VA Benefits You Can Use for Senior Care in Maine

VA benefits for senior care in Maine can cover far more than most families realize, from home-based medical care to nursing homes to monthly cash payments. If your loved one is a veteran, the challenge usually isn't eligibility. It is knowing what to ask for.

In This Guide

• Key Takeaways
• VA Senior Care Benefits in Maine
• Maine Veterans' Homes
• Aid and Attendance
• Veteran-Directed Care
• Community Care (MISSION Act)
• How VA Benefits Work with Medicare and Medicaid
• How to Get Started
• Frequently Asked Questions
• Next Steps

VA Senior Care Benefits in Maine: Long-Term Care Options

The VA offers a menu of long-term and home- and community-based care programs for eligible veterans.1 Each program has its own rules, and the veteran's VA care team is who confirms which ones a particular veteran can use.

Home Based Primary Care (HBPC)

A VA doctor leads a health care team that provides care in the veteran's home, with services such as nursing care, physical therapy, and help with daily tasks.1 If getting to a clinic has become hard, ask the veteran's VA care team whether HBPC is an option.

Adult Day Health Care

Veterans attend a structured daytime program that provides social activities, companionship, recreation, care, and support.1 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, that provide nursing-home-level care.1

A CLC stay can also be used for Nursing Home Respite Care, a short stay while the family caregiver takes a break.6 Ask the veteran's VA care team which Community Living Center serves your area and what levels of care it offers.

Community Nursing Home Program

The VA contracts with community (non-VA) nursing homes so veterans can get nursing home care near home.1 Whether the VA pays depends on the veteran's eligibility and on the extended care copay rules: there is no copay for geriatric or extended care for the first 21 days of care in a 12-month period, and starting on the 22nd day the VA bases the copay on the level of care being received and the financial information the veteran provides on the Application for Extended Care Services (VA Form 10-10EC).7 Some veterans do not have to pay copays at all: they are exempt because of their disability rating, income level, or special eligibility factors.7 Confirm the copay that will apply, or whether an exemption applies, before assuming the cost is covered.

Respite Care

Respite care gives a family caregiver a temporary break. All enrolled veterans are eligible for VA respite care if they meet the clinical criteria for the service and it is available.6 Respite from a community agency, adult day health care center, or nursing home also requires community care eligibility, and a copay may apply. Some veterans are exempt, including those with a compensable service-connected disability; for others the first 21 days of extended care in a 12-month period are free, then up to $97 a day for institutional respite or $15 for non-institutional, limited to available resources. To apply, or to learn the actual copay, contact the veteran's VA social worker or case manager to complete VA Form 10-10EC.6

Two different day counts get confused here, so keep them apart:

• VA's 2026 copay page describes overnight respite care and daily respite care as each available up to 30 days each calendar year. Respite comes as Nursing Home Respite Care (a short stay in a VA Community Living Center or community nursing home) or Home Respite Care (a substitute caregiver at home, or adult day health care).6
• Separately, a Primary Family Caregiver approved under the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) receives at least 30 days of respite care per year as part of that program. That is a PCAFC benefit, not a figure that applies to every enrolled veteran's caregiver.6

The VA Caregiver Support Line, 1-855-260-3274, offers family caregivers help, support, and referrals on weekdays.8

Maine Veterans' Homes

Maine Veterans' Homes (MVH) is an independent nonprofit, created by the Maine Legislature in 1977, that operates six long-term care facilities serving Maine veterans and eligible family members; it is a separate organization from the U.S. Department of Veterans Affairs.2 Across the six campuses, the system provides a full continuum of care: skilled nursing and therapy, residential care (assisted living and memory care), long-term care, and respite services.2

Who can be admitted. Honorably discharged veterans who were Maine residents when they entered the U.S. Armed Forces, or who are Maine residents when they apply, are eligible for admission; spouses, widows, widowers, and Gold Star parents of eligible veterans may also qualify, though veterans always take priority and federal law caps non-veterans at 25 percent of a home's residents.2 Combat service and a service-connected disability aren't required, but every applicant must meet medical eligibility: most Residential Care Homes require a dementia diagnosis, and a spouse must need nursing home or assisted living level care.2

How care is paid for. Families usually combine several payment sources at a state veterans' home rather than paying out of pocket alone. A veteran or surviving spouse can apply VA benefits such as Aid and Attendance toward the cost, and MaineCare (Maine's Medicaid program) can cover long-term nursing-facility care for those who qualify, so VA and MaineCare can layer together, subject to the rules described below.9 Contact Maine Veterans' Homes directly for current rates and the payment options at each campus.

