If a doctor or discharge planner has said "nursing home" and your veteran parent can't bear the idea, a VA medical foster home is the option to ask about. In a VA medical foster home, a trained caregiver looks after the veteran around the clock in a private house with no more than three residents, and VA's own home care team visits. It isn't free, and it isn't everywhere, but for the right veteran it's a real alternative.

In This Guide

What Is a VA Medical Foster Home?

Picture a regular house on a regular street. In a VA medical foster home, the caregiver who owns or rents the house lives there and has agreed, with VA's approval, to care for people who can no longer live on their own. That's the heart of the VA Medical Foster Home program run by the U.S. Department of Veterans Affairs.

The federal regulation, 38 CFR 17.73, sets three tests for a VA medical foster home: the caregiver lives in the home, the caregiver owns or rents it, and "there are not more than three residents receiving care (including veteran and non-veteran residents)." VA's program page adds that some, but not all, residents are veterans.

VA says a medical foster home "can serve as an alternative to a nursing home," and may be appropriate for veterans who need nursing home care but would rather live in a smaller, non-institutional setting. In a VA medical foster home, the caregiver and relief caregivers provide care and supervision 24 hours a day, 7 days a week.

According to VA's Medical Foster Home program page, the caregiver can provide:

  • Help with daily activities like bathing and getting dressed
  • Help taking medications
  • Some nursing assistance
  • All of the veteran's meals
  • Planned recreational and social activities

Under 38 CFR 17.73, the medical foster home caregiver, helped by relief caregivers, provides "a safe environment, room and board, supervision, and personal assistance, as appropriate for each veteran."

The doctor visits come from VA, not the caregiver. VA says veterans living in a medical foster home receive Home Based Primary Care, VA's program that sends a team to the veteran's home, including primary care visits by a physician, nurse practitioner or physician's assistant, plus social work, rehabilitation, psychology, nutrition and pharmacy. Our guide to VA Home Based Primary Care explains that program in full.

Does Your Parent Qualify for a VA Medical Foster Home?

This is the question that keeps families up at night, so here is the rule exactly as the regulation writes it. Under 38 CFR 17.73(c), VA health care staff may refer a veteran for placement in a VA medical foster home when all three of these are true:

  1. The veteran is unable to live independently safely, or needs nursing-home-level care.
  2. The veteran is enrolled in, or agrees to enroll in, VA Home Based Primary Care, VA Spinal Cord Injury Homecare, or a similar VA program for medically complex veterans living at home.
  3. The home has been approved by VA.

VA's own Medical Foster Home program page says the same thing in fewer words: the veteran needs to be enrolled in Home Based Primary Care, and a home needs to be available.

Two practical points follow. First, your parent has to be signed up for VA health care before any of this. VA says veterans apply with the Application for Health Benefits, VA Form 10-10EZ, online, by phone at 877-222-8387, by mail, or in person at a VA medical center or clinic. Second, "a home needs to be available" is doing a lot of work. VA says services may vary by location, and the veteran's VA social worker or case manager can help with the eligibility guidelines for both Home Based Primary Care and Medical Foster Home care.

It also helps to know how small VA's formal role is. Under 38 CFR 17.73, the choice to move into a medical foster home is voluntary, and "VA's role is limited to referring veterans to approved medical foster homes." Once a veteran moves in, VA inspects the home to make sure it keeps meeting VA's requirements and provides oversight and caregiver training. VA will not refer anyone to a home that fails its approval criteria.

What a VA Medical Foster Home Costs, and Who Pays

Here is the part families most need to hear plainly, even though it's hard. VA's Medical Foster Home program page says medical foster homes "are not provided or paid for by VA," and that the veteran will have to pay for the home themselves or through other insurance.

VA puts the charge for a medical foster home at "about $1,500 to $3,000 each month based on your income and the level of care you need," and says the specific cost is agreed upon ahead of time between the veteran and the medical foster home caregiver. That's a negotiated price between your family and the caregiver, not a VA rate, so get it in writing before the move.

VA's long-term care page groups medical foster homes with adult family homes and assisted living as community residential care, and says of that group: "These places are not run, staffed, or paid for by VA, but we do inspect and approve each one." VA adds that benefits may help pay for extra services, such as visits from a VA health care provider.

Part of the arrangement Who provides it Who pays
The room, meals and 24/7 caregiver The medical foster home caregiver The veteran or family, at a price agreed in advance with the caregiver
Medical care at home The VA Home Based Primary Care team VA health care, though an HBPC copay may apply
Inspection, oversight and caregiver training VA Part of VA's role under 38 CFR 17.73

The Home Based Primary Care piece can carry its own copay. VA says an HBPC copay may be charged based on the veteran's service-connected disability status and financial information, that the veteran may owe a basic copay each time a VA staff team member makes a medical visit to the home, and that the veteran's VA social worker or case manager can help complete VA Form 10-10EC to learn the amount. Our guide to VA long-term care copays walks through those rules.

