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.

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 health care team led by a VA doctor provides services such as nursing care, physical therapy, and help with daily tasks in the veteran's home.

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, any enrolled veteran who meets the clinical criteria can get VA respite care where it's available, but respite from a community agency, adult day health care center, or nursing home also requires community care eligibility. Overnight and daily respite are each available up to 30 days a calendar year. Respite can be at home (a substitute caregiver comes in, or the veteran attends adult day health care) or a short stay in a CLC or community nursing home. It may carry a copay under the extended-care rules above, and VA doesn't quote it up front: ask the veteran's VA social worker or case manager to complete VA Form 10-10EC and settle the copay before booking a long stay. The VA Caregiver Support Line is 1-855-260-3274, weekdays 8:00 a.m. to 8:00 p.m. Eastern.

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

New Hampshire State Veterans Home

The New Hampshire Veterans Home at 139 Winter Street, Tilton, NH 03276 (603-527-4400) is the state veterans home New Hampshire law establishes for the support, care, and treatment of 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 State law says care there includes nursing care, assisted living, domiciliary, day care, dementia, chemical dependency and psychiatric services, and related programs
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

State law is broader than that eligibility list: since August 31, 2026 it covers a general discharge under honorable conditions, and it waives the residency year for an active duty veteran with a New Hampshire home of record discharged straight from a medical facility. Admission also requires that the applicant's condition be within the Home's ability to treat and that they not pose potential harm to themselves or other residents. Contact the Home directly for current availability and rates.

VA Aid and Attendance

Aid and Attendance is an increased monthly payment added to a VA pension, for a wartime veteran (or surviving spouse) who needs regular help from another person.,

2026 Rates

These Maximum Annual Pension Rates (MAPRs) apply from December 1, 2025 through November 30, 2026. A MAPR is a ceiling, not a payment: VA subtracts countable income, divides the rest by 12, and rounds down to the dollar. Unreimbursed medical expenses above 5% of the MAPR can lower countable income.

Category Yearly maximum (MAPR)
Veteran with no dependents $29,093
Veteran with one dependent (such as a spouse) $34,488
Surviving spouse with no dependents $18,697

Who Qualifies

To be eligible, the veteran must have:

  • At least 1 day of wartime service, plus generally 90 days of active duty if service began before September 8, 1980, or, for a later-starting enlisted veteran, 24 months or the full period called up (with some exceptions)
  • 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 meets this step without any disability rating
  • At least one aid-and-attendance need: help from another person with daily activities like bathing, feeding, and dressing; staying in bed much of the day because of illness; being a nursing home patient due to lost mental or physical abilities related to a disability; or eyesight of 5/200 or less in both eyes (or a visual field of 5 degrees or less)
  • 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. Only a transfer that would otherwise have put net worth over the limit counts, and spending on care or anything else at fair market value carries no penalty. Talk to an accredited Veterans Service Organization representative before moving any money or property.

How to Apply

Every claim needs VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), with the examination section filled out by a medical examiner. A wartime veteran not already receiving a VA pension also files Form 21P-527EZ (Application for Veterans Pension), and for a nursing home resident, a nursing home official completes VA Form 21-0779. File online at VA.gov, by mail to the VA Pension Intake Center, or at a VA regional office. Still gathering papers? File VA Form 21-0966 (Intent to File) first; VA says it can secure the earliest possible effective date for retroactive payments.

Don't do this alone. Veterans Services Officers at New Hampshire's Division of Veterans Services help resident veterans and dependents file pension claims and represent them through the process, free of charge.

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

If Your Claim Is Denied

If VA denies the claim or grants less than you expected, you have three decision-review options:

  • Supplemental Claim: file new and relevant evidence VA didn't have before. There's no deadline, but one received more than a year after the decision notice generally takes an effective date no earlier than the day VA gets it, which can cost back pay.
  • Higher-Level Review: ask a higher-level reviewer to look at the case, with no new evidence submitted. You elect it within one year of the date on the decision letter.
  • Board Appeal: a Veterans Law Judge at the Board of Veterans' Appeals reviews the case, on the same one-year clock. In a contested claim, where several people claim a benefit only one can get, a Board Appeal within 60 days is the only route.

Only one review can be pending on the same issue at a time. After a Board decision, you can file a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims within 120 days, filed with the Court rather than VA; a properly mailed notice counts as received on its legible postmark date. An accredited representative can help you request a review, and New Hampshire's Division of Veterans Services helps with appeals free of charge.,

Veteran-Directed Care

The Veteran-Directed Care (VDC) program gives veterans 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. Those workers can include family, friends, or neighbors. All enrolled veterans are eligible if they're eligible for community care, meet the clinical criteria for the service, and it's available.

VA medical centers deliver VDC through aging and disability network agencies, such as aging and disability resource centers and area agencies on aging. Through an options counselor, the agency does the assessment and care planning, arranges fiscal management services, and keeps providing counseling and support. This is a good option for veterans who want control over their care and prefer family members as caregivers.