Closure of the Caribou and Machias homes was announced in February 2022 and was publicly opposed by Governor Janet Mills, whose statement said the move would displace more than 70 veterans and spouses. Both homes remain among the six Maine Veterans' Homes locations operating today.2

VA Aid and Attendance

Aid and Attendance is not a stand-alone benefit. It is an increase to the VA pension: a higher monthly pension for veterans and survivors who need help with daily activities.9

2026 Rates

The VA publishes these amounts as Maximum Annual Pension Rates (MAPR), effective December 1, 2025 through November 30, 2026.3 The MAPR is a ceiling, not a payment: the VA bases the actual award on the difference between the household's income for VA purposes and the MAPR, so a household with other income receives less than the figure below.3 Pension is paid monthly, and federal regulation sets the conversion: the VA subtracts countable income from the MAPR, divides what remains by 12, and rounds down to the nearest whole dollar.3

Who Qualifies

To be eligible, the veteran must not have received a dishonorable discharge, and must meet all of the following:10

• Wartime service, with the length test keyed to when service started. The VA lists three paths, any one of which meets this test. A veteran who started active duty before September 8, 1980 needs at least 90 days of active duty with at least 1 day during a wartime period. A veteran who started active duty as an enlisted person after September 7, 1980 generally needs at least 24 months (with some exceptions), or the full period for which they were called or ordered to active duty, with at least 1 day during wartime. A veteran who started active duty as an officer after October 16, 1981 and had not previously served on active duty for at least 24 months, with at least 1 day during wartime, also meets it.10
• At least one of four situations. The veteran is 65 or older, has a permanent and total disability, is a patient in a nursing home for long-term care because of a disability, or is getting Social Security Disability Insurance or Supplemental Security Income. Any one of the four is enough.10
• An established need for aid and attendance. The criteria are set at 38 CFR 3.352(a): inability to dress or undress, or to keep oneself ordinarily clean and presentable; frequent need to adjust special prosthetic or orthopedic appliances; inability to feed oneself; inability to attend to the wants of nature; or physical or mental incapacity requiring care or assistance on a regular basis to protect from hazards or dangers in daily life. Being bedridden also qualifies, as does being a patient in a nursing home due to the loss of mental or physical abilities related to a disability, or having eyesight of 5/200 or less in both eyes or a visual field contracted to 5 degrees or less.10
• Net worth under $163,699 for 2026.10 The VA's net worth calculation adds together the claimant's and their dependents' assets and their annual income, so comparing assets alone against $163,699 gives the wrong answer. The primary home and the car are excluded, along with basic home items like appliances.10

The VA enforces a 3-year (36-month) look-back on assets transferred for less than fair market value before the claim, and a resulting penalty period may not exceed 5 years.10

If the Aid and Attendance Test Isn't Met, Ask About Housebound

Housebound is the other pension increase, for a veteran who spends most of their time at home because of a permanent disability. It raises the maximum annual pension for a veteran with no dependents to $21,313, against $29,093 with Aid and Attendance. A veteran cannot receive Aid and Attendance and Housebound at the same time, so the VA awards one or the other.3 A veteran who falls short of the aid-and-attendance criteria is still worth screening for Housebound.

How to Apply

The steps below are the pension route: the VA's instructions say 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), which a medical examiner must fill out. A wartime veteran who is not already receiving a VA pension files it together with Form 21P-527EZ (Application for Veterans Pension), the means-tested wartime pension application.11 Form 21-2680 also covers Aid and Attendance that will be added to monthly compensation benefits, so a veteran who receives VA disability compensation rather than a pension should ask an accredited representative which application applies before filing 21P-527EZ.11 On timing, the VA's own answer to how long a decision takes is "It depends." It processes claims in the order it receives them, unless a claim requires priority processing.11

Don't do this alone. The Maine Bureau of Veterans' Services employs Veteran Service Officers who help Maine veterans and their families apply for federal VA benefits, including the Aid and Attendance enhanced pension, at no cost.5

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

If a Claim Is Denied

If the VA denies a pension or Aid and Attendance claim, or grants less than you expected, you have three decision review options: a Supplemental Claim with new and relevant evidence the VA didn't have before, a Higher-Level Review by a higher-level reviewer with no new evidence, or a Board Appeal to a Veterans Law Judge at the Board of Veterans' Appeals. Only one can be pending at a time (38 CFR 3.2500(b)). A Higher-Level Review or Board Appeal must be requested within one year of the date on the decision letter; in a simultaneously contested claim (several people claiming a benefit only one can receive), the only route is a Board Appeal within 60 days. A Supplemental Claim can otherwise be filed any time, but one received more than a year after the decision notice takes an effective date no earlier than its receipt (38 CFR 3.2500), which can cost back pay, so file inside the year. An accredited attorney, claims agent, or Veterans Service Organization representative can file the review, and the VA's search tool finds one.12 A Maine Bureau of Veterans' Services officer, who provides claims help free of charge, is a good place to start if you need to respond to a denial.5

