Does the VA Pay for Long-Term Care? Options and Who Qualifies (2026)

Yes, the VA pays for long-term care, but through two separate doors with different rules: care it provides through VA health care, and a higher payment added to a VA pension. If you're asking because a parent can't safely live alone anymore, or because a nursing home bill just arrived and you need to know what the VA does pay for, you're asking the right question. The hard part is knowing which door you're standing in front of, because each has its own eligibility test and its own forms.

In This Guide

• Does the VA Pay for Long-Term Care?
• Door One: Long-Term Care Through VA Health Care
• Who Qualifies for VA Long-Term Care?
• What VA Long-Term Care Costs, in Brief
• Door Two: Aid and Attendance and Housebound
• Which Door Fits Your Family?
• Where Medicare and Medicaid Fit
• How to Get VA Long-Term Care Started
• Frequently Asked Questions
• Learn More

Does the VA Pay for Long-Term Care?

Yes, through two different benefits, and a lot of what you'll read online blends them together.

The first door is care the U.S. Department of Veterans Affairs (VA) arranges. For a veteran signed up for VA health care, the VA offers long-term care that ranges from nursing homes to help at home, adult day health care, respite, hospice, and palliative care. Some of it is run by the VA, and some by state or community organizations.1

The second door is money. VA describes Aid and Attendance and Housebound as "monthly payments added to the amount of a monthly VA pension for qualified Veterans and survivors."2 That's the VA Pension program, with its own service, age or disability, income, and net worth tests.5

A family can qualify through one door and not the other, or through both. Knowing which is which keeps you from giving up on help your parent could actually get.

Door One: Long-Term Care Through VA Health Care

The VA's long-term care page sorts its residential settings into two groups, and the group decides what VA benefits do. Mixing the two up is how families get surprised at move-in.

The first group is nursing home care. The VA says "You can get nursing home care in 1 of the 3 different nursing home settings listed here": Community Living Centers, community nursing homes, and State Veterans Homes. For that group, "You may be able to get VA benefits to help pay for nursing home care. It depends on your income and the level of your service-connected disability."1

The second group is community residential care, and the VA says medical foster homes, adult family homes, and assisted living facilities "are not run, staffed, or paid for by VA, but we do inspect and approve each one. And you may be able to use VA benefits to help pay for extra services." The VA's example of an extra service is a visit from a VA health care provider.1

Each row draws on the VA's own program descriptions.1,6,7,8,9,10,11,12

Some programs carry an extra condition families don't expect. Homemaker and home health aide care and Veteran-Directed Care are open to enrolled veterans who are also eligible for community care, meet the clinical criteria, and live where the service is available.9,11 Respite from a community agency, an adult day health care center, or a nursing home carries the same community care requirement.10

As of 2026, the VA's medical foster home page says a medical foster home is not provided or paid for by the VA, and that the charge is about $1,500 to $3,000 a month based on income and the level of care needed.13 A 2022 law gave the VA a narrow, capped authority to pay for medical foster home care for some veterans it is required to provide nursing home care to; our medical foster homes guide explains where that stands.14

Who Qualifies for VA Long-Term Care?

If you're trying to work out whether your dad or mom can get any of this, start with VA health care enrollment, because everything behind door one runs through it.

Enrolling in VA health care takes active military, naval, or air service without a dishonorable discharge. Veterans who enlisted after September 7, 1980, or entered active duty after October 16, 1981, generally must have served 24 continuous months or the full period they were called to active duty, with exceptions that include a discharge for a service-related disability. Once enrolled, the VA assigns the veteran to 1 of 8 priority groups based on service history, disability rating, income, Medicaid eligibility, and other benefits such as VA pension.15 Our guide to VA health care enrollment and priority groups shows where a particular veteran lands.

Enrollment alone doesn't get a bed, though. The VA states the test itself: "All of these must be true:" the veteran is signed up for VA health care, and "We conclude that you need a specific service to help with your ongoing treatment and personal care," and "The service (or space in the care setting) is available near you."1 A Community Living Center bed that doesn't exist nearby isn't help your family can use this month.

