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

This guide covers every VA program that helps pay for or provide senior care, how to access them in New Hampshire, and what happens when VA care isn't enough on its own.

In This Guide

VA Senior Care Programs in New Hampshire: 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 list isn't closed. 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 physician supervises a health care team that visits the veteran at home. HBPC is designed for veterans with complex medical needs who have difficulty getting to a clinic regularly. The team typically includes a doctor, nurse, social worker, and may include rehabilitation therapists and a dietitian.

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. For veterans who qualify, it's one of the best programs the VA offers.

Adult Day Health Care

Veterans attend a daytime program that offers social activities, companionship, and recreation, as well as care and support. It also gives family caregivers reliable daytime respite. Programs may be at VA facilities or contracted community adult day centers.

Community Living Centers (VA Nursing Homes)

Community Living Centers are VA nursing centers, designed to feel like home, that provide nursing-home-level care. CLCs operate at VA facilities across the country. New Hampshire veterans are served through the Manchester VA Medical Center and may be placed in a CLC based on clinical need and bed availability.

A CLC stay can be short-term or long-term, and VA's long-term care services also include hospice care and palliative care. Nursing Home Respite Care can also be a short stay in a CLC. To pursue a CLC bed, ask the veteran's VA care team or the Manchester VA Medical Center's social work or geriatrics staff to start a clinical assessment.

Community Nursing Home Program

The VA contracts with community (non-VA) nursing homes so veterans can get nursing home care near home. What the veteran pays follows VA's extended-care copay rules: no copay for the first 21 days of care in a 12-month period, and from the 22nd day VA sets the copay from the level of care and the financial information the veteran provides on VA Form 10-10EC. Not every veteran owes a copay: some are exempt because of their disability rating, income level, or special eligibility factors.

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. Separately, all enrolled veterans are eligible for VA respite care if they meet the clinical criteria for the service and it is available, and Nursing Home Respite Care is available for a maximum of 30 days per calendar year. Respite can be in-home (a substitute caregiver comes to the house) or facility-based (the veteran stays temporarily in a CLC or community nursing home). Contact the VA Caregiver Support Line at 1-855-260-3274.

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

New Hampshire State Veterans Home

New Hampshire operates one state-run veterans home: the New Hampshire Veterans Home at 139 Winter Street, Tilton, NH 03276. It is the state's long-term care facility dedicated to veterans.

Detail Information
Location 139 Winter Street, Tilton, NH 03276
Capacity Not published on the Home's own site; ask the Home for current bed availability
Care provided Long-term care for veterans
Eligibility Active duty service (other than active duty for training) in the armed forces as defined by 38 U.S.C. section 101, or service in reserve units or the New Hampshire Army or Air National Guard, with an honorable discharge (no combat service, service-connected disability, or minimum age required), plus at least one year of New Hampshire residency before applying, or New Hampshire listed as "home of record" on discharge papers
Cost Assets determine the applicant's financial contribution to room and board; there is a one-year financial look-back, and a house isn't counted as an asset if the applicant's spouse lives in it

Admission also depends on whether the applicant's condition is within the Home's resources and ability to treat. Contact the Home directly for current availability and rates.

VA Aid and Attendance

The Aid and Attendance pension is a monthly cash benefit for veterans (or surviving spouses) who need help with daily activities.

2026 Rates

These are the current maximums, effective December 1, 2025 through November 30, 2026. The VA publishes them as yearly Maximum Annual Pension Rates (MAPRs), and the monthly payment is the yearly award divided by 12.

