If your loved one is a veteran, the VA offers more senior care benefits than most families realize. From home-based medical care to nursing homes and monthly cash payments, VA benefits for senior care in California can cover a wide range of needs. The challenge isn't usually eligibility. It's knowing what to ask for.

In This Guide

VA Senior Care Programs: Long-Term Care Options

The VA offers multiple long-term care programs. Access isn't automatic once a veteran is enrolled: VA also has to conclude the veteran needs that specific service for their ongoing treatment and personal care, and the service, or a space in the care setting, has to be available near them. That test isn't closed: the VA says it may also consider other factors, like the veteran's service-connected disability status or insurance coverage.

Home Based Primary Care (HBPC)

A VA doctor leads a health care team that provides services such as nursing care, physical therapy, and help with daily tasks in the veteran's home.

This isn't the same as home health care through Medicare. HBPC provides ongoing, coordinated primary care at home, not just short-term skilled visits.

Adult Day Health Care

Veterans attend a structured daytime program that provides social activities, companionship, recreation, care, and support. It also gives family caregivers reliable daytime respite.

Community Living Centers (VA Nursing Homes)

Community Living Centers are VA nursing centers designed to feel like home, providing nursing-home-level care. Stays can be short-term or long-term, and CLCs also take veterans for overnight respite. Your VA medical center's social work department can tell you which CLC serves your area.

Community Nursing Home Program

The VA contracts with community (non-VA) nursing homes so veterans can get nursing home care near home. Whether the VA pays for the stay is a separate question from whether a bed is available. The VA covers some long-term care services under standard health benefits for a veteran signed up for VA health care, and the veteran may still owe a copay on a covered service; other services aren't covered under VA health care benefits, and Medicaid, Medicare, or private insurance has to pay for those. Ask your VA medical center's social work department what the veteran would owe before assuming the cost is covered.

Respite Care

Through the VA's Program of Comprehensive Assistance for Family Caregivers (PCAFC), eligible Primary Family Caregivers receive at least 30 days of respite care per year. More broadly, all enrolled veterans are eligible for VA respite care if they meet the clinical criteria and it is available, but respite from a community agency, adult day health care center, or nursing home also requires community care eligibility, and VA may charge a copay based on service-connected disability status and finances. Respite can be in-home (a substitute caregiver comes to the house, or the veteran attends an adult day health care program) or facility-based (a short stay in a VA Community Living Center or a community nursing home). VA's 2026 copay page lists overnight and daily respite as each available up to 30 days each calendar year. The first 21 days of extended care in any 12-month period carry no copay, and veterans with a compensable service-connected disability are exempt; to learn the copay, contact the veteran's VA social worker or case manager to complete VA Form 10-10EC, the Application for Extended Care Services. Family caregivers can also call the VA Caregiver Support Line at 1-855-260-3274 (weekdays, 8 a.m. to 8 p.m. Eastern).

Not sure which VA program fits your family's situation? Chat with Brevy to get a personalized recommendation.

California Veterans Homes

The California Department of Veterans Affairs (CalVet) operates eight Veterans Homes of California for aged and disabled veterans and their eligible spouses and domestic partners. Levels of care range from independent living programs with minimal support up to 24/7 skilled nursing care for veterans with significant clinical needs. CalVet's four levels of care are not offered at every Home, though, and its own per-Home table is what settles which Home does what: independent living at Chula Vista and Yountville; assisted living at Chula Vista, Fresno, Lancaster, Redding, Ventura, West Los Angeles and Yountville; skilled nursing at Barstow, Chula Vista, Fresno, Redding, West Los Angeles and Yountville; and memory care, which CalVet runs as dedicated units within some skilled nursing programs, at Fresno, Redding, West Los Angeles and Yountville. So a family that needs skilled nursing will not find it at Lancaster or Ventura, which are assisted-living only, and Barstow is listed for skilled nursing only. Pick the Home by the level of care first and by the drive second.

Location Region
Redding Northern California
Yountville Northern California
Fresno Central California
Barstow Southern California
Chula Vista Southern California
Lancaster Southern California
Ventura Southern California
West Los Angeles Southern California

CalVet describes the Homes as affordable long-term care, but its Veterans Homes page doesn't state admission criteria or what a stay costs; for how to apply, which documents you need, and how each Home's waitlist works, it sends applicants to its separate Getting Started page. CalVet's toll-free number is 1-800-952-5626. If you're calling from another state, CalVet also lists 1-800-221-8998.

VA Aid and Attendance

Aid and Attendance is an increased monthly payment added to a VA pension, for veterans and surviving spouses who need regular aid and attendance., On the pension route it works as a higher maximum pension rate that replaces the basic rate, not as a second check on top.

