VA Long-Term Care Benefits: A Complete Guide for Veterans

For veterans who need help with daily activities as they age, the Department of Veterans Affairs offers one of the most comprehensive long-term care systems in the country. The VA provides nursing home care, home health services, adult day health care, and assisted living support to eligible veterans through a network of more than 170 VA medical centers and contracted community providers. Yet many veterans are unaware of these programs or unsure whether they qualify. This guide explains what VA long-term care covers, who is eligible, what it costs, and how it works alongside Medicare and Medicaid.

Overview of VA Long-Term Care Programs

The VA groups its long-term care services under what it calls geriatrics and extended care. These programs are designed to help veterans live as independently as possible for as long as possible, and to provide higher levels of care when independence is no longer realistic. The major categories of VA long-term care include institutional care, home-based care, and community-based care.

Institutional care includes Community Living Centers, which are VA-run nursing homes located at VA medical centers. These facilities provide round-the-clock skilled nursing, rehabilitation, and end-of-life care. The VA also contracts with community nursing homes and partners with state veterans homes to expand the number of beds available to veterans.

Home-based care includes home-based primary care, where interdisciplinary VA clinical teams visit veterans at home to manage chronic and complex conditions. Homemaker and home health aide programs send trained aides to help with activities of daily living such as bathing, dressing, and meal preparation. Skilled home health care provides nursing and therapy services in the home for veterans who need clinical care but do not require facility admission.

Community-based care includes adult day health care, which provides supervised daytime programs that offer social activities, meals, health monitoring, and therapeutic services. These programs allow veterans to remain at home while receiving structured support during the day. The VA also supports assisted living through its Medical Foster Home and community residential care programs, which place veterans in supervised home-like settings in the community.

Who Is Eligible for VA Long-Term Care

Eligibility for VA long-term care is based on a combination of military service history, service-connected disability rating, income, and clinical need. Not every enrolled veteran automatically qualifies for every program. The VA uses a priority system that gives first access to veterans with the greatest service-connected needs.

The VA is required by law to provide nursing home care to two groups of veterans. The first group includes veterans with a service-connected disability rating of 70 percent or higher. The second group includes veterans who need nursing home care for a condition that is itself service-connected. For all other veterans, nursing home care is provided based on clinical need and available resources.

For home and community-based programs, eligibility is generally broader. Most veterans enrolled in VA health care can access home-based primary care, homemaker and home health aide services, and adult day health care if they have a clinical need. However, availability varies by location, and some programs have waiting lists. Your VA care team will assess your needs and recommend appropriate services.

To be enrolled in VA health care in the first place, you must have served on active duty and received a discharge that was not dishonorable. Additional factors such as length of service, combat status, and income may affect your enrollment priority group.

VA Community Living Centers: The VA's Nursing Homes

Community Living Centers are the VA's version of nursing homes and are located at VA medical centers across the country. There are approximately 130 CLCs nationwide, and they provide a range of services including short-term rehabilitation, long-term nursing care, hospice and palliative care, and respite care for caregivers. Each CLC is staffed with registered nurses, physicians, therapists, social workers, and other clinical professionals.

CLCs tend to focus heavily on rehabilitation and returning veterans to the community whenever possible. The average length of stay in a CLC is shorter than in a private nursing home because of this rehabilitation focus. However, CLCs also serve veterans who need long-term custodial care, particularly those with high service-connected disability ratings.

Bed availability is limited in many CLCs, and not every veteran who requests admission can be accommodated immediately. Priority is given to veterans with a 70 percent or higher service-connected disability, those needing care for a service-connected condition, those in need of post-acute rehabilitation, and those receiving end-of-life care. If a CLC cannot accommodate you, the VA may arrange placement in a community nursing home or a state veterans home.

Home-Based and Community-Based Care Options

Many veterans prefer to receive care at home rather than in a facility, and the VA has expanded its home and community-based programs significantly in recent years. These programs are designed to delay or prevent the need for institutional care by providing support in the veteran's own home or community.

Home-based primary care brings a full clinical team to your home, including a physician, nurse, social worker, therapist, dietitian, and pharmacist. This program is designed for veterans with complex chronic conditions who have difficulty traveling to a VA facility. The team manages your medical care, coordinates services, and helps you stay at home as long as it is safe to do so.

Homemaker and home health aide services provide trained aides who visit your home to help with personal care, light housekeeping, and meal preparation. These are not medical services but rather support services that help you manage daily life. The VA contracts with community agencies to provide these aides.

Adult day health care programs operate at VA medical centers and in the community. They provide structured daytime activities, meals, social interaction, and health monitoring for veterans who need supervision or support during the day. These programs are particularly helpful for veterans with dementia or cognitive decline and for caregivers who need daytime relief.

The VA's Medical Foster Home program places veterans in private homes in the community where a trained caregiver provides round-the-clock assistance. This is an alternative to nursing home care for veterans who prefer a home-like setting. The veteran pays the foster home caregiver directly, but the VA provides clinical oversight and regular home visits.

Understanding VA Long-Term Care Copays

The cost of VA long-term care depends on your service-connected disability rating, your income, and the type of care you receive. Many veterans qualify for free or reduced-cost long-term care, making VA programs significantly more affordable than private alternatives.

Veterans with a service-connected disability rating of 70 percent or higher are exempt from copays for nursing home care. Veterans receiving care for a service-connected condition are also exempt. For all other veterans, the VA calculates extended care copays based on a financial assessment that considers income, assets, and expenses. The copay amount varies but is typically much lower than the cost of private nursing home care, which averages more than $10,000 per month nationally.