Category Yearly maximum (MAPR) Per month (yearly ÷ 12)
Veteran alone $29,093 About $2,424
Veteran with spouse $34,488 About $2,874
Surviving spouse $18,697 About $1,558

Who Qualifies

To be eligible, the veteran must have:

  • Served during a wartime period
  • No dishonorable discharge, plus at least one of these four: 65 or older, a permanent and total disability, a patient in a nursing home for long-term care because of a disability, or receiving Social Security Disability Insurance or Supplemental Security Income. Any one branch is enough, so a wartime veteran under 65 on SSI qualifies without any disability rating
  • Need regular help with daily activities
  • Have a net worth below $163,699 (for December 1, 2025 through November 30, 2026), counted as the sum of the veteran's and their dependents' assets and annual income, excluding the primary home (up to a 2-acre lot), a vehicle, and basic household goods

If the veteran is over the net-worth limit, be careful about giving away or transferring assets to qualify. The VA reviews assets transferred for less than fair market value during a 36-month (3-year) look-back before the claim, and a covered transfer can trigger a penalty period of up to five years during which no pension is paid. Talk to an accredited Veterans Service Officer before moving any money or property.

How to Apply

The steps below are the pension route, the one VA describes when it says you may be eligible for this benefit if you get a VA pension. Everyone uses VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination information section a medical examiner must fill out; that form covers Aid and Attendance added to monthly compensation benefits as well as to pension. A wartime veteran pursuing the pension route who is not already receiving a VA pension also files Form 21P-527EZ (Application for Veterans Pension), the means-tested wartime pension application. A veteran who receives VA disability compensation rather than pension does not belong on that form. You can file online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office. If you're still gathering information, file VA Form 21-0966 (Intent to File) first: VA says submitting an intent to file can secure the earliest possible effective date for any retroactive payments you may be eligible to receive. Asked how long a decision takes, VA's answer is "It depends." It works through claims in the order it receives them, unless a claim qualifies for priority processing.

Don't do this alone. Veterans Services Officers at New Hampshire's Division of Veterans Services help state-resident veterans and their dependents file compensation and pension claims with the VA and represent them through the process, and the Division's own benefits guide says the service is free of charge.

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

If Your Claim Is Denied

If the VA denies the claim or grants less than you expected, an initial decision opens three decision-review options (the menu narrows after that: following a Higher-Level Review decision it's a Supplemental Claim or a Board Appeal, and following a Board decision it's a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, which must be filed within 120 days from the date on the Board's decision letter):

  • Supplemental Claim: file new and relevant evidence the VA did not have when it reviewed the case before. The door stays open indefinitely, but file inside the year anyway. A Supplemental Claim the VA receives more than one year after the date on the decision notice takes an effective date no earlier than the date VA receives it (38 CFR 3.2500(h)(2)), and continuous pursuit of the claim is broken unless VA grants an extension of the one-year period for good cause (38 CFR 3.109(b)). In plain terms, filing late can cost back pay all the way to the original claim date.
  • Higher-Level Review: ask a higher-level reviewer to look at the case, with no new evidence submitted. For most VA benefits you elect it within one year of the date the VA issued notice of the decision, but certain VA benefits have shorter time limits, and your decision letter tells you the deadline that applies.
  • Board Appeal: appeal to the Board of Veterans' Appeals and have a Veterans Law Judge review the case, on that same clock, so check the letter rather than assuming a full year.

An accredited attorney, claims agent, or Veterans Service Organization representative can help you request a decision review, and the VA's search tool will find one. New Hampshire's Division of Veterans Services does it free of charge, so you don't have to navigate the appeal alone.

Veteran-Directed Care

The Veteran-Directed Care (VDC) program gives veterans a flexible budget to hire their own caregivers, including family members. The veteran (or their representative) decides who provides care, what services to purchase, and how to manage the budget.

A person-centered options counselor at an Aging and Disability Network agency helps set up the plan, and a financial management services (FMS) provider handles payroll and tax obligations. This is a good option for veterans who want control over their care and prefer family members as caregivers.

In New Hampshire, the aging-and-disability network's access point is the state's Aging and Disability Resource Centers (formerly ServiceLink), reachable at 1-866-634-9412. Because VDC availability is tied to the local VA, also contact the Manchester VA Medical Center's social work department to confirm the program is offered in your area and to start the enrollment.