In New Hampshire, the state's Aging and Disability Resource Centers are 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 six conditions has to be true, including these:

  • VA can't offer an appointment within a 30-minute average drive or 20 days (primary care, mental health, extended outpatient care), or a 60-minute drive or 28 days (specialty care). Missing either one is enough, though a veteran who agrees to a later date can't qualify on the wait
  • The veteran needs a service VA doesn't provide at any VA health facility
  • The veteran and their VA provider agree community care is in the veteran's best medical interest
  • VA can't provide the service in a way that meets its quality standards

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.

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 an older veteran or surviving spouse can qualify for and receive a VA pension and Medicaid at the same time., But VA doesn't bill Medicare or Medicaid, and VA health care is no shield against Medicare's Part B late-enrollment penalty: delay Part B and the penalty grows with every year you wait, and you pay it for the rest of your life.

  • VA + Medicare: Many veterans use both. VA health care and Medicare are separate programs: 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. One exception: if VA authorizes a non-VA hospital stay but not every service in it, Medicare may pay for the covered services VA didn't authorize. 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 federal rules cap the pension for a veteran without a spouse or child, a surviving spouse without a child, or a surviving child who is receiving Medicaid-covered nursing home care: 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)). The statute behind it (38 U.S.C. 5503(d)) excludes a State home VA pays a per diem for, so for a state veterans home stay, ask a Veterans Services Officer whether the cap applies. The statute also dates the cap from the month of admission, not the month Medicaid begins, so check which date VA used. 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. Under the SSI income rules most states use for eligibility, VA aid and attendance and housebound allowances aren't income, but New Hampshire is one of 8 states with stricter 209(b) rules, so confirm how DHHS treats it. For a nursing facility resident, New Hampshire's cost-of-care rules (DHHS Medical Assistance Manual 619.01) start from income and subtract, in order: the $90 VA pension or the $93 personal needs allowance (never both); income allocated to a spouse or family at home; the resident's own health insurance premiums (including Medicare Part B), coinsurance, deductibles, uncovered needed care, and unpaid prior medical debt; continuing SSI; and, for a verified stay of 3 months or less with a planned return home, a home upkeep allowance. Only then is the Aid and Attendance allowance added back; the result is what the resident owes toward care. That add-back reaches only a pension not cut to the federal $90 cap, such as one paid to a veteran with a spouse or child; a capped $90 pension is subtracted first and never added back. In a state veterans home VA pays a per diem for, pension above $90 a month for a veteran with no spouse or child (or a surviving spouse with no child) counts as income only toward the home's cost of care. For Choices for Independence waiver services, New Hampshire's rule applies the Aid and Attendance allowance to the cost of care; for the rest of that calculation, ask a DHHS caseworker, and check the whole picture with an accredited Veterans Services Officer before relying on both programs.

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/how-to-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.

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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. The main office is at 275 Chestnut Street, Room 517, Manchester, NH 03101-2411, and service officers also meet veterans by appointment at sites around the state, including the Manchester VA Medical Center, Nashua, North Conway, Portsmouth, and the New Hampshire Veterans Home in Tilton. Book through the main number; the Division also says you can contact the site most convenient to you.

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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, at least one aid-and-attendance need (such as needing help with bathing, feeding, and dressing), 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?

A veteran who served on active duty (other than for training), in the reserves, or in the New Hampshire Army or Air National Guard, with an honorable discharge, or, under state law since August 31, 2026, a general discharge under honorable conditions. No combat service, service-connected disability, or minimum age is required. They also need a year of New Hampshire residency before applying, or New Hampshire as their "home of record" on discharge papers, and the condition must be within the Home's 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. A Veterans Services Officer from New Hampshire's Division of Veterans Services can help file the claim and represent the veteran through the VA process, free of charge.

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. Assisted living fees can also count as deductible medical expenses when VA calculates the award, under conditions. Payments for health care from a health care provider count. Help with daily activities from other staff counts 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. Meals and lodging count only if the facility provides or contracts for the veteran's care, or a clinician states in writing that the veteran must live there to receive care. 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 benefits for senior care nationwideA complete guide to VA benefits for senior care: long-term care, Aid and Attendance, pensions, DIC, and home grants for older veterans and surviving spouses. VA BenefitsVA Aid and Attendance in New HampshireVA Aid and Attendance in New Hampshire for 2026: who qualifies, up to $2,874 a month for a veteran with a spouse, how to apply, and where to get help 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. VA BenefitsNew Hampshire Disabled Veteran Property Tax Credit and ExemptionNew Hampshire's disabled veteran property tax exemption is mostly a credit: $700, or up to $5,000 by town vote. Full exemption needs a VA-adapted home.
Your next step Find personalized help with 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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