What a Service-Connected Rating Changes

Two separate federal rules sit behind the 70% shorthand families hear, and keeping them apart stops you planning around the wrong one.3

The first rule is about access. Under 38 U.S.C. 1710A(a), the VA must provide nursing home care it determines is needed to any veteran who needs that care for a service-connected disability, and to any veteran in need of nursing home care who has a service-connected disability rated at 70% or more. Under 38 U.S.C. 1710A(d), the VA's 1710A(a) duty to provide needed nursing home care to these service-connected and 70%-rated veterans terminates on December 11, 2026, unless the statute is amended to extend it.3 If you're planning a long stay around that rule, check the statute's current text before counting on it.

The second rule is about cost, and it reaches further. Under 38 CFR 17.111(f), a veteran with any compensable service-connected disability, not only 70% or more, is among those not subject to VA's extended-care copays.3

A veteran without a service-connected disability isn't shut out of door one. Under 38 U.S.C. 1710B(c), the VA may not furnish extended care for a non-service-connected disability, other than to a veteran with a compensable service-connected disability, unless the veteran agrees to pay a copayment for days beyond the first 21 in a year, with exceptions that include a veteran whose income is below the VA pension rate and a veteran receiving hospice care.12 For many veterans, then, the condition is agreeing to a copay, not holding a rating.

What VA Long-Term Care Costs, in Brief

VA long-term care is neither automatically free nor automatically expensive, and the daily numbers are ceilings rather than bills.

For a veteran who isn't exempt, there's no copay for the first 21 days of geriatric or extended care in a 12-month period. From the 22nd day, the 2026 copay for each day of care is up to $97 for inpatient care such as a Community Living Center stay, up to $15 for outpatient care such as adult day health care, and up to $5 for domiciliary care for homeless veterans. A veteran owes the copay only to the extent the veteran and spouse have available resources, and the VA sets the amount from VA Form 10-10EC, the Application for Extended Care Services.1 A VA social worker or case manager helps complete that form.6

For a family facing a long stay, that resources rule matters most. The $97 is the most the VA can charge for a day of inpatient care, and a parent with little left is charged only what the couple's resources allow. For the first 180 days of VA extended care, available resources come from the couple's income after allowances and expenses; savings and other assets count only from day 181, and a spouse still living in the community has part of the couple's assets protected from that count.1 Our VA long-term care copays guide has the full exemption list and how the VA figures available resources.

State Veterans Homes work on a different payment track. For a veteran who needs nursing home care for a service-connected disability, or who is rated 70% or more and needs that care, 38 U.S.C. 1745(a) has the VA contract with the State home, and the VA's payment counts as payment in full. Put plainly, the State home may not bill the veteran, an insurer, or anyone else for the nursing home care the VA paid for, so a qualifying veteran's family should not see that bill. Outside those rules, the VA pays the state a basic per diem that can never exceed half the cost of the veteran's care, so that per diem alone won't cover the whole bill.7 Our State Veterans Homes guide covers what that leaves for the family.

Door Two: Aid and Attendance and Housebound

The pension door pays money, not care, under its own rules and forms.

To get Aid and Attendance, a veteran first has to qualify for VA Pension, and VA Pension starts with a minimum length of service. At least one of these must be true: the veteran started active duty before September 8, 1980 and served at least 90 days on active duty; started active duty as an enlisted person after September 7, 1980 and served at least 24 months or the full period called or ordered to active duty, with some exceptions; or was an officer who started active duty after October 16, 1981 and hadn't previously served 24 months on active duty. Every one of those routes also requires at least 1 day of the service during a wartime period. VA Pension then requires no dishonorable discharge and at least one of these: being at least 65, having a permanent and total disability, being a nursing home patient for long-term care because of a disability, or receiving Social Security Disability Insurance or Supplemental Security Income. From December 1, 2025 to November 30, 2026, the VA Pension net worth limit is $163,699, not counting the primary residence, the car, or basic home items.5

Aid and Attendance then requires a care need: for example, needing another person's help with daily activities like bathing, feeding, and dressing, or being a nursing home patient due to the loss of mental or physical abilities related to a disability.5 Housebound is the other option, for a pensioner who spends most of their time at home because of a permanent disability, and the VA says a claimant can't get Aid and Attendance and Housebound at the same time.2

Each 2026 rate is a ceiling, not a payment: the monthly pension is the Maximum Annual Pension Rate minus the claimant's countable income, divided by 12. Unreimbursed medical expenses can lower countable income, which is why care costs matter so much here.4 Housebound and Aid and Attendance each replace the basic rate rather than stacking on top of it.2 Our guide to VA Aid and Attendance covers the calculation, and the setting guides cover nursing homes, assisted living, and care at home.