Community Care Through the MISSION Act

The MISSION Act (2018) expanded when veterans can receive care from community (non-VA) providers. Two requirements always apply first: the veteran has to be enrolled in or eligible for VA health care, and has to get approval from their VA care team before seeing a community provider, except in cases like urgent or emergency care. On top of 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) or 60 minutes (specialty care)
  • The care you need isn't available at your VA facility
  • You and your VA provider agree community care is in your best medical interest

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

For New Hampshire 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 Benefits Work with Medicare and Medicaid

VA benefits don't replace Medicare or Medicaid, a veteran isn't required to enroll in Medicare to keep VA health care, and a veteran or surviving spouse can often receive a VA pension and Medicaid at the same time., But these programs don't coordinate or pay each other, and VA health care isn't creditable coverage for Medicare Part B, so delaying Part B while relying on the VA alone leaves a lifetime penalty that grows every year.

  • VA + Medicare: Many veterans use both. VA health care and Medicare are separate programs that do not coordinate or pay each other: the two generally can't pay for the same items or services, so the veteran chooses which coverage to use each time they get care. Having Medicare means being covered at non-VA hospitals and doctors, so having both gives you more options.
  • VA + Medicaid: VA Aid and Attendance and New Hampshire Medicaid long-term care are separate programs run by different agencies, and the two interact. New Hampshire's Medicaid long-term care benefits, including nursing facility care and the home- and community-based Choices for Independence (CFI) waiver, are administered by the NH Department of Health and Human Services (DHHS), which sets its own income and asset limits. A veteran may qualify for both, but under federal rules a single veteran with no dependents who is receiving Medicaid-covered nursing home care generally has the VA pension capped: no pension in excess of $90 per month is paid for any period after the month in which the Medicaid payments begin (38 CFR 3.551(i)). That federal cap does not set New Hampshire's Medicaid personal needs allowance. Under New Hampshire's own cost-of-care rules for nursing facility residents, a resident entitled to the VA $90 nursing facility pension has that $90 protected instead of the state's $93 personal needs allowance, not on top of it.

Medicaid's eligibility step and its share-of-cost step treat Aid and Attendance differently. For eligibility, states apply SSI income rules to the aged, blind, and disabled Medicaid groups, and under those rules VA aid and attendance and housebound allowances are not counted as income. New Hampshire is one of only 8 states that elected the more restrictive 209(b) option, so its own eligibility rule governs at that step and may differ; confirm how it treats the Aid and Attendance amount with the Department of Health and Human Services before relying on it. Once a person is eligible and receiving care in a nursing facility or other medical institution, income that was disregarded at the eligibility step must be counted in the share-of-cost calculation, so the Aid and Attendance amount does count toward what the resident owes for care. Before that income reaches the facility, federal law requires the state to subtract five things from it, in this order: a personal needs allowance the resident keeps for clothing and other personal needs; an additional amount for the maintenance needs of a spouse still at home; an additional amount for the maintenance needs of other family members at home; amounts for incurred medical or remedial care expenses that Medicaid does not pay for; and the full amount of any SSI or state supplement payments the resident keeps receiving. Those are duties DHHS owes the resident, not options a family has to ask for, though the first of them carries the New Hampshire wrinkle noted above: the VA nursing facility pension is protected instead of the state's personal needs allowance, never in addition to it. That share-of-cost rule is written for people in a nursing facility or other medical institution. Choices for Independence waiver services are governed by a separate federal post-eligibility rule, and the maintenance allowance a waiver participant keeps is set differently and is generally much larger, so ask DHHS which calculation applies to you before you budget for one. The exact treatment depends on the household, so confirm with a NH DHHS caseworker and an accredited Veterans Services Officer before relying on both.

How to Get Started

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Step 1

Confirm VA health care enrollment

If the veteran isn't already enrolled in VA health care, apply at va.gov/health-care/apply. Once the VA processes the application and the veteran is enrolled, it assigns the veteran to 1 of 8 priority groups, based on military service history, disability rating, income level, whether the veteran qualifies for Medicaid, and other benefits the veteran may be receiving.

