VA benefits for senior care in Vermont can cover more than most families realize. If your loved one is a veteran, the VA offers home-based medical care, nursing home care, monthly cash payments, and flexible budgets to hire caregivers. 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 Vermont, and what happens when VA care isn't enough on its own.

In This Guide

VA Senior Care Benefits in Vermont: Long-Term Care Programs

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. The VA 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 structured daytime program that provides social activities, companionship, recreation, 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-run nursing centers, designed to feel like home, that provide nursing-home-level care. They are typically located at larger VA medical centers.

CLCs serve veterans who need short-term rehabilitation (after surgery or hospitalization), long-term nursing care, hospice care, or respite care.

Community Nursing Home Program

The VA contracts with community (non-VA) nursing homes so veterans can get nursing home care near home. Don't assume the stay is free. The VA covers some extended care under a veteran's standard VA health benefits, and the veteran may still owe a copay: there is no copay for the first 21 days of geriatric or extended care in a 12-month period, and from the 22nd day the VA sets the copay from the level of care and the financial information the veteran gives on VA Form 10-10EC. Ask the VA social worker which copay applies before you plan around the cost.

Respite Care

All enrolled veterans are eligible for VA respite care if they meet the clinical criteria for the service and it is available, and through the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC), eligible Primary Family Caregivers receive at least 30 days of respite care per 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; Nursing Home Respite Care is available for a maximum of 30 days per calendar year). 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.

The Vermont Veterans' Home

Vermont operates one State Veterans Home, the Vermont Veterans' Home at 325 North Street in Bennington, a residential and healthcare campus serving veterans, their spouses, and Gold Star parents. It is a licensed healthcare facility whose services include short-term and long-term care, post-operative wound care, intravenous medications, physical, speech, and occupational therapy, and a certified dementia unit, with nursing care supervised by a registered nurse twenty-four hours a day, year-round.

Detail Description
Location 325 North Street, Bennington
Care provided Short- and long-term care, wound care, IV medications, physical/speech/occupational therapy, certified dementia unit
Bed capacity 130 nursing care beds and 8 domiciliary beds (per the National Association of State Veterans Homes)
Who is served Veterans, their spouses, and Gold Star parents
Admission priority Vermont veterans (veterans from other states are welcome to apply)
Payment accepted Private payment, Medicare, and Vermont Medicaid

Eligible veterans are those who served at least ninety days in the Armed Forces of the United States and were discharged under honorable conditions. Spouses of qualified veterans and Gold Star parents are also eligible for admission. Contact the home 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

The VA sets these as maximum annual pension rates, effective December 1, 2025 through November 30, 2026, and the monthly figure is the yearly rate divided by 12. Each one is a ceiling rather than a payment. VA pays the difference between a household's income for VA purposes and the applicable maximum, so a veteran with countable income receives less than the table shows. Unreimbursed medical expenses are subtracted from that income first, which is what lets a veteran with a modest pension still qualify for a meaningful benefit.

Category Annual Amount Monthly Equivalent
Veteran alone Up to $29,093 $2,424
Veteran with spouse Up to $34,488 $2,874
Surviving spouse Up to $18,697 $1,558

Read "up to" literally. These are ceilings, not payments. The VA bases the payment amount on the difference between your income for VA purposes and a limit Congress sets, and the Maximum Annual Pension Rate is that limit: the maximum amount of pension payable. A veteran with other income receives the maximum less that countable income, and a veteran whose countable income reaches the limit receives nothing. Unreimbursed medical expenses, including what the family is already paying for care, lower that countable income and so raise the award, though only the portion above 5% of the MAPR is deductible. That is why two veterans with the same Social Security check can end up with very different awards. Build the care budget from the award letter the VA sends you, not from the figures in the table above.

Who Qualifies

To be eligible, the veteran must not have a dishonorable discharge, and must:

  • Have served during a wartime period
  • Meet at least one of four alternatives: be 65 or older, have a permanent and total disability, be a patient in a nursing home for long-term care because of a disability, or be getting Social Security Disability Insurance or Supplemental Security Income
  • Need regular aid and attendance with everyday activities (the standard is set at 38 CFR 3.352(a)). VA tests that need four different ways, and any one of them is enough on its own: you need "another person to help you perform daily activities, like bathing, feeding, and dressing"; or you have to stay in bed, or spend a large portion of the day in bed, because of illness; or "You're a patient in a nursing home due to the loss of mental or physical abilities related to a disability"; or "Your eyesight is limited (even with glasses or contact lenses you have only 5/200 or less in both eyes; or concentric contraction of the visual field to 5 degrees or less)". The eyesight route is the one families overlook.
  • Have a net worth below $163,699. The VA's net-worth calculation counts the claimant's and their dependents' assets and annual income together, excluding the primary home and a vehicle.,

The VA enforces a 3-year look-back period on asset transfers.