The $90 Rule When Medicaid Pays the Nursing Home

This is the rule most likely to blindside a family. When a veteran with no spouse or child, or a surviving spouse with no child, has Medicaid paying for nursing home care, federal law caps the VA pension, Aid and Attendance included, at $90 a month. A pension that was helping pay for care shrinks to an allowance for personal expenses, so plan for that drop before the Medicaid application goes in, because the order and timing of applying for each program matter.16 The VA says the facility can't count that $90 as income toward the cost of care, and the beneficiary keeps "the full $90 for personal expenses."16

The timing needs a close look. Under 38 U.S.C. 5503(d)(2), the $90 cap on a veteran's pension applies for any period after the month of admission to the Medicaid-covered nursing facility. VA's own regulation, 38 CFR 3.551(i), instead caps the pension "for any period after the month in which the Medicaid payments begin," so when Medicaid is approved months after admission, confirm the effective date of the reduction with the VA rather than assuming either one. If the VA is slow to make the cut, 38 U.S.C. 5503(d)(4) says the veteran isn't liable to repay the excess pension unless the delay came from the veteran willfully concealing information.17

One setting sits outside the cap. The definition of "nursing facility" in 38 U.S.C. 5503 leaves out a State home the VA pays per diem to for nursing home care, so a Medicaid-covered veteran in a State Veterans Home receiving that VA per diem is outside the $90-a-month VA pension limit.17

Which Door Fits Your Family?

Side by side, here are the tests your family is actually facing.

Those tests come from the VA's health care and pension eligibility rules.15,5,1,18

A veteran without wartime service can still use door one, and a wartime veteran with modest savings and a high care need may be able to use both.

Where Medicare and Medicaid Fit

Holding Medicare alongside VA health care is normal. The VA says that if you have other coverage like a private plan, Medicare, Medicaid, or TRICARE, you can use VA health care benefits along with it. Medicare says generally Medicare and the VA can't pay for the same items or services, so each time you get care you choose which benefit to use.19 How VA benefits work with Medicare has the exceptions.

Medicaid is a separate application to your state's Medicaid agency, and an older veteran or surviving spouse can qualify for and receive VA pension and Medicaid at the same time. At the initial eligibility step, states that use SSI rules treat the Aid and Attendance allowance as not countable income, while the 8 states the Social Security Administration lists as 209(b) states (Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, and Virginia) may count it.16 Our guide to VA benefits and Medicaid covers what happens after eligibility.

How to Get VA Long-Term Care Started

You don't have to sort all of this out before you start. Both doors have a first step you can take this week.

For door one, apply for VA health care with VA Form 10-10EZ, the Application for Health Benefits: online at VA.gov, by phone at 877-222-8387 (Monday through Friday, 8:00 a.m. to 8:00 p.m. ET), by mail to the Health Eligibility Center, in person at a VA medical center or clinic, or with help from an accredited attorney, claims agent, or Veterans Service Organization representative.15 Once the veteran is enrolled, ask a VA social worker or case manager about long-term care and the VA Form 10-10EC that sets the copay.6

For door two, a wartime veteran not yet receiving pension files VA Form 21P-527EZ, and Aid and Attendance is documented on VA Form 21-2680, which a medical examiner completes. A nursing home resident also needs VA Form 21-0779. If you're still gathering papers, file VA Form 21-0966, the intent to file, first; the VA says it "can secure the earliest possible effective date for any retroactive payments you may be eligible to receive."18 Our intent to file guide explains the timing.

Learn More

Find personalized help choosing the right VA long-term care door for your family 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.