When VA Can Pay for a Medical Foster Home

There is one exception to "the family pays," and it matters most to the family of a veteran with a high service-connected disability rating. A 2022 federal law, the Cleland-Dole Act, gave VA authority to pay for medical foster home care for certain veterans, now written into 38 U.S.C. 1720 as subsection (h).

Under 38 U.S.C. 1720(h), for five years starting with the law's enactment on December 29, 2022, VA "may" place a veteran in a medical foster home at government expense if VA is required to provide that veteran nursing home care under 38 U.S.C. 1710A and the veteran asks. A veteran whose medical foster home care VA pays for this way must agree to accept VA home health services.

Who is VA required to give nursing home care? 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 who needs nursing home care and has a service-connected disability rated 70% or more. Under current federal law, that 1710A(a) requirement ends on December 11, 2026 unless Congress extends it.

Three limits keep the VA-paid medical foster home path from being a sure thing:

  • It's capped. Under 38 U.S.C. 1720(h)(3), in any year no more than a daily average of 900 veterans can have their medical foster home care covered at government expense under this authority.
  • It's permissive. The law says VA "may" pay. It doesn't say VA must.
  • It hadn't started, as of the last public report. The U.S. Government Accountability Office (GAO) reported in September 2025 that, as of May 2025, VA had not begun making payments for veterans' medical foster home costs because it was not able to update its payment systems due to competing priorities, according to VA officials, who were exploring manual payment options.

If your parent has a 70% or higher VA service-connected rating, or needs nursing home care because of a service-connected condition, ask the VA Medical Foster Home coordinator directly whether VA is paying for medical foster home care at your parent's VA medical center today. We can't tell you the current answer, because GAO's September 2025 report describes VA's medical foster home payment status only as of May 2025.

Using VA Pension and Aid and Attendance to Help Pay

VA's Medical Foster Home program page tells veterans to talk with a VA social worker or case manager to find out whether they're entitled to other VA benefits that can help pay for a medical foster home. One benefit to ask about is VA Pension with its Aid and Attendance increase.

Three federal rules make VA Pension worth a close look for a veteran in a medical foster home:

  • The home's bill counts as a medical expense. Under 38 CFR 3.278(d)(1), for VA Pension, payments to medical foster homes, including the meals and lodging they charge, are medical expenses. Only the part above 5% of the veteran's maximum pension rate, not counting the Aid and Attendance increase, can be deducted. For December 1, 2025 to November 30, 2026, VA prints that VA Pension deduction threshold as $872 for a veteran with no spouse or child.
  • The house your parent left can stay protected. Under 38 CFR 3.275(b)(1)(ii), VA Pension doesn't count the veteran's primary residence as an asset even while the veteran lives in a medical foster home, though rental income from that house counts as income.
  • Net worth still has a ceiling. For VA Pension from December 1, 2025 to November 30, 2026, the net worth limit is $163,699.

For VA Pension with Aid and Attendance from December 1, 2025 to November 30, 2026, the maximum annual rate for a veteran with no dependents is $29,093, and $34,488 for a veteran with one dependent. VA bases the payment on the difference between that maximum and the veteran's income for VA purposes. Our guides to VA Aid and Attendance and deducting unreimbursed medical expenses show how the math works.

How Hard Is It to Find a Medical Foster Home?

Honestly, it can be hard, and it's better to know that going in. GAO reported that as of May 2025, 483 VA medical foster homes were aligned with 150 VA medical centers, and 707 veterans were participating in the program nationwide.

That's small, but it has been growing. GAO reported that VA spent approximately $18.6 million from fiscal years 2021 through 2024 to expand the Medical Foster Home program, which led 42 more VA medical centers to start one.

VA's Medical Foster Home program page links to a list of the VA medical centers currently operating a program, says many other facilities are developing their own, and tells veterans to ask their VA social worker when a medical foster home will be available locally. Each VA medical foster home cares for three residents at most under 38 CFR 17.73, so it's worth asking early, before a crisis forces a nursing home decision.

How to Ask About a Medical Foster Home, Step by Step

1
Step 1

Make sure your parent is enrolled in VA health care

VA says veterans apply with VA Form 10-10EZ online, by phone at 877-222-8387, by mail, or in person at a VA medical center.

2
Step 2

Call your parent's VA social worker or case manager

VA says the social worker or case manager can help with the eligibility guidelines for Home Based Primary Care and Medical Foster Home care.

3
Step 3

Ask about Home Based Primary Care at the same time

Under 38 CFR 17.73(c), a veteran must be enrolled in, or agree to enroll in, Home Based Primary Care or a similar VA home program to be referred to a medical foster home.

4
Step 4

Ask whether a VA-approved home has an opening

VA says the social worker can help locate a medical foster home and assist with making arrangements.

5
Step 5

Agree on the monthly price in writing

VA says the specific cost is agreed ahead of time between the veteran and the caregiver.

