If your loved one is a veteran, the VA offers more senior care benefits than most families realize. From home-based medical care to nursing homes and a higher monthly pension, VA benefits for senior care in Virginia can cover a wide range of needs. Much of the work is knowing which program to ask for.

In This Guide

VA Senior Care Benefits in Virginia: 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. The 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. The team provides services such as nursing care, physical therapy, and help with daily tasks.

VA lists skilled home health care as a separate service.

Adult Day Health Care

Veterans attend a structured daytime program that provides social activities, companionship, recreation, care, and support. VA also counts an adult day health care program as one form of home respite, giving a family caregiver a daytime break.

Community Living Centers (VA Nursing Homes)

Community Living Centers are VA nursing centers designed to feel like home, providing nursing-home-level care.

A CLC stay can be short-term or long-term, and VA also uses CLCs for overnight 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. Some veterans don't have to pay copays at all: they're exempt because of their disability rating, income level, or special eligibility factors. And for nursing home care specifically, whether VA benefits help pay depends on the veteran's income and the level of their service-connected disability. 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 and it's 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 at home (a substitute caregiver, or an adult day health care program) or a few days in a CLC or community nursing home while the family is away; VA lists overnight and daily respite as available up to 30 days each calendar year. If a community agency, adult day center or nursing home provides it, the veteran must also meet community care eligibility. It isn't automatically free either. A veteran with a compensable service-connected disability, or yearly income below the basic VA pension rate, is exempt from the copay. Others get no copay for the first 21 days of extended care in a 12-month period; after that VA can charge up to $97 a day for overnight respite or $15 for daily respite, only to the extent the veteran has available resources. Have the VA social worker work out the copay before booking., Caregivers can also call the VA Caregiver Support Line at 1-855-260-3274, weekdays 8 a.m. to 8 p.m. Eastern.

For more on respite options, see our guide to respite care in Virginia.

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

Virginia State Veterans Care Centers

The Virginia Department of Veterans Services (DVS) operates state Veterans Care Centers that provide affordable long-term skilled nursing care, dementia and memory care, and short-term rehabilitative care for Virginia's veterans. DVS lists four, but no DVS page says which are accepting applications, so check with the center before you apply. That goes double for the newest, Puller in Fauquier County, whose pages describe it both as delivering care and as moving closer to opening. Puller keeps a waitlist; call (540) 680-5200 to confirm it's admitting.

Location Center Notable Details
Richmond Sitter & Barfoot Veterans Care Center 200 beds, single-occupancy rooms, secure dementia/memory care unit
Roanoke Davis & McDaniel Veterans Care Center Skilled nursing and rehabilitative care
Fauquier County (Warrenton) Puller Veterans Care Center 128 beds, all private rooms; waitlist open, call to confirm it's admitting
Virginia Beach Jones & Cabacoy Veterans Care Center 128 beds, all-private rooms in 16-bed households

Admissions criteria at the centers include an honorable discharge from the U.S. Armed Forces, Virginia residency at the time of admission or entry into active duty from Virginia, and meeting the medical requirements for nursing home care. Prospective residents apply through the Virginia DVS or the individual care center. For the Puller center's waitlist, DVS asks families to call (540) 680-5200 or email PVCCAdmissions@dvs.virginia.gov.

VA Aid and Attendance

Aid and Attendance is a higher VA pension, paid monthly, for veterans (or surviving spouses) who need help with daily activities. It raises the pension's yearly ceiling rather than adding a second check.,

2026 Rates

Category Maximum annual rate
Veteran, no dependents Up to $29,093
Veteran with one dependent (such as a spouse) Up to $34,488
Two married veterans (both A&A) Up to $46,143
Housebound (veteran, no dependents) Up to $21,313
Surviving spouse, no dependents Up to $18,697

These yearly figures are ceilings, not awards: each is the maximum pension payable. The VA pays monthly, and under 38 CFR 3.273 the payment is the yearly rate minus the claimant's countable income, divided by 12 and rounded down to the whole dollar.

Who Qualifies

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

  • Have served at least 90 days of active duty with at least one day during a wartime period, if they started active duty before September 8, 1980; those who started active duty as an enlisted person after September 7, 1980 generally need at least 24 months (or the full period for which they were called or ordered to active duty), also with at least one day during a wartime period; and an officer who started active duty after October 16, 1981 and had not previously served on active duty for at least 24 months meets the service test on that basis, again with at least one day during a wartime period
  • Meet at least one of four qualifying circumstances, any one of which is enough on its own: be at least 65 years old; 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. A wartime veteran under 65 who receives SSI meets this one through SSI alone
  • Need help with daily activities such as bathing, dressing, or feeding (or have to stay in bed, or spend a large portion of the day in bed, because of illness; be a nursing home patient because of lost mental or physical abilities related to a disability; or have very limited eyesight)
  • Have a net worth below $163,699. The VA's net-worth calculation counts the claimant's and their dependents' assets and their annual income; the primary home and a vehicle are excluded,

A 3-year look-back applies: a below-value transfer in the 36 months before the claim can bring a penalty of up to 5 years, but only if keeping the asset would have pushed net worth over the limit.,

How to Apply

The steps below are the pension route: the VA says 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), whose examination information section must be filled out by a medical examiner. That form also covers Aid and Attendance that will be added to monthly VA compensation, so a veteran who receives disability compensation rather than pension still uses it. A wartime veteran pursuing the pension route who isn't already receiving a VA pension files Form 21P-527EZ (Application for Veterans Pension) as well. You can apply online at VA.gov, by mail to the VA Pension Intake Center, or in person at a VA regional office; an accredited attorney, claims agent, or Veterans Service Organization representative can also help you file. If you're still gathering information, you can submit VA Form 21-0966 (Intent to File) first, because the 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, the VA's answer is "It depends," and it works claims in the order it receives them unless a claim requires priority processing.

