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 monthly cash payments, VA benefits for senior care in Virginia can cover a wide range of needs. 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 Virginia, and what happens when VA care isn't enough on its own.

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. 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 nursing centers designed to feel like home, providing nursing-home-level care. CLCs are located at larger VA medical centers around the country.

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. 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 for the service 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 in-home (a substitute caregiver comes to the house) or facility-based (the veteran stays temporarily in a CLC or community nursing home), and Nursing Home Respite Care specifically is available for a maximum of 30 days per calendar year. Contact the VA Caregiver Support Line at 1-855-260-3274.

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 an admissions contact for all four centers. The newest, the Puller Veterans Care Center near Warrenton, has been built on the former Vint Hill Farms Station and now delivers care to Virginia veterans; it keeps a waitlist for prospective residents.

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
Warrenton Puller Veterans Care Center 128 beds, all private rooms; now delivering care, waitlist open
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

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

2026 Rates

Category Annual (published) Monthly (approximate)
Veteran, no dependents Up to $29,093 Up to about $2,424
Veteran with spouse Up to $34,488 Up to $2,874
Two married veterans (both A&A) Up to $46,143 Up to about $3,845
Housebound (veteran, no dependents) Up to $21,313 Up to about $1,776
Surviving spouse Up to $18,697 Up to about $1,558

The VA publishes annual rates; a monthly amount is the yearly award divided by 12, so treat the monthly column as approximate. These figures are ceilings, not awards: each is the maximum amount of pension payable, and the VA pays the difference between the claimant's income for VA purposes and that limit.

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
  • 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 qualifies on that basis, with no adjudicated disability rating
  • Need help with daily activities such as bathing, dressing, or feeding (or be bedridden, spend a large portion of the day in bed because of illness, be in a nursing home, 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,

The VA enforces a 3-year look-back period on asset transfers made for less than fair market value.

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; that form is the means-tested wartime pension application, so it isn't the right form for someone whose Aid and Attendance would ride on compensation. 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 representative can also file the claim for you. 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 the federal cash benefit, and Virginia adds a state one for veterans with the highest disability ratings. The Commonwealth exempts a qualifying disabled veteran's principal residence from local real estate tax, filed with your locality rather than the VA, and 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.

A financial management services provider handles payroll and employer responsibilities. 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. 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 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 the following has to be true:

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

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.

For Virginia 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 qualify for and receive VA pension and Medicaid 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 coverage 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. 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: VA Pension, including Aid and Attendance, generally counts as income when a senior applies for Medicaid long-term care, but the two programs use different income rules. Under VA rules, countable income can be reduced by unreimbursed medical expenses, so much of the A&A amount is often effectively tied to care costs. For Medicaid, that medical-expense portion can frequently be offset, so not all of the VA pension counts against Medicaid's much lower income limits. The exact treatment depends on the Medicaid pathway and is determined case by case.
  • In Virginia, Medicaid is called Cardinal Care, administered by the Department of Medical Assistance Services (DMAS). It provides long-term services and supports, including nursing-facility care and home- and community-based waivers such as the Commonwealth Coordinated Care Plus (CCC+) waiver, and applies special income and resource rules to applicants seeking long-term care.

The interaction between these programs gets complicated, and eligibility is only the first step. Once a person is eligible and receiving nursing-facility care, income that was disregarded at the eligibility stage must be counted again in the post-eligibility share-of-cost calculation, so any A&A amount set aside earlier is counted back in. What follows is the agency's duty, not a courtesy: under 42 CFR 435.725(c) the agency must deduct "a personal needs allowance that is reasonable in amount for clothing and other personal needs of the individual while in the institution," which "must be at least" $30 a month for an aged, blind, or disabled individual (a federal floor, not the amount Virginia sets), and it must deduct "Amounts for incurred expenses for medical or remedial care that are not subject to payment by a third party." Ask DMAS for the full list of deductions and the amounts before you budget on the gross figure. Two limits on that rule matter in Virginia. Its own applicability paragraph reads: "This section applies to the following individuals in medical institutions and intermediate care facilities," and it does not on its own settle the post-eligibility treatment in a 209(b) state or for home and community-based waiver services. Virginia is one of the eight 209(b) states, and Commonwealth Coordinated Care Plus is a waiver, so in either situation have DMAS state which rule governs your calculation instead of assuming this one does. 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. Higher priority groups get more benefits with lower or no copays.

2
Step 2

Get free help

Don't file claims or applications alone. The Virginia Department of Veterans Services provides benefits claims assistance through a statewide network of 38 benefit service offices, and states that all services are provided free of charge. DVS handles disability claims and pensions, its team members receive comprehensive training, and many of them are veterans or military spouses who have been through the claims process themselves. Virginia veterans are highly encouraged to seek assistance from a DVS Veterans Services Representative before filing a claim, which DVS says affords a number of advantages over self-filing. Find your nearest office through the Virginia DVS.

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. Veterans with higher service-connected disability ratings get priority access to VA long-term care. But other enrolled veterans can access many programs too, depending on their priority group and available resources. 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), and need for help with daily activities.

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. For most VA benefits, a Higher-Level Review or a Board Appeal must be elected within 1 year of the date the VA issues notice of its decision, though certain benefits carry time limits shorter than a year and your decision letter tells you which deadline applies; a Supplemental Claim can be filed at any time after that notice, though the VA recommends filing within one year to keep your effective date. That deadline carries a real cost: 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 the VA receives it, so filing late can forfeit back pay reaching all the way to the original claim date. 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. 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. Working with a Virginia DVS claims representative can reduce 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. 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. They can assess which benefits apply and help you file at no charge.

Learn More

VA BenefitsVA Aid and Attendance in VirginiaVA Aid and Attendance in Virginia for 2026: who qualifies, monthly rates up to $2,874, how to apply, and free help from Virginia veterans services. 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 $6,944 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.

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