The VA covers some nursing home costs, but only for specific veterans and only certain types of care
The Department of Veterans Affairs does pay for nursing home care, but not for all veterans and not for all kinds of nursing homes. The VA runs its own nursing homes and also pays for care in community nursing homes, but you must meet service-connected disability requirements and pass a financial review. The VA does not cover custodial care (help with daily tasks like bathing and dressing) unless it is tied to a service-connected condition that requires skilled nursing or rehabilitation.
Understanding which veterans the VA covers, what types of care count, and how to move forward requires knowing the difference between VA facilities and community facilities, and between skilled nursing care and custodial care. Many families assume the VA covers all nursing home costs for all veterans—it does not. Others assume they must use a VA facility—they do not have to.
Key Takeaways
- The VA covers nursing home care only for veterans with a service-connected disability rated at 0% or higher, or for non-service-connected veterans who are 65 or older and have limited income.
- The VA distinguishes between skilled nursing care (which it may cover) and custodial care (which it covers only if related to a service-connected condition), and between VA facilities and community nursing homes.
- You can receive VA-paid nursing home care at a VA facility, a state veterans home, or a community nursing home that has a contract with the VA.
- The VA requires a financial assessment and may ask you to pay a copay or share costs, depending on your income and the type of care you receive.
- The first step is to contact your VA regional office or a veterans service officer to determine whether you meet the requirements and what your out-of-pocket costs would be.
Who the VA covers for nursing home care
The VA covers nursing home care for two main groups of veterans. The first group includes any veteran with a service-connected disability rated at any percentage—even 0%—who needs care related to that condition. The second group includes non-service-connected veterans who are 65 or older, have limited income and assets, and need nursing home care for any reason.
A service-connected disability means the VA has determined that a medical condition was caused by or made worse by military service. The rating can be as low as 0%, which means the VA recognizes the connection but assigns no percentage. If you have any service-connected rating, you may be covered. Non-service-connected veterans must be at least 65 years old and meet income limits that vary by state and change each year. You will need to provide recent tax returns and documentation of assets to determine whether you fall within the income threshold.
Veterans who do not meet either condition may still find coverage through Medicaid or Medicare, depending on their situation. Medicaid covers nursing home care for people with very limited income and assets, regardless of military service. Medicare covers short-term skilled nursing care after a hospital stay. These are separate from VA coverage but may be your only option if you do not meet VA requirements.
The difference between skilled nursing care and custodial care
The VA covers skilled nursing care—care that requires a nurse or therapist, such as wound care, medication management, physical therapy, or recovery after surgery. The VA does not cover custodial care—help with bathing, dressing, toileting, and eating—unless that custodial care is necessary because of a service-connected condition that also requires skilled nursing.
This distinction matters because many people enter nursing homes primarily for custodial care. If you need help with daily tasks but do not have a service-connected condition requiring skilled care, the VA will not pay. You would need to pay out of pocket, use Medicaid (if you may have access to), or explore other resources. If you have a service-connected condition—such as a spinal cord injury or dementia—and that condition requires both skilled nursing and custodial support, the VA may cover the full stay.
Ask the nursing home and your VA contact to clarify in writing what portion of your care is skilled and what portion is custodial. This affects both your coverage and your copay. Some facilities bill the VA for the skilled portion and you for the custodial portion, while others bundle the costs differently.
VA facilities, state veterans homes, and community nursing homes
You have three options for where to receive VA-covered nursing home care. VA nursing homes are run directly by the Department of Veterans Affairs. State veterans homes are run by individual states but receive VA funding and oversight. Community nursing homes are private facilities that have contracts with the VA to accept VA-covered residents.
VA nursing homes are free or low-cost for may be able to access veterans, but they often have waiting lists and may not be located near you. State veterans homes vary by state—some are free, some charge a copay, and some ask you to contribute a portion of your income. Community nursing homes are the most common option; the VA pays them directly, and you may owe a copay depending on your income and the type of care.
