.

One key difference is that the VA does not cover room and board in most residential settings; veterans or their families are responsible for housing costs. VA may cover certain care services within these settings, sometimes requiring a co-pay based on income and priority group.

These programs are designed for veterans who cannot safely live alone due to medical, cognitive, or functional needs and require a structured environment with trained staff available 24/7.

Below we'll list the residential options:

  • Community Residential Care (CRC): CRC is for veterans who don’t require full nursing home care but cannot safely live alone. Care is provided in assisted living facilities, group homes, or community homes, depending on the veteran’s needs. CRC provides supervision, support with daily activities, and assistance with medications.

  • Medical Foster Homes: These are private homes where veterans receive individualized long-term care, sometimes at a nursing home level. Residents may include a mix of veterans and non-veterans. MFHs offer a more intimate, home-like environment while providing 24-hour care for veterans with significant medical or personal care needs.

  • Adult Family Homes: These small, private homes house up to six residents and provide shared common spaces, with some residents sharing bedrooms or bathrooms. Caregivers are available around the clock to assist with daily activities, personal care, and supervision.

  • Assisted Living Facilities: These larger facilities provide private or semi-private rooms, sometimes with small kitchens or appliances. Residents maintain as much independence as possible while receiving support and care from staff. Services include help with daily living, medication management, and social engagement.

  • Community Living Center (CLC): CLCs are VA nursing homes, designed for veterans with intensive medical or personal care needs. CLCs can accommodate short-term rehabilitation stays or long-term residency, providing around-the-clock nursing care, therapy, and medical supervision.

Understanding VA Aid & Attendance Benefits

Aid & Attendance (A&A) benefits provide an additional monthly payment on top of your VA pension. These benefits are designed specifically for veterans and surviving spouses who need extra help with activities of daily living (ADLs) or require assistance due to severe medical conditions.

To qualify for Aid & Attendance VA benefits, you must have a current VA pension and already be receiving VA benefits. In addition, you must meet at least one of the following criteria:

  • Need help with daily living activities such as bathing, dressing, eating, or mobility.

  • Are bedridden due to illness or injury.

  • Live in a nursing home because of cognitive or physical disabilities.

  • Have severe vision impairment, defined as 5/200 vision or less in both eyes, or a visual field of 5 degrees or less, even with corrective lenses.

A&A is not available to veterans receiving only service-connected compensation, except when they qualify for Special Monthly Compensation (SMC-L through O) for Aid & Attendance under disability law.

Veterans or surviving spouses who are housebound may qualify for a separate "Housebound Allowance". You cannot receive both Aid & Attendance and Housebound benefits at the same time.

How To Apply for VA Aid & Attendance Benefits

You can apply for Aid & Attendance benefits in several ways: 

  • In person: Visit a VA regional office and bring your information. 

  • By mail: Fill out VA Form 21-2680

    • To complete the form, you’ll need your doctor to fill out the examination information section. 

    • You can also attach additional information to your application, such as how your day-to-day life looks, doctor’s evidence of a need for A&A, or details about your injury, illness, or disability. 

    • Nursing home residents: You’ll need to work with your nursing home staff to fill out an additional request: VA Form 21-0779.

You can mail your application to: 

  • Department of Veterans Affairs
  • Pension Intake Center
  • PO Box 5365
  • Janesville, WI 53547-5365

The application process can be detailed, so gathering medical records, care assessments, and documentation of daily care needs beforehand can help ensure your application is processed more smoothly.

It can be difficult to predict how long it will take to receive VA Aid & Attendance benefits. Applications are reviewed in the order they’re submitted, though cases with special priority may be processed more quickly.

State Veterans Homes: What You Should Know

State Veterans Homes (SVHs) are facilities that provide long-term care services similar to those found in nursing homes, assisted living facilities, or adult day health centers. 

While they are supported and regulated by the U.S. Department of Veterans Affairs (VA), these homes are owned and operated by individual states rather than the federal government.

Eligibility for admission to a State Veterans Home is based on both clinical need and the availability of space. Each state sets its own rules, which means requirements can vary. Some homes admit only veterans, while others may also provide care for veterans’ spouses or Gold Star parents.