2026 Rates

Category Maximum annual rate
Veteran, no dependents $29,093
Veteran with one dependent $34,488
Surviving spouse, no dependents $18,697

VA publishes these as Maximum Annual Pension Rates (MAPRs), and they are ceilings, not checks. A MAPR is the most pension VA will pay, and the award is the ceiling minus the household's income for VA purposes. Pension is paid monthly, and federal regulation sets the conversion: VA takes the MAPR, subtracts countable income, divides what's left by 12, and rounds down to the whole dollar. Income for VA purposes is what is left after deductions: VA may subtract applicable deductible expenses, including medical expenses the household is not reimbursed for, from annual income before it makes that comparison. Only the part of those medical expenses above 5% of the MAPR counts; VA prints that threshold as $872 for a veteran with no spouse or child and $1,141 for a veteran with one dependent.

Who Qualifies

To be eligible, the veteran must meet all of the following:

  • Have qualifying active-duty service that includes at least 1 day during a wartime period (for someone who started active duty before September 8, 1980, at least 90 days; enlisted members who started later generally need 24 months or the full period they were called up for), and not have been discharged dishonorably
  • Meet at least one of four alternatives: be at least 65 years old, have a permanent and total disability, be a patient in a nursing home for long-term care because of a disability, or be getting Social Security Disability Insurance or Supplemental Security Income. Any one of the four satisfies this test, so a wartime veteran under 65 who receives SSI meets it without a permanent and total rating.
  • Need aid and attendance, shown by at least one of these: needing another person's help with daily activities such as bathing, feeding, and dressing; having to stay in bed, or spend much of the day in bed, because of illness; being a nursing home patient because of lost mental or physical abilities related to a disability; or severely limited eyesight
  • Have a net worth below $163,699. The VA's net-worth calculation combines the claimant's and their dependents' assets and their annual income, excluding the primary home, the car, and basic home items, so comparing assets alone against the limit gives the wrong answer.

The VA enforces a 3-year look-back period on asset transfers.

How to Apply

The steps below are the pension route: the VA's condition is that you may be eligible for this benefit if you get a VA pension. Apply using VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination section a medical examiner fills out. A wartime veteran pursuing the pension who isn't already receiving one files a pension claim on Form 21P-527EZ (Application for Veterans Pension) alongside it. Form 21-2680 also serves a second route, Aid and Attendance added to monthly compensation benefits, which these pension steps don't describe. A nursing home patient also needs VA Form 21-0779, which a nursing home official uses to verify the stay. On how long a decision takes, the VA's answer is "It depends." It works claims in the order it receives them, unless a claim requires priority processing.

Don't do this alone. California's County Veterans Service Offices help veterans and their families prepare and submit VA claims, and CalVet provides claims review and representation for appeals at its District Offices. The VA says the services an accredited VSO representative provides on your VA benefit claims are always free, though an accredited attorney or claims agent can charge fees.

For the full application walkthrough, see our VA Aid and Attendance guide.

Veteran-Directed Care

The Veteran-Directed Care (VDC) program gives veterans a flexible budget to hire their own caregivers, including family, friends and/or neighbors. The veteran (or their representative) manages the budget. VA medical centers deliver VDC through local aging and disability network agencies, such as an Area Agency on Aging or a Center for Independent Living, whose options counselor helps with assessment and care planning, arranges fiscal management services, and provides ongoing counseling and support.

All enrolled veterans are eligible for VDC if they are eligible for community care, meet the clinical criteria for the service, and it is available. This is a good option for veterans who want control over their care and prefer family members as caregivers.

Contact your local VA medical center's social work department to ask about VDC availability in your area.

Community Care Through the MISSION Act

The MISSION Act of 2018 has, since 2019, let enrolled veterans receive care from community (non-VA) providers at the VA's expense. Two things are always required: the veteran has to be enrolled in or eligible for VA health care, and, apart from cases like urgent or emergency care, the VA health care team has to approve the community care before the veteran gets it. Beyond that, at least one of these has to be true:

  • The VA can't offer an appointment within 20 days (primary care, mental health, and extended outpatient care) or 28 days (specialty care)
  • The average drive to a VA facility exceeds 30 minutes (primary care, mental health, and extended outpatient care) or 60 minutes (specialty care)
  • You need a service VA doesn't provide at any VA health facility
  • You live in a state or territory without a full-service VA health facility, or qualified under the old 40-mile rule as of June 2018 and live in Alaska, Montana, North Dakota, South Dakota, Wyoming, or another location that still qualifies
  • You and your VA provider agree community care is in your best medical interest
  • VA can't provide the service in a way that meets its quality standards

Those four access numbers are a test VA applies, not a promise it makes. The regulation designates them "for purposes of eligibility determinations," and the condition is met when VA "cannot schedule an appointment" that falls inside both the drive-time standard and the wait-time standard, so failing either one on its own is enough. Falling outside them can make a veteran eligible for community care. It does not entitle anyone to a VA appointment by day 20.

