VA Long-Term Care Copays 2026: Who Pays and Who Is Exempt

A VA long-term care copay is never charged for the first 21 days of care in a 12-month period, and in 2026 it tops out at $97 a day for a VA nursing home stay.1 If your dad or mom has just moved into a VA Community Living Center and nobody has told you the number yet, that worry is completely understandable. The good news is that $97 is a ceiling, not a bill, and some veterans owe nothing at all.

In This Guide

• The 2026 VA Long-Term Care Copay Rates
• Who Pays No VA Long-Term Care Copay
• How VA Figures What Your Family Actually Owes
• The House, the Car, and the Spouse at Home
• The 70 Percent Rule and Its December 2026 End Date
• State Veterans Homes and Other Settings
• How to Get Your Family's Number: VA Form 10-10EC
• Frequently Asked Questions
• Learn More

The 2026 VA Long-Term Care Copay Rates

The U.S. Department of Veterans Affairs calls long-term care "extended care," and the copay rules sit in one federal regulation, 38 CFR 17.111. If you haven't already, the veteran has to be signed up for VA health care before any of this applies. VA's own copay rates page sets out what each level of care costs per day once the free period ends.1

Those figures come from VA's 2026 table, and the same $97, $15 and $5 amounts appear in 38 CFR 17.111(b)(1).1 A Community Living Center is a VA nursing home, and VA says most Community Living Center stays are short stays after a hospital discharge.3 The maximum VA extended care copay for any month equals the daily copay amount multiplied by the number of days in the month, and the monthly copay may be less if the veteran shows it should be reduced or eliminated.4

Here's the part that matters most for your budget: every number in that table is "up to." A non-exempt veteran owes the VA extended care copay only to the extent the veteran and spouse have available resources, so nobody is automatically billed $97 a day.1 What your family actually owes depends on whether the veteran is exempt and, if not, on the household's finances.

Who Pays No VA Long-Term Care Copay

If you're bracing for a big bill, check this list first. VA says some veterans don't have to pay copays at all because of their disability rating, income level, or special eligibility factors.1 Under 38 CFR 17.111(f), the veterans and care not subject to VA extended care copays include:4

• A veteran with a compensable service-connected disability, at any compensable rating.
• A veteran whose annual income is below the VA pension amount in effect under 38 U.S.C. 1521(b).
• Care for a veteran's noncompensable zero percent service-connected disability.
• A veteran VA finds catastrophically disabled, but only for adult day health care, non-institutional respite care, and non-institutional geriatric care.
• A veteran who was awarded the Medal of Honor.
• A veteran who meets the federal definition of Indian or urban Indian, for noninstitutional extended care provided on or after January 5, 2022.
• Care for sexual trauma under 38 U.S.C. 1720D, care for psychosis or other mental illness under 38 CFR 17.109, care under 38 U.S.C. 1710(e) for herbicide-exposed, radiation-exposed, Persian Gulf War, post-Persian Gulf War combat-exposed or Camp Lejeune veterans, certain head and neck cancer care under 38 U.S.C. 1720E, and an episode of extended care that began on or before November 30, 1999.

That first exemption is easy to miss. The 70% figure often attached to VA long-term care belongs to a different federal rule, the VA nursing home care mandate covered below, not to the VA extended care copay.2

How VA Figures What Your Family Actually Owes

If the veteran isn't exempt, the VA extended care copay follows the calendar in three stages, all set by one federal regulation, 38 CFR 17.111. It helps to think of the daily rate as a ceiling that the household's finances can lower, sometimes all the way to zero.

Days 1 to 21. No VA extended care copay is owed for the first 21 days of extended care in any 12-month period, and that 12-month period starts on the date VA first provided extended care to the veteran.4 VA bases the copay from day 22 on the level of care and the financial information on the veteran's VA Form 10-10EC.1

Days 22 to 180: income only. For a veteran who has received VA extended care for 180 days or less, the VA copay looks only at money coming in: the income of the veteran and spouse, minus the veterans allowance, the spousal allowance, and expenses.1 The VA veterans allowance is $20 per day, and a VA spousal allowance of $20 per day is added only if the spouse lives in the community.4 In plain terms, the family's savings and property play no part in the VA extended care copay during the first 180 days.1

Day 181 on: assets count too. Once a veteran has received VA extended care for 181 days or more, the resources VA counts toward the copay also include the liquid assets and fixed assets of the veteran and spouse, minus the allowances, the spousal resource protection amount, and expenses, with expenses subtracted only if a spouse or dependents live in the community.5 For a family, day 181 is the turning point: from then on, savings and, in some cases, the house can push the VA extended care copay up toward its daily ceiling. That makes the first 180 days the time to learn which of your family's assets count, before they do.

The expenses VA subtracts from available resources for the extended care copay are basic living costs: rent or mortgage on the primary residence, a payment on one vehicle, food and education for the veteran, spouse and dependents, court-ordered payments such as alimony or child support, utilities and insurance on the home, out-of-pocket medical costs, health insurance premiums, and taxes on income and personal property.5 That list is worth gathering receipts for, because every allowed expense lowers the amount VA treats as available for a copay.

The House, the Car, and the Spouse at Home

This is usually the question behind the question: will the copay eat the family home? The honest answer depends on who lives in the house and what kind of care the veteran is getting.