You do not have to choose a VA facility. Many veterans prefer community nursing homes because they are closer to family, have more amenities, or have shorter waiting lists. The VA will pay its standard rate to any contracted community facility. If you choose a facility that charges more than the VA rate, you pay the difference. Ask any nursing home whether it accepts VA payment before you explore.
How much you will pay out of pocket
The VA requires a financial assessment to determine your copay. The amount depends on your income, your assets, and the type of care you receive. Veterans with very low income may pay nothing. Veterans with higher income may pay a daily copay that ranges from a few dollars to over $100 per day, depending on the VA's assessment and your state.
The VA uses a formula that looks at your gross household income, subtracts certain expenses (such as mortgage or rent, utilities, and medical costs), and calculates what you can afford to contribute. If you have a spouse, the VA counts household income but may protect some of your spouse's income. If you have significant assets, the VA may count those as well, though the rules vary.
You will receive a letter stating your copay amount before you enter the facility. If your financial situation changes—you lose income, incur large medical bills, or your spouse passes away—you can request a reassessment. Keep records of your income and expenses so you can document changes if needed.
How to start the process
Contact your VA regional office or call the VA's main line at 1-800-827-1000 to ask about nursing home coverage. You can also work with a veterans service officer, who is often available through your county or a veterans organization and can help you gather documents and submit your request at no cost. Have your discharge papers (DD Form 214) ready, along with recent tax returns and a list of any service-connected conditions.
The VA will ask you to complete an process and provide financial documents. This process typically takes several weeks. Once approved, you will receive a letter stating your copay and the facilities where you can receive care. You can then contact nursing homes directly to check availability and schedule a tour.
If you are in crisis—for example, you are being discharged from a hospital and have nowhere to go—tell the hospital social worker that you are a veteran. Many hospitals have VA liaisons who can speed up the process or connect you with temporary placement while your VA process is pending.
What happens if you are denied or do not meet the requirements
If the VA denies your request, you have the right to appeal. You can also ask a veterans service officer to review the decision and help you file an appeal. The appeal process can take several months, so it is worth pursuing if you believe the VA made an error.
If you do not meet VA requirements, Medicaid is often the next option. Medicaid covers nursing home care for people with income below a certain threshold (which varies by state) and limited assets. You can explore for Medicaid through your state's Medicaid office or through your local social services department. Medicare covers skilled nursing care for up to 100 days after a hospital stay of at least three days, though you pay a copay after day 20.
Some veterans also explore long-term care insurance, Veterans Aid and Attendance benefits (a separate VA benefit that provides a monthly stipend for care), or family caregiving arrangements. A veterans service officer can help you understand all your options if VA nursing home coverage is not available to you.
Frequently Asked Questions
Does the VA cover nursing home care for all veterans?
No. The VA covers nursing home care only for veterans with a service-connected disability (any rating percentage) or for non-service-connected veterans who are 65 or older and meet income limits. Veterans who do not fit these categories may be covered by Medicaid or Medicare instead.
Can I choose any nursing home, or does it have to be a VA facility?
You can choose a VA nursing home, a state veterans home, or a community nursing home that has a contract with the VA. You do not have to use a VA facility. If you choose a facility that charges more than the VA rate, you pay the difference.
Will I have to pay a copay for VA nursing home care?
Most likely, yes. The VA calculates your copay based on your income and assets. Veterans with very low income may pay nothing, while others may pay a daily copay. The VA will send you a letter stating your exact copay before you enter the facility.
What if I need custodial care but do not have a service-connected condition?
The VA will not cover custodial care unless it is tied to a service-connected condition requiring skilled nursing. If you need only custodial care, explore Medicaid (if you have low income and assets) or Medicare (if you recently left a hospital). You may also pay out of pocket or arrange family caregiving.
How long does it take to get approved for VA nursing home care?
The approval process typically takes several weeks to a few months, depending on how quickly you submit documents and how busy your VA regional office is. If you are in crisis, tell the hospital social worker you are a veteran—they may be able to speed up the process or arrange temporary placement.