The regulation adds three conditions VA's public eligibility page leaves out. You have to have "contacted an authorized VA official to request the care" first, so there is no self-referral on drive time alone. The drive time is an "average driving time" from the veteran's residence that VA calculates with geographic information system software, not the trip on your own odometer. And each wait-time limb applies "unless a later date has been agreed to by the veteran in consultation with the VA health care provider," so accepting a later appointment date gives up the wait-time route. If VA decides you do not qualify, that decision is reviewable through VA's clinical appeals process and may not be appealed to the Board of Veterans' Appeals.

On May 19, 2025, the VA streamlined the best-medical-interest pathway by implementing language in the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Public Law 118-210, enacted January 2, 2025) that removes the extra step of review by a second VA doctor, making it faster for eligible veterans to access community care.

How VA Benefits Work with Medicare and Medi-Cal

VA benefits don't replace Medicare or Medi-Cal, California's Medicaid program, a veteran doesn't have to enroll in Medicare to keep VA health care, and an older veteran or surviving spouse can qualify for and receive VA pension and Medicaid at the same time., Generally Medicare and VA can't pay for the same service, so you choose which benefit to use each time you get care, though they aren't sealed off from each other: if VA authorizes only some of the services during a non-VA hospital stay, Medicare may pay for the Medicare-covered services VA didn't authorize. And if you delay Part B while relying on VA alone and later have to sign up, you'll pay a penalty that grows the longer you waited and that you keep paying for life.

  • VA + Medicare: Holding both is normal, and VA doesn't bill Medicare. VA encourages veterans to sign up for Medicare as soon as they can, so they're covered at a non-VA hospital or doctor.
  • VA + Medi-Cal: Aid and Attendance is a federal VA pension, administered separately from Medi-Cal, and a veteran can receive both at the same time. The programs count income and assets differently. Since January 1, 2026, California law requires Medi-Cal to count assets for some programs, and DHCS says those limits apply to people who are 65 or older, have a disability, or live in a nursing home, among others. Through June 30, 2027, the limit is $130,000 for one person plus $65,000 for each extra person in the house, up to 10 people. DHCS cautions that not everyone in your home counts toward family size, and some married couples and registered domestic partners may qualify for higher limits under spousal impoverishment rules, so confirm your limit with the county Medi-Cal office. The limit is on countable assets only: DHCS doesn't count your main home, main vehicle, household items like furniture and clothes, or retirement funds you're drawing regular payments from, while second homes, second vehicles, cash and bank accounts count. A California homeowner is not over the limit because of the home they live in. On July 1, 2027, DHCS states the limit drops to $21,000 for one person and $31,000 for two, plus $1,550 for each additional person in the house, so plan any 2027 spend-down around the lower figure. Federal Medicaid rules treat VA pension income in two separate steps. At eligibility, the aged, blind, and disabled programs use SSI income methodology, under which the Aid and Attendance allowance is not income; the basic pension is not covered by that exclusion, and states with criteria more restrictive than SSI apply other methods. At the second step, the share of cost, the federal rule, 42 CFR 435.725, covers residents of medical institutions and intermediate care facilities (a family on home- and community-based waiver services should ask the county Medi-Cal office or DHCS which rule applies instead), and for them "Income that was disregarded in determining eligibility must be considered in this process." So an Aid and Attendance amount VA still pays at the full rate counts toward the resident's share of cost and can raise what the resident owes, but only after required deductions: a personal needs allowance, maintenance for a spouse or family at home, medical or remedial expenses no third party will pay, and any SSI and state supplement still received. A state's own rules can exempt the Aid and Attendance portion, so ask your county Medi-Cal office or DHCS how Medi-Cal treats your case. A different rule applies when Medi-Cal covers nursing-facility care for a veteran with no spouse or child, or a surviving spouse with no child: VA caps the pension at $90 a month, and that $90 may not reduce the facility's Medicaid payment. The cap doesn't reach a State home VA pays a nursing-care per diem for; there, pension above $90 a month, Aid and Attendance included, counts as income only toward the home's cost of nursing home care. Whether a CalVet Home is one depends on that per diem, so check with a VA-accredited representative. The order and timing of applications matters.
  • CalVet Veterans Homes: VA counts State Veterans Homes among its nursing home settings, where VA benefits may help pay depending on the veteran's income and level of service-connected disability. CalVet's Veterans Homes page doesn't state what a stay costs, so ask CalVet at 1-800-952-5626.