How to Apply

Most families reach this benefit by the pension route, and the VA's own condition for it reads: you may be eligible for this benefit if you get a VA pension. On that route, apply using VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance), whose examination information section a medical examiner fills out, and, for a wartime veteran not already receiving a VA pension, Form 21P-527EZ (Application for Veterans Pension), which is the wartime, means-tested pension application. Form 21-2680 is not pension-only: the VA also uses it for Aid and Attendance that will be added to monthly compensation benefits, so a veteran drawing VA disability compensation rather than a pension still uses 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. Asked how long a decision takes, the VA answers "It depends," and says it processes claims in the order received unless a claim requires priority processing.

Don't do this alone. The Vermont Office of Veterans Affairs tells veterans not to apply for Disability Compensation or Improved Pension by themselves: its certified service officers complete the application and make sure the VA has everything it needs to process it, which the office says increases the chances of success and helps prevent delays.

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

Veteran-Directed Care

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

Unlike the VA Pension/Aid and Attendance benefit, VDC has no prohibition on paying a spouse to provide the care. A financial management services provider handles payroll and employer responsibilities, with support from local Aging and Disability Network Agencies such as Area Agencies on Aging and Centers for Independent Living. This is a good option for veterans who want control over their care and prefer family members as caregivers.

Contact your local VA medical center's social work department to ask about VDC availability in your area.

Community Care Through the MISSION Act

The MISSION Act (2018) expanded when veterans can receive care from community (non-VA) providers. Two things always apply: the veteran has to be enrolled in (or eligible for) VA health care, and, outside of cases like urgent or emergency care, the VA care team has to approve the community care first. Beyond that, you may be eligible for community care if:

  • The VA can't offer an appointment within 20 days (primary care, mental health, and extended outpatient care) or 28 days (specialty care)
  • The drive to a VA facility exceeds 30 minutes (primary care, mental health, and extended outpatient care) or 60 minutes (specialty care)
  • The care you need isn't available at your VA facility
  • Community care is in your best medical interest

Those thresholds are narrower than they look. The regulation designates them "for purposes of eligibility determinations," so they are the test the VA applies, not a promise of an appointment: the condition is met when the VA cannot schedule an appointment that is both near enough and soon enough, so missing either standard on its own is enough. The day count applies "unless a later date has been agreed to by the veteran in consultation with the VA health care provider," so agreeing to a later appointment date means you do not become eligible on wait time. And the drive time is an "average driving time" from your residence that the VA calculates using geographic information system software, not your own measured trip.

Eligibility on these grounds also starts with a request. You have to contact an authorized VA official to ask for the care, and the VA then determines whether it can furnish it within those standards, so there is no self-referral on drive time alone. A VA decision on any of these eligibility conditions is reviewable through the VA's clinical appeals process and may not be appealed to the Board of Veterans' Appeals. None of that closes the route. It means asking the VA first, and knowing that the answer turns on the VA's own measurement rather than yours.

On May 19, 2025, the VA removed an extra review step by a second VA doctor, implementing language in the Senator Elizabeth Dole Act and 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 a veteran or surviving spouse can often receive VA pension and Vermont Medicaid (Green Mountain Care) at the same time., But they don't coordinate or pay each other: you choose which coverage to use each time you get care, and VA health care isn't creditable coverage for Medicare Part B, so delaying Part B while relying on the VA carries a lifetime Part B late-enrollment penalty the VA won't shield you from.

  • VA + Medicare: Many veterans use both. Medicare covers care from non-VA providers, while VA covers care at VA facilities. You can't bill both for the same service, but having both gives you more options.
  • VA + Medicaid: A veteran may potentially qualify for both Aid and Attendance and Medicaid long-term care, which in Vermont (Green Mountain Care / Vermont Medicaid) is administered by the Department of Vermont Health Access, primarily through the Choices for Care program. But the programs interact in two separate steps. At the eligibility step, a state applies SSI income methodologies to aged, blind, and disabled applicants, and under those methodologies the aid-and-attendance and housebound allowances are not income, so generally only the basic VA pension counts toward the Medicaid income limit; a state using eligibility criteria more restrictive than SSI may count it, so the state's own rule governs there. Once a person is eligible and Medicaid is paying for care in a medical institution or an intermediate care facility, the federal baseline is that the post-eligibility share-of-cost calculation must consider income disregarded at eligibility, with the deductions the regulation requires taken first. That federal section does not reach someone receiving home and community based services at home, so a Choices for Care household at home should ask which post-eligibility rule applies to them. Vermont's own rule is more generous for nursing-facility residents: Vermont's Health Benefits Eligibility and Enrollment rule § 24.04 lists VA payments for aid and attendance paid to a veteran residing in a nursing facility, or to the veteran's surviving spouse residing in a nursing facility, among the amounts deducted from gross income when Vermont determines the actual patient share. That deduction as written names nursing-facility residents, so confirm with DVHA how Aid and Attendance will be treated in a home and community-based setting such as Choices for Care. Separately, under federal law, a veteran having neither spouse nor child who is covered by a Medicaid plan for nursing-facility services may be paid no more than $90 a month in VA pension for any period after the month of admission, and the same rule applies to a surviving spouse having no child. Which facilities that cap reaches turns on a definition: for purposes of that subsection, 38 U.S.C. 5503(d)(1)(B) defines a nursing facility as one described in section 1919 of the Social Security Act, "other than a facility that is a State home with respect to which the Secretary makes per diem payments for nursing home care pursuant to section 1741(a) of this title", so if the facility is a State veterans home, ask a Vermont Veterans Service Officer to check the stay against that statutory definition rather than assume the cap applies. The facility cannot count that $90 toward the cost of care, and the VA says you would keep the full $90 for personal expenses. That is a statement about the facility's cost of care, not about Vermont's Medicaid personal needs allowance, which is a separate deduction whose relationship to the $90 is set by each state's own post-eligibility rules and varies by state. Never assume the two add together; confirm with DVHA how the $90 will be applied in a specific Vermont case.
  • The Vermont Veterans' Home accepts private payment, Medicare, and Vermont Medicaid, so these payment sources can layer together; other insurers may require special arrangements, and the VA will cover the stay of a veteran with a service-connected disability rating of 70% or higher.