Under 38 CFR 17.111, fixed assets are real property and other non-liquid assets, and burial plots never count.5 The home and the car are treated differently depending on the type of care:

• Care without an overnight stay. For a veteran receiving only noninstitutional extended care, such as adult day health care, VA does not count the veteran's own primary residence or own vehicle as a fixed asset for the copay.5
• Nursing home or other institutional care. For a veteran receiving institutional extended care, VA excludes a home from the copay calculation only when it is the primary residence of the veteran's spouse, or of the veteran's dependents if there is no spouse, and the same rule applies to a vehicle.5

So for a widowed veteran with no dependents in a VA nursing home, the value of the house can enter the VA extended care copay calculation from day 181 of extended care, while for a married veteran whose spouse still lives in the house, the house is excluded.5 That difference can change the monthly copay a great deal, which is why it's worth asking the VA social worker about it directly.

A spouse still at home gets another protection. VA says that if the veteran's spouse lives in the community and isn't also receiving extended care, the 2026 community spouse resource allowance of $162,660 reduces the liquid assets VA uses to set the extended care copay.1 And when a veteran is legally separated, VA leaves the spouse's income, expenses and assets out of the resources it counts for the extended care copay.5

The 70 Percent Rule and Its December 2026 End Date

Two different federal rules get blended into "70 percent means free long-term care," and keeping them apart protects your family from a costly surprise.

The first is about access. Under 38 U.S.C. 1710A(a), VA must provide needed nursing home care to a veteran who needs it for a service-connected disability and to a veteran with a service-connected disability rated at 70% or more.2 Under 38 U.S.C. 1710A(d), that mandatory nursing home care requirement in 38 U.S.C. 1710A(a) terminates on December 11, 2026, unless the statute is amended to extend it.2 The 38 U.S.C. 1710A text is where to check whether Congress has acted.

The second is about cost. The VA extended care copay exemption in 38 CFR 17.111(f) covers any compensable service-connected rating, so a veteran rated 70% or higher is also exempt from the copay because that rating is compensable.2 The December 11, 2026 date in 38 U.S.C. 1710A(d) applies to subsection (a), the duty to provide nursing home care, while the copay exemption comes from a separate federal rule, 38 CFR 17.111(f). Our guide to VA nursing homes covers who qualifies for a placement in the first place.

State Veterans Homes and Other Settings

VA's copay table is built around VA's own care. Families often look at two other kinds of nursing homes, and each works differently.

State Veterans Homes. State Veterans Homes are owned and run by state governments, not by VA, and VA says the cost to the resident varies by state.6 VA pays each state a per diem for eligible veterans that is the lesser of half the daily cost of care or the VA basic per diem rate.7 For a veteran who needs nursing home care for a service-connected disability, or who has a service-connected rating of 70% or more and needs that care, VA's payment under a State home care agreement is payment in full, and under 38 U.S.C. 1745 and 38 CFR 51.41 the State home may not charge anyone else for the care VA paid for.7 Our State Veterans Homes guide walks through admission and cost state by state.

Community Nursing Homes. A Community Nursing Home is a non-VA nursing home that VA contracts with, and VA will pay for that care only if the veteran meets VA eligibility criteria involving service-connected status, level of disability, and income.8 A veteran who doesn't meet VA's Community Nursing Home eligibility criteria pays for that nursing home care from their own resources, which may include Medicare benefits or applying for Medicaid.8

Medicare. Medicare Part A covers skilled nursing facility care only on a short-term, post-acute basis, not long-term custodial care.9 Our VA and Medicaid guide explains how VA benefits and Medicaid fit together for long-term care.

Respite and adult day care. The same 21-day rule and resource test apply at the low end of VA's schedule. Under 38 CFR 17.111, VA respite care costs up to $15 a day when non-institutional and $97 a day when institutional, after the first 21 days.10 VA says respite care, overnight or daily, is available up to 30 days each calendar year.1 Our VA adult day care guide covers the $15 daytime program in detail.

How to Get Your Family's Number: VA Form 10-10EC

The only way to learn the real copay is to let VA run the numbers. VA directs families to a VA social worker or case manager to complete the Application for Extended Care Benefits, VA Form 10-10EC.3 After the form is entered, the local VA medical facility tells the veteran, or the person holding the veteran's power of attorney, the estimated monthly copay.5

A few rules on VA Form 10-10EC are worth knowing before you sit down with it:

1. Declining to share finances has a price. The 10-10EC says a veteran who does not wish to provide income, asset and expense information must sign agreeing to make copayments and will be charged the maximum copayment amount for all services.5
2. Include every insurance card. The 10-10EC instructions say current insurance may help to reduce your copayment responsibility.5
3. The form is not one-and-done. Under 38 CFR 17.111(e), a non-exempt veteran must submit the 10-10EC at the first request for extended care, after a break in extended care of more than 30 days, and each year along with VA Form 10-10EZ.5
4. Report changes within 10 days. VA's extended care copay rules also require a veteran to report changes that might change the copay, such as marital status, assets, expenses, income, or whether a spouse or dependents live in the community, to a VA medical facility within 10 days.5

If the veteran may be exempt, say so up front. An exempt veteran doesn't owe the copay at all, and the social worker can confirm which exemption applies.

Learn More

Find personalized help estimating your family's VA long-term care copay 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.