2
Step 2

Get free help

Don't file claims or applications alone. New Hampshire's Division of Veterans Services helps free of charge, per its own benefits guide, at (603) 624-9230 or NH toll-free 1-800-622-9230. Its main office at 275 Chestnut Street, Room 517, Manchester, NH 03101-2411 schedules every appointment, including the ones service officers hold at the Manchester VA Medical Center and in Nashua, North Conway, Portsmouth, and at the New Hampshire Veterans Home in Tilton.

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. A veteran with any compensable service-connected disability rating, not only a 70 percent rating, is exempt from VA's extended-care copayments, so the long-term care VA provides or pays for carries no VA copayment. That exemption applies to VA's own extended care; it does not cover State Veterans Home fees or care you arrange outside VA. But other enrolled veterans can access many programs too, so long as VA concludes the veteran needs that specific service and the service, or a space in the care setting, is available near them, and VA may weigh other factors as well, like service-connected disability status or insurance coverage. Aid and Attendance doesn't require a service-connected disability at all. It requires wartime service, no dishonorable discharge, need for help with activities of daily living (ADLs), and any one of four branches: 65 or older, permanently and totally disabled, in a nursing home for long-term care because of a disability, or receiving SSDI or SSI.

Who is eligible to live in the New Hampshire Veterans Home?

An applicant must have served on active duty (other than active duty for training) in the U.S. Armed Forces, or in reserve units or the New Hampshire Army or Air National Guard, and must have been honorably discharged. No combat service, service-connected disability, or minimum age is required. The applicant must also have been a New Hampshire resident for at least one year before applying, or have listed New Hampshire as their "home of record" on their military discharge papers. Admission further depends on whether their condition is within the Home's resources and ability to treat.

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

VA's own answer is "It depends." It works through claims in the order it receives them, unless a claim qualifies for priority processing. Working with a Veterans Services Officer through New Hampshire's Division of Veterans Services can speed up the process and reduce the chance of errors that cause delays. You can apply while your loved one is already receiving care.

Does the VA pay for assisted living?

The VA doesn't directly operate assisted living facilities, but Aid and Attendance is paid to the veteran as an increase to the monthly VA pension, and the household can put that money toward assisted living. The cost of the care itself can also count as a deductible medical expense when VA calculates the award, but only if the veteran is receiving health care or custodial care in the facility and either needs aid and attendance, is housebound, or a physician, physician assistant, certified nurse practitioner, or clinical nurse specialist has stated in writing that they need to be in a protected environment. Veteran-Directed Care is a different tool: its flexible budget is for hiring and supervising workers who help a veteran live at home or in their community, so ask the VA social worker making the referral whether it fits an assisted living plan. Families who also need Medicaid help should ask the NH Department of Health and Human Services about the Choices for Independence (CFI) waiver.

Next Steps

If you're caring for a veteran who needs help, start by calling the NH Division of Veterans Services at 1-800-622-9230. They can assess which benefits apply and help you file.

Learn More

VA BenefitsVA Aid and Attendance in New HampshireVA Aid and Attendance in New Hampshire for 2026: who qualifies, rates up to $2,874 a month, how to apply, and free help filing your claim in NH. Care TypesHome Care vs Home Health in New HampshireHome care vs. home health in New Hampshire: home health is skilled care Medicare covers under RSA 151:2; home care is non-medical help it won't pay for. Care TypesNursing Homes in New HampshireNursing homes in New Hampshire in 2026: costs run well above the national median. What a stay costs, who pays, and how to vet a facility before you choose. Care TypesCost of Senior Care in New HampshireWhat senior care costs in New Hampshire in 2026, from assisted living to nursing homes and in-home care, why the state runs high, and how families pay. Care TypesAssisted Living vs Nursing Home in New HampshireAssisted living vs. a nursing home in New Hampshire comes down to level of care and who pays. Compare the cost gap and what New Hampshire Medicaid covers.
Your next step Find personalized help navigating VA senior care benefits in New Hampshire 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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