Priority is given to veterans with service-connected disabilities. The VA does not pay for the care of non-veteran residents, such as spouses or family members.

Costs for State Veterans Homes also vary by state and by the type of care provided. The VA subsidizes State Veterans Homes through a daily per-diem payment, but residents often pay the remaining balance. Since facilities are state-run, waiting lists and costs can vary significantly. 

VA Caregiver Support Programs

Many veterans rely on their families and loved ones for care and support during difficult times.

Unlike most people, however, veterans have access to special programs through the Department of Veterans Affairs (VA) that provide resources, training, mental health support, and in some cases, financial assistance for their caregivers.

The VA Caregiver Support Program (CSP) includes two main options:

  • The Program of Comprehensive Assistance for Family Caregivers (PCAFC): Offers financial support, training, and respite care to eligible family caregivers of veterans with serious injuries or illnesses.

  • The Program of General Caregiver Support Services (PGCSS): Provides education, skills training, peer support, and access to resources for caregivers of any enrolled veteran, regardless of injury or illness status.

In addition, veterans may also qualify for Veteran-Directed Care (VDC). This program allows veterans to manage their own care budget and choose a caregiver, usually a family member, who can receive compensation for providing support.

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers training, counseling, health coverage, caregiver education, respite care, a monthly stipend, and other benefits to eligible family caregivers who assist veterans with serious care needs.

PCAFC is the primary VA program that offers financial compensation to caregivers, and it has stricter eligibility requirements compared with other caregiver programs.

To qualify for PCAFC, the veteran must meet all of the following criteria:

  • Enrolled in VA Health Care.

  • Require at least 6 months of in-person personal care assistance, including help with activities of daily living.

  • Discharged or medically discharged from the U.S. military.

  • Have a service-connected disability rating of 70% or higher.

Some veterans with service-connected disabilities rated 70% or higher qualify for VA-paid nursing home care, even if not enrolled in standard VA Health Care first. It's important to consult with a VA representative to determine if this applies to you.

Caregivers must be 18 years or older and meet at least one of the following:

  • Be a spouse, sibling, parent, child, or other close relative of the veteran

  • Live full-time with the veteran or be willing to do so and provide full-time care

Veterans may designate one primary caregiver and up to two secondary caregivers. The primary caregiver receives the majority of benefits, while secondary caregivers provide supplemental support.

Both the veteran and the caregiver must complete an application, which can be submitted in person, by mail, or online through the VA.

In recent years, the Program of Comprehensive Assistance for Family Caregivers (PCAFC) has expanded and changed some of the rules, offerings, and considerations. Here's a quick summary:

  • Inclusion of veterans from all eras: As of October 1, 2022, the PCAFC now includes veterans from all service eras. This means veterans who served after May 7, 1975, through September 11, 2001, are now eligible to apply, along with those from earlier eras.

  • Moratorium (temporary pause) on removing legacy participants: Veterans and caregivers who were enrolled in the program before October 1, 2020, who no longer meet newer eligibility standards, will continue receiving PCAFC benefits for now.

  • Extended eligibility for legacy participants: As of July 2025, the VA announced it would extend eligibility for legacy participants and new applicants through September 30, 2028. This extension gives the VA time to finalize updated program rules.

In addition, there are a few other updates:

  • Expanding the definition of what qualifies as a “serious injury.”

  • Allowing telehealth home visits instead of requiring all visits to be in person.

  • Reducing the frequency of reassessments to stay in the program.

Because these proposed changes are still under review, it’s important to check the VA’s Caregiver Support Program website or contact your local Caregiver Support Program team for the most current information.

Program of General Caregiver Support Services (PGCSS)

The Program of General Caregiver Support Services (PGCSS) is designed for caregivers who do not qualify for the more comprehensive PCAFC program.

It is generally easier to access, but it does not provide financial compensation. Instead, PGCSS focuses on connecting caregivers with resources to help them provide effective care.

Services may include:

  • Peer support groups for caregivers.