Don't do this alone. The Virginia Department of Veterans Services provides benefits claims assistance and states that all of its services are free of charge, and DVS says working with one of its Veterans Services Representatives before you file affords a number of advantages over self-filing.

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

Aid and Attendance is a federal pension benefit, and Virginia adds a state one for veterans with the highest disability ratings. The Commonwealth exempts the principal residence of a veteran the VA rates 100 percent service-connected, permanent and total from real estate tax, administered by your locality rather than the VA. Our guide to Virginia's disabled veteran property tax exemption covers the rating it takes and how to apply.

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, with assistance from Aging and Disability Network Agencies such as Area Agencies on Aging.

Through an options counselor, that agency helps with assessment and care planning, arranges fiscal management services, and keeps counseling and supporting the veteran. 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.

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 are always required: you have to be enrolled in (or eligible for) VA health care, and, except in cases like urgent or emergency care, you need approval from your VA health care team before you see a community provider. Beyond that, at least one of six conditions must apply. The common ones:

  • The VA can't offer an appointment within 20 days (primary, mental health or non-institutional extended care) or 28 days (specialty care), unless you agree to a later date
  • The VA can't offer one within a 30-minute average drive (same categories) or 60-minute average drive (specialty care); failing either the wait or the drive is enough
  • You need a service the VA doesn't provide at any VA health facility
  • You and your VA provider agree that care from an in-network community provider is in your best medical interest

The others cover rarer cases, such as living in a state with no full-service VA facility.

In May 2025, the VA put Dole Act language into effect that removed the extra step of review by a second VA doctor on 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 a veteran or surviving spouse can qualify for and receive VA pension and Medicaid at the same time., But the VA doesn't bill Medicare, and you generally choose which coverage to use each time you get care. 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.

  • VA + Medicare: Many veterans use both. Medicare pays for Medicare-covered services, and the VA pays for services it authorizes, in a VA or non-VA facility. Generally the two can't pay for the same service, but if the VA authorizes only some of the care during a non-VA hospital stay, Medicare may pay for the covered services the VA didn't authorize.
  • VA + Medicaid: The two use different income rules. On the VA side, medical expenses your insurance doesn't cover can reduce income for VA purposes, but only the amount above 5% of the pension's maximum annual rate. Virginia is a 209(b) state, which uses at least one eligibility rule stricter than SSI's but must let applicants spend down to the income limit through uninsured medical costs. For a long-term care applicant, Virginia's eligibility manual says VA Aid and Attendance payments are not income when it decides eligibility as an institutionalized individual, in every covered group except the ones it labels "F&C MN."
  • In Virginia, Medicaid is part of Cardinal Care, run by the Department of Medical Assistance Services (DMAS), which says eligibility is complicated, with extra rules for long-term services and supports. For care at home, the Commonwealth Coordinated Care Plus (CCC Plus) waiver serves people 65 and older (and younger people with disabilities) who meet a hospital or nursing facility level of care.

Eligibility is only the first step. Once a person is eligible and receiving long-term care, Virginia sets a monthly patient pay, the share of their income that goes toward the cost of care. Virginia's manual counts VA Aid and Attendance and pension payments above $90 a month toward patient pay for a veteran with no community spouse or dependent child, a surviving spouse with no dependent child, or a veteran's dependent child. It counts none of them for a veteran with a community spouse or dependent child, or a surviving spouse with a dependent child, and the rule applies in a Veterans Care Center too. Federal law adds a limit: for a veteran with no spouse or child (or a surviving spouse with no child) in Medicaid-covered nursing-facility care, the statute caps the pension at $90 a month after the month of admission, while VA's regulation applies it after the month Medicaid payments begin, so check which date VA used. A state home VA pays a per diem for is outside that cap; ask an accredited Veteran Service Officer whether that covers a particular Veterans Care Center stay. The federal patient-pay rule for nursing-facility residents in a 209(b) state like Virginia is 42 CFR 435.733, which requires deductions including a personal needs allowance, an allowance for a spouse or family at home, and medical costs no third party pays. That's the federal list, not Virginia's amounts, and it covers institutions rather than waiver services like CCC Plus, so get Virginia's deductions from DMAS before you budget. A veteran receiving A&A who also needs Medicaid long-term care should have their income and medical-expense treatment reviewed for their specific situation, ideally with a DVS benefits representative and/or DMAS.