For home and community-based services, copay structures vary by program. Some services, such as home-based primary care, are treated as outpatient visits and follow standard outpatient copay rules. Others, such as adult day health care and homemaker services, are considered extended care and follow the extended care copay schedule. Your VA financial counselor can explain your specific copay obligations based on your enrollment priority group and financial situation.

How VA Long-Term Care Differs from Private Long-Term Care

VA long-term care and private long-term care serve similar purposes but operate very differently. Understanding these differences can help you decide which option best fits your needs and financial situation.

Cost is the most significant difference. Private nursing home care costs an average of $10,965 to $11,294 per month in 2026, depending on whether you choose a semi-private or private room. Assisted living averages around $5,350 per month. VA long-term care, by contrast, is available at no cost to veterans with high service-connected disability ratings, and at reduced copays for others. Even veterans who do pay copays typically pay a fraction of private market rates.

Access is another key difference. Private long-term care is available to anyone who can pay for it, and you can choose from a wide range of facilities and providers. VA long-term care is available only to eligible veterans, and bed availability is limited. You may face waiting lists, especially for CLC admission. You also have less choice in where you receive care, as you must use VA facilities or VA-approved providers.

Focus of care also differs. VA CLCs emphasize rehabilitation and returning veterans to the community, so average stays tend to be shorter. Private nursing homes often serve residents who need indefinite custodial care. For veterans who need long-term custodial placement, the VA may arrange care at a state veterans home or a community nursing home rather than keeping them in a CLC.

Coordinating VA Benefits with Medicare and Medicaid

Many veterans are eligible for VA health care, Medicare, and potentially Medicaid. Understanding how these programs interact is important for getting the most out of your benefits without paying more than necessary.

The VA and Medicare operate as separate systems. The VA does not bill Medicare, and Medicare does not pay for care received at VA facilities. If you receive long-term care at a VA Community Living Center, the VA covers those costs through its own funding. If you choose to receive care at a non-VA facility, Medicare may cover up to 100 days of skilled nursing care if you meet the standard Medicare requirements.

Medicaid is often a last resort for long-term care funding, but it can work alongside VA benefits in some situations. If you need long-term nursing home care and do not qualify for VA nursing home admission, Medicaid may cover the cost at a community nursing home once you meet the financial eligibility requirements. Some veterans use VA home and community-based services to delay the need for nursing home care and the associated Medicaid spend-down.

It is important to enroll in Medicare Part B when you first become eligible, even if you rely primarily on VA care. VA health care does not count as creditable coverage for Medicare Part B purposes, and delaying Part B enrollment can result in permanent late enrollment penalties. Having both VA health care and Medicare gives you the flexibility to receive care at VA or non-VA providers depending on your needs.

What VA Long-Term Care Does Not Cover

While the VA's long-term care programs are extensive, there are limitations. Not every veteran will qualify for every program, and some services are not covered at all.

The VA does not guarantee nursing home placement for all veterans. Only those with a 70 percent or higher service-connected disability or those needing care for a service-connected condition have a guaranteed right to VA nursing home care. Other veterans may be placed on a waiting list or referred to community options.

The VA does not cover private assisted living facility fees. While the VA offers alternatives like Medical Foster Homes and community residential care, these are different from commercial assisted living facilities. If you choose a private assisted living facility, you will pay out of pocket unless you have other coverage such as long-term care insurance or state Medicaid waiver programs.

The VA also does not provide 24-hour home care. Home-based services are delivered on a visiting or part-time basis. If you need round-the-clock supervision at home, you would need to combine VA services with private-pay caregivers, family support, or other resources.

Geographic availability is another limitation. Not all VA medical centers offer every long-term care program. Rural veterans may have fewer options nearby, though the VA has worked to expand telehealth and community partnerships to address this gap. Check with your local VA medical center to find out which programs are available in your area.

How to Apply for VA Long-Term Care

Applying for VA long-term care starts with being enrolled in VA health care. If you are not currently enrolled, you can apply online at VA.gov, call the VA health benefits hotline at 1-877-222-8387, or visit your local VA medical center in person. You will need your DD-214 discharge papers, Social Security number, and financial information.

Once enrolled, the next step is to discuss your long-term care needs with your VA primary care provider or a VA social worker. They will conduct a clinical assessment to evaluate your physical and cognitive needs. Based on this assessment, your care team will recommend the programs that best fit your situation.

For nursing home care, the VA will assess your priority level based on your service-connected disability, the nature of your condition, and your financial status. If you qualify, the VA will work with you and your family to arrange placement. If your local CLC does not have available beds, the VA may offer alternatives such as a community nursing home or a state veterans home.

For home and community-based services, the process is similar. Your care team will determine which services you need and coordinate referrals. Some programs, such as homemaker and home health aide services, are delivered through VA contracts with community agencies, so availability may depend on your location.

Planning ahead is important because some programs have waiting lists, and the application and assessment process takes time. If you think you or a family member may need long-term care in the near future, start the conversation with the VA sooner rather than later. Early planning gives you the best chance of accessing the programs that fit your needs and avoids a crisis-driven scramble for care.

VA long-term care benefits represent a significant resource for eligible veterans, offering programs that can save tens of thousands of dollars compared to private alternatives. Whether you need nursing home care, help at home, or daytime support, the VA has programs designed to meet a range of needs. The key is understanding your eligibility, knowing what is available, and working with your VA care team to build the right care plan for your situation.