  • Training and education on caregiving skills.

  • Referrals to other VA or community programs that assist veterans and their families.

Unlike PCAFC, caregivers in PGCSS do not need to be related to the veteran or live with them. Eligibility requires that the veteran:

  • Is enrolled in VA Health Care.

  • Needs assistance with activities of daily living or requires supervision due to cognitive decline.

There is no formal application for PGCSS. Caregivers can get involved by contacting their Veteran’s Caregiver Support Program (CSP) team or caregiver support coordinator at their local VA facility.

Veteran’s Directed Care (VDC)

The Veteran-Directed Care (VDC) program is a unique VA long-term care option that gives veterans control and flexibility over their care. It is designed for veterans who need a high level of support but want to remain at home rather than move to a nursing facility.

The way this program works is simple: a VA care coordinator will conduct an assessment of the veteran's needs and help them develop a personalized care plan.

Then the veteran will be given a flexible care budget, which they can use to hire a caregiver of their choosing. The program allows veterans to hire professional caregivers, family members, or friends.

Informal caregivers receive training and regular monitoring to ensure they provide quality care and support their loved ones in the best possible way.

The budget can also be used to pay for approved services, equipment, and supplies that help veterans live independently and remain safely at home.

Veterans can choose the type of care they want, who provides it, and the schedule that best supports their lifestyle. This helps older adults stay at home longer, avoiding the rigidity of life in a long-term care facility.

This also helps family caregivers, who often lack support, resources, or financial assistance. The VDC program helps family caregivers receive compensation for the care they provide and offers guidance on how to care for their loved ones effectively.

The VDC program offers a flexible, person-centered approach that balances care needs, independence, and family support. This makes it an excellent option for veterans who want more control over how their long-term care is delivered.

Please note: The Veteran-Directed Care program is jointly administered through VA Medical Centers and local Area Agencies on Aging (AAAs). This program may not be available at all VA Medical Centers; check local availability through the Caregiver Support Program office. 

Long-Term Care Insurance for Veterans: Do You Need It?

Although there are several programs designed to help veterans cover the cost of care, VA long-term care benefits do not directly pay for room and board at a residential long-term care facility or home.

Most VA programs focus on covering care-related expenses, such as pensions, payments for services, or skilled long-term care provided at a facility. However, the bulk of the cost, room and board, remains the responsibility of veterans and their families.

This is where Long-Term Care (LTC) Insurance can help. LTC Insurance covers room and board in addition to the cost of long-term care services you may need. Coverage depends on the amount of money in your policy, not on the type of care required.

VA benefits and LTC Insurance can complement each other; receiving VA benefits usually does not disqualify you from using your policy.

One caveat is that if you already need care, you won't be able to purchase a new policy. This is why it’s so important to plan ahead and understand the potential costs of long-term care.

The best time to apply for LTC Insurance is before you need care, generally recommended in your 40s, 50s, or 60s. Once a policy is in place, you are guaranteed benefits until the policy funds are used, and insurance companies cannot deny claims or cancel your policy. 

Premiums are also stable, meaning once your price is set, it is unlikely to increase. In addition, partnership-qualified policies offer protection from Medicaid estate recovery or spend-downs, providing a reliable safety net no matter what life throws your way.

A Long-Term Care Insurance Specialist can help you find and apply for a policy that fits your needs and provides security for you or your loved one. 

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Recap: Veteran’s Long-Term Care Guide

Our veterans are a unique and valued population; they gave their all to keep us safe, and the least we can do is support them and their caregivers. There are several options available for veterans to access long-term care, including programs that cover services directly, provide a monthly stipend, and offer support for family caregivers.

Outside of these veteran-specific programs, Long-Term Care (LTC) Insurance is the most reliable way to cover the full cost of long-term care. 

Most VA programs do not directly pay for residential care. This makes LTC Insurance an essential component of retirement planning, helping ensure veterans and their families have access to the care they may need.

LTC News is your one-stop for everything long-term care, LTC Insurance, caregiving, health, and aging. LTC News offers a Care Directory tool that can help you find high-quality care in your or your loved one's area.

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