6
Step 6

If your parent has a 70% or higher VA service-connected rating, or needs nursing home care because of a service-connected condition, ask about VA payment under 38 U.S.C. 1720(h)

GAO reported that as of May 2025 VA had not begun those payments, so ask for the current status.
7
Step 7

Ask about VA Pension and Aid and Attendance

VA tells veterans to ask their social worker or case manager whether other VA benefits can help pay for a medical foster home.

Medical Foster Home vs. a Nursing Home

If a medical foster home isn't available, or your parent needs more skilled nursing than a home caregiver provides, VA's other residential options are nursing homes. Our guide to VA nursing home care covers them in depth. Here's how they compare with a medical foster home.

VA Medical Foster Home VA Community Nursing Home State Veterans Home
Setting A private home, 3 residents receiving care at most A non-VA nursing home under VA contract A state-owned, state-run facility
Care 24/7 caregiver plus VA Home Based Primary Care 24-hour skilled nursing, therapy, social work Nursing home, domiciliary or adult day health care
Who sets eligibility VA, under 38 CFR 17.73 VA, by service-connected status, disability level and income Each state
Who usually pays The family, at a price agreed in advance VA if the veteran meets VA's criteria, otherwise the family, Medicare or Medicaid The resident, at a cost that varies by state, with VA per diem help for eligible veterans

The medical foster home details come from 38 CFR 17.73 and VA's program page. VA says Community Nursing Homes always provide 24-hour skilled nursing care, and that VA pays only for a veteran who meets criteria involving service-connected status, level of disability and income; others use their own resources, which may include Medicare or Medicaid. VA says State Veterans Homes are owned and run by states, each state sets its own admission rules, the cost to the resident varies by state, and VA pays per diem to states for eligible veterans. Our guide to State Veterans Homes has more.

Frequently Asked Questions

Can my veteran parent's spouse live in the same medical foster home?

Possibly. Under 38 CFR 17.73, a VA medical foster home's limit of three residents receiving care counts veteran and non-veteran residents together, so a spouse who needs care would take one of the three places. Ask the VA social worker whether a particular home has room for both of them.

What happens to VA Pension if we sell Dad's house after he moves into a medical foster home?

Under 38 CFR 3.275(b)(1), if the veteran's primary residence is sold after VA Pension entitlement is established, the net proceeds of the sale count as an asset for VA Pension, except to the extent they are used to buy another residence within the same calendar year as the sale. VA will deny or discontinue VA Pension when net worth exceeds the limit, which is $163,699 from December 1, 2025 to November 30, 2026, so work out the numbers before listing the house. Other programs, such as Medicaid, have their own rules, so check those separately; our guide to VA benefits and Medicaid is a starting point.

What happens if the medical foster home closes or doesn't work out?

Because VA doesn't physically place veterans in medical foster homes, 38 CFR 17.73(d)(2) says VA doesn't help them move out, but VA will help a veteran find another approved medical foster home when relocation is necessary.

Can a veteran with dementia live in a VA medical foster home?

The 38 CFR 17.73(c) referral test turns on safety and level of care rather than on a diagnosis. For a VA medical foster home, VA says it ensures the caregiver is well trained to provide VA planned care, and 38 CFR 17.73(e) ties supervision to what is appropriate for each veteran. Before a move, ask the Home Based Primary Care team and the caregiver how nights, wandering and changing needs will be handled.

My parent already lives in a medical foster home. Can VA start paying?

Possibly. Under 38 U.S.C. 1720(h)(1)(B), VA may also pay for the care of a veteran placed in a medical foster home before the Cleland-Dole Act was enacted on December 29, 2022, if the home meets VA standards, under a contract or agreement between VA and the home. The same 38 U.S.C. 1720(h)(3) cap, a daily average of 900 veterans in any year, covers these payments too.

Learn More

VA BenefitsVA Home Based Primary Care: Who Qualifies and What It CoversYes, VA can send a primary care team to a veteran's home, and being homebound isn't required. Who qualifies for HBPC, what the team does, and what it costs. VA BenefitsVA Nursing Home CareVA community living centers, contracted nursing homes, and state veterans homes: who VA must cover, what the 70% rule means, 21 free days, and the daily copay. VA BenefitsVA Aid and AttendanceVA Aid and Attendance explained: the 2026 monthly amounts, who qualifies, the medical-expense rule that unlocks it, what it pays for, and how to apply. VA BenefitsVA Long-Term Care CopaysThe first 21 days are free. After that, the VA long-term care copay is up to $97 a day for a nursing home stay, and some veterans owe nothing. Who is exempt. Care TypesBoard and Care HomesBoard and care homes are small homes, usually 20 or fewer residents, with meals, personal care and 24-hour staff. What they cost, who pays, and how to vet one. Care TypesNursing Home vs. Home CareNursing home vs. home care: 2026 national costs, what each provides, what Medicare and Medicaid pay in each setting, and the signs that tell you which one fits.

Find personalized help weighing a VA medical foster home for your parent 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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