Veteran-Directed Care

Veteran-Directed Care (VDC) gives an enrolled veteran a flexible budget, managed by the veteran or their representative, to hire and supervise their own workers so they can keep living at home or in their community.13 Veterans may hire family, friends, and/or neighbors to provide services.13

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.13 VA medical centers deliver VDC through aging and disability network agencies, such as Area Agencies on Aging, aging and disability resource centers, centers for independent living, and state units on aging. Through an options counselor, the agency helps assess needs and plan care, arranges fiscal management services, and gives the veteran ongoing counseling and support.13

VDC is a VA Geriatrics and Extended Care program, delivered as a home and community based service.13 Each VA benefit has its own rules about who may be paid to provide care, so before you count on paying a specific family member, ask an accredited Veterans Service Organization representative or the social work team at your VA medical center to confirm the rules for the benefit you are using.

Community Care Through the MISSION Act

The MISSION Act (2018) expanded when veterans can receive care from community (non-VA) providers.4 Two things are always required: you must be enrolled in or eligible for VA health care, and you must get approval from your VA care team before going to a community provider, except in cases such as urgent or emergency care.4 Beyond that, at least one of these must be true:

• You need a service the VA does not provide at any VA health facility4
• You live in a state or territory that doesn't have a full-service VA health facility
• The VA can't provide the care within its standards for drive and wait times. Those access standards are a 30-minute average drive time or a 20-day wait for primary care, mental health, and extended outpatient care, and a 60-minute average drive time or a 28-day wait for specialty care4
• You and your VA provider agree that community care is in your best medical interest
• The VA can't provide the service in a way that meets its quality standards
• You qualified under the 40-mile distance requirement as of June 6, 2018 and live somewhere that still makes you eligible under those requirements4

On May 19, 2025, the VA implemented language from the Senator Elizabeth Dole Act (enacted January 2, 2025) that removes the extra step of review by a second VA doctor on the best-medical-interest path, making it faster for eligible veterans to access community care.4

For Maine veterans in rural areas far from a VA medical center, the MISSION Act can be the difference between getting timely care and waiting months.

How VA Senior Care Benefits in Maine Work with Medicare and Medicaid

VA benefits don't replace Medicare or MaineCare, a veteran isn't required to enroll in Medicare to keep VA health care, and a veteran or surviving spouse can qualify for and receive VA pension and Medicaid at the same time.14,15 VA doesn't bill Medicare, though, and generally the two can't pay for the same service: you choose which coverage to use each time you get care, and holding VA health care is no shield against the Medicare Part B late-enrollment penalty, which grows each year you delay and lasts for the rest of your life.14

• VA + Medicare: Medicare pays for Medicare-covered services, and VA pays for VA-authorized care in a VA or non-VA facility. If VA authorizes only part of a non-VA hospital stay, Medicare may pay for covered services VA didn't.14
• VA + MaineCare: A veteran or surviving spouse can potentially receive both Aid and Attendance and MaineCare long-term care, but the two programs interact and can offset each other.9 Under federal rules, VA pension counts as income for Medicaid, except the Aid and Attendance portion, which is generally not counted for MaineCare long-term care eligibility. At the cost-of-care step, federal rules for institutional residents say income disregarded at eligibility must be considered (42 CFR 435.725), but Maine's MaineCare Eligibility Manual excludes the Aid and Attendance portion with two exceptions: in a State Veteran's Nursing Home, benefits above $90 a month count for a veteran or surviving spouse with no dependents, and nothing is excluded in a residential care facility, cost reimbursement boarding home, or adult family care home.9 Home and Community Based Waivers don't count Aid and Attendance toward the cost of care. For an ordinary nursing facility the manual is silent, so ask the Office for Family Independence whether any counts, and whether MaineCare allows the optional, up-to-six-month home-upkeep deduction. Counted income is first reduced by five required deductions: a personal needs allowance, spouse and family allowances, uncovered medical expenses, and any SSI or state supplement.9
• The $90 pension cap: once MaineCare covers nursing-facility care for a veteran with no spouse or child, or a surviving spouse with no child, federal law limits the VA pension to $90 a month, and the facility's payment can't be reduced by that $90, so don't budget a full Aid and Attendance pension toward the bill.9 The statute excludes a State home for which VA pays a nursing-home per diem, so ask a Veteran Service Officer whether the cap reaches a Maine Veterans' Home stay.9

Confirm how your benefits interact with MaineCare through the Maine DHHS Office for Family Independence or a Maine Bureau of Veterans' Services officer.9

How to Get Started

Next Steps

If you're caring for a veteran who needs help, start by calling the Maine Bureau of Veterans' Services at 207-287-7020. They can assess which benefits apply and help you file at no cost.5

Learn More

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.