A benefits counselor or accredited representative who understands both should review a case before you apply.

How to Get Started

1
Step 1

Confirm VA health care enrollment

If the veteran isn't already enrolled in VA health care, start the application at va.gov/health-care/how-to-apply. The VA assigns a priority group (1-8) based on military service history, disability rating, income, Medicaid eligibility, and other benefits such as VA pension. Disability rating and income also decide whether the veteran owes long-term care copays at all.

2
Step 2

Get free help

Don't file claims or applications alone. The VA says an accredited VSO representative's services on your VA benefit claims are always free, though an accredited attorney or claims agent can charge fees:

  • County Veterans Service Offices (CVSOs): Staffed by what CalVet describes as trained and accredited professionals, who handle claims initiation and development. Call 844-SERV-VET to be connected to your local office.
  • CalVet: 800-952-5626. CalVet provides claims review and representation for appeals at its District Offices.
  • Your local VA medical center
3
Step 3

Gather records

You'll need the veteran's DD-214 (discharge papers), medical records documenting the need for care, and financial information. If you can't find the DD-214, the National Personnel Records Center can provide copies (request through va.gov).

Frequently Asked Questions

Do you have to be service-connected disabled to get VA long-term care?

Not for all programs. By statute, VA's extended care for a non-service-connected condition comes with a copay after the first 21 days of care in a year, but a veteran with a compensable service-connected disability is exempt, as is a veteran whose annual income is below the limit in 38 U.S.C. 1521(b). For nursing home care, whether VA benefits help pay depends on the veteran's income and level of service-connected disability. Aid and Attendance doesn't require a service-connected disability at all; it requires qualifying wartime service, a need for aid and attendance (such as help with daily activities), and that the veteran be 65 or older, permanently and totally disabled, in a nursing home for long-term care because of a disability, or receiving SSDI or SSI.

Can a veteran's spouse live in a CalVet Veterans Home?

In some cases, yes. The Veterans Homes of California serve aged and disabled veterans and their eligible spouses and domestic partners. CalVet's Getting Started page covers how to apply and the rules for the Homes. Contact CalVet at 1-800-952-5626 for current admission policies.

How long does it take to get Aid and Attendance approved?

The VA's own answer is "It depends." It works these claims in the order it receives them, unless a claim requires priority processing. Working with a County Veterans Service Officer or CalVet claims representative reduces the chance of errors that cause delays. You can apply while your loved one is already receiving care.

Does receiving Aid and Attendance affect Medi-Cal eligibility?

A veteran can receive both, but the programs count money differently. At eligibility, Medi-Cal's aged, blind, and disabled programs use SSI income methodology, under which the Aid and Attendance allowance is not income. For a resident of a medical institution or intermediate care facility, 42 CFR 435.725 then counts it in the share of cost after required deductions, so a full-rate amount can raise what the resident owes, though a state's own rules can exempt it. Where VA has cut the pension to $90 because Medi-Cal covers nursing-facility care for a veteran with no spouse or child, that $90 may not reduce the facility's Medicaid payment., Have a counselor who knows both programs review your case before you apply.

Next Steps

If you're caring for a veteran who needs help, start by contacting the County Veterans Service Officer nearest you, or call CalVet at 1-800-952-5626. They can assess which benefits apply and help you file.

Learn More

VA BenefitsVA benefits for senior care nationwideA complete guide to VA benefits for senior care: long-term care, Aid and Attendance, pensions, DIC, and home grants for older veterans and surviving spouses. VA BenefitsVA Aid and Attendance in CaliforniaVA Aid and Attendance in California for 2026: who qualifies, pension ceilings up to $34,488 a year, how to apply, and free help from CalVet and county offices. Care TypesNursing Homes in CaliforniaNursing homes in California in 2026: what a skilled nursing facility costs, how to check a facility's quality, and how Medi-Cal pays for nursing-home care. Care TypesAssisted Living in CaliforniaAssisted living in California means an RCFE, licensed by CDSS. What it costs in 2026, and what Medi-Cal and the Assisted Living Waiver will and won't cover. Care TypesMemory Care in CaliforniaMemory care in California: how dementia care works inside an RCFE, staff training rules, what it costs, and whether Medi-Cal's ALW helps pay. VA BenefitsCalifornia Disabled Veteran Property Tax ExemptionCalifornia's disabled veteran property tax exemption takes $180,671 off a 100% disabled veteran's assessed home value in 2026 ($271,009 if low-income). VA BenefitsCalifornia Veteran Benefits by VA RatingCalifornia disabled veteran benefits by VA rating: state job top rank at any rating, park pass at 50%, homes priority at 70%, property tax relief at 100%.
Your next step Find personalized help navigating VA senior care benefits in California at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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