How to Get Started

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. The VA assigns a priority group (1-8) based on service-connected disabilities, income, and other factors.

2
Step 2

Get free help

The Virginia Department of Veterans Services offers free claims help through 38 benefit service offices, handles disability claims and pensions, and highly encourages veterans to see a DVS Veterans Services Representative before filing. Find your nearest office through the Virginia DVS.

3
Step 3

Gather records

DVS publishes a list of documents to bring to a first claims appointment, among them the veteran's DD-214 (discharge papers) and a photo ID. Lost the DD-214? VA explains how to request service records at va.gov.

Frequently Asked Questions

Do you have to be service-connected disabled to get VA long-term care?

Not for all programs, though VA may weigh service-connected disability status, among other factors, when it decides access to long-term care. Aid and Attendance doesn't require a service-connected disability at all; it requires wartime service, at least one of the VA's four qualifying circumstances (65 or older, a permanent and total disability, being a patient in a nursing home for long-term care because of a disability, or receiving SSDI or SSI), a need for aid and attendance such as help with daily activities, and income and net worth within the VA pension limits.

Can a veteran live in a Virginia Veterans Care Center if they need memory care?

Yes. Virginia's state Veterans Care Centers provide dementia and memory care alongside skilled nursing and rehabilitation. The Sitter & Barfoot Veterans Care Center in Richmond, for example, has a 40-bed secure dementia/memory care unit. Admissions criteria include an honorable discharge, Virginia residency at the time of admission or entry into active duty from Virginia, and meeting the medical requirements for nursing home care.

What if an Aid and Attendance or pension claim is denied?

You can challenge it. If the VA denies a claim (or grants less than expected), the claimant has three decision review options after that initial decision: file a Supplemental Claim with new and relevant evidence the VA didn't have when it reviewed the case before, request a Higher-Level Review in which a higher-level reviewer looks at the case with no new evidence, or a Board Appeal to the Board of Veterans' Appeals for a Veterans Law Judge to decide. You pick one: under 38 CFR 3.2500(b), while one review is pending you can't file a different one. A Higher-Level Review or a Board Appeal must generally be elected within 1 year of the date the VA issues notice of its decision. (One exception: when several people claim a benefit only one can receive, the only route is a Board Appeal within 60 days.) A Supplemental Claim can be filed any time after the notice, but one received more than a year later takes an effective date no earlier than its receipt, so filing late can forfeit back pay. The menu also changes as a case moves along. After a Higher-Level Review decision the choices are a Supplemental Claim or a Board Appeal (there is no second Higher-Level Review), and after a Board decision they are a Supplemental Claim or an appeal to the U.S. Court of Appeals for Veterans Claims, which must be filed within 120 days of the date on the Board's decision letter. That appeal is filed with the Court, not with the VA. A properly addressed notice mailed with a legible postmark inside the 120 days counts as on time even if it arrives later. A Virginia DVS Veterans Services Representative can help, and DVS states that all of its services are provided free of charge.

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

The VA's own answer is "It depends." It works claims in the order it receives them, unless a claim requires priority processing. If your loved one is already a nursing home patient, the claim also needs VA Form 21-0779, which a nursing home official uses to verify the stay.

Does the VA pay for assisted living?

Not directly. VA says assisted living facilities are not run, staffed, or paid for by VA, though VA benefits may help pay for extra services there, such as visits from a VA provider. Assisted living fees can also count as deductible medical expenses under 38 CFR 3.278(d)(3), if the facility is licensed where required and, if residential, staffed around the clock. Care from a health care provider counts; help with daily activities from others counts if the veteran is receiving care there and needs aid and attendance, is housebound, or has a clinician's written statement that they need a protected environment. Meals and lodging count only if the facility provides or contracts for the care (or a clinician states in writing that the veteran must live there to get it). Only expenses above 5% of the pension's maximum annual rate, not counting any Aid and Attendance or Housebound increase, reduce income for VA purposes. The Veteran-Directed Care program can also fund care services for veterans who want to direct their own budget.

Next Steps

If you're caring for a veteran who needs help, start by contacting the Virginia Department of Veterans Services, whose benefits claims help is free.

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 VirginiaVA Aid and Attendance in Virginia for 2026: who qualifies, up to $2,874 a month for a married veteran, how to apply, and free help from Virginia DVS. VA BenefitsVirginia Veteran Benefits by VA RatingVirginia disabled veteran benefits by VA rating: DV plates at any rating, VMSDEP tuition at 90% permanent, a free park pass at 100%, car-tax breaks at P&T. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. Care TypesCost of Senior Care in VirginiaWhat senior care costs in Virginia in 2026: assisted living about $6,945 a month, a nursing home about $123,005 a year. See every setting and how to pay. Care TypesNursing Homes in VirginiaNursing homes in Virginia in 2026: what a skilled nursing facility costs, how to check a facility's quality, and how Virginia Medicaid pays for long-term care. Care TypesMemory Care in VirginiaMemory care in Virginia is an assisted living 'safe, secure environment.' See the admission rules, staffing protections, cost, and how to vet a place.
Your next step Find personalized help navigating VA senior care benefits in Virginia 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.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

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