Because the precise treatment of VA pension income and the order in which to apply varies by situation, confirm how Vermont Medicaid will treat the benefit before applying, ideally with an accredited Vermont Veterans Service Officer or the Department of Vermont Health Access.

How to Get Started With VA Senior Care Benefits in Vermont

1
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 veteran is enrolled, the VA assigns them to one of eight priority groups based on military service history, disability rating, income, whether they qualify for Medicaid, and other benefits they receive, with the highest priority going to veterans who have service-connected disabilities. Some veterans are exempt from copays because of their disability rating, income level, or special eligibility factors.

2
Step 2

Get free help

Don't file claims or applications alone. The Vermont Office of Veterans Affairs runs a Veteran Service Officer program for veterans applying for federal VA benefits such as Disability Compensation and Improved Pension, which Aid and Attendance is paid as part of; its certified service officers complete the application and make sure the VA has all the information it needs. To speak with a Veteran Service Officer, call 802-828-1082. The office's main line is (802) 828-3379 and its toll-free Vermont number is (888) 666-9844; it is at 118 State Street, Montpelier, VT 05620-4401. Your local VA medical center can also direct you to enrollment and care resources.

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. Priority Group 1 covers veterans with a service-connected disability the VA rates as 50% or more disabling, and some veterans are exempt from copays because of their disability rating, income level, or special eligibility factors. Other enrolled veterans can still access many programs, depending on their priority group and available resources. Aid and Attendance doesn't require a service-connected disability at all; it requires wartime service, a documented need for regular aid and attendance, and any one of four alternatives: being 65 or older, having a permanent and total disability, being a nursing home patient receiving long-term care because of a disability, or getting SSDI or SSI.

Can a veteran's spouse live in the Vermont Veterans' Home?

Yes. The Vermont Veterans' Home gives admission priority to Vermont veterans, and spouses of qualified veterans and Gold Star parents are also eligible for admission. Contact the home in Bennington for current admission policies and availability.

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

The VA's own answer is "It depends." It processes claims in the order received, unless a claim requires priority processing. Working with a certified Vermont Veteran Service Officer means the VA gets all the information it needs the first time, which the state office says increases the chances of success and helps prevent 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. How much arrives is not the headline figure: $29,093 a year for a veteran alone (or $34,488 with a spouse) is a ceiling, and the VA pays the difference between your countable income and that limit, so a veteran with income receives less. 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. The Veteran-Directed Care program can also fund care services, and lets the veteran direct a flexible budget toward the help they need.

Next Steps

If you're caring for a veteran who needs help, start by calling the Vermont Office of Veterans Affairs toll-free at (888) 666-9844. They can help assess which benefits apply and file your claims at no cost.

Learn More

VA BenefitsVA Aid and Attendance in VermontVA Aid and Attendance in Vermont for 2026: who qualifies, monthly rates up to $2,874, how to apply, and free help from the Vermont Office of Veterans Affairs. Care TypesHome Care vs Home Health in VermontHome care vs. home health in Vermont: home health is skilled, DAIL-designated care Medicare covers; home care is non-medical help it won't. See who pays. Care TypesNursing Homes in VermontNursing homes in Vermont in 2026: a private room runs about $186,333/year, among the highest in the country. What it costs, who pays, and how to vet a facility. Care TypesCost of Senior Care in VermontWhat senior care costs in Vermont in 2026: assisted living about $103,137 a year, a private nursing-home room about $186,333. See every setting and how to pay. Care TypesAssisted Living vs Nursing Home in VermontAssisted living vs. nursing home in Vermont turns on level of care and who pays: about $103,137 a year private-pay assisted living vs. Medicaid-covered nursing.
Your next step Find personalized help navigating VA senior care benefits in Vermont 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.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.