What the VA covers for nursing home care
The Department of Veterans Affairs does pay for some nursing home costs, but only for veterans who meet specific service and financial requirements. The VA runs its own nursing homes and also pays private facilities to care for may be able to access veterans. The amount the VA pays depends on your service history, disability rating, and income.
The VA distinguishes between three types of nursing home care: VA-operated facilities (which the VA runs directly), state veterans homes (which states run with VA support), and private facilities (which the VA pays on a case-by-case basis). Each has different payment rules and may be able to access paths.
Key Takeaways
- The VA pays for nursing home care through Aid and Attendance benefits, disability pensions, or direct admission to VA facilities, depending on your service record and income.
- Veterans with a 70% or higher disability rating, or those needing help with daily activities, may may have access to for Aid and Attendance, which can cover nursing home costs.
- State veterans homes charge on a sliding scale based on income and assets, and the VA reimburses the state for may be able to access veterans' care.
- Private nursing home placement through the VA requires a VA doctor's recommendation and proof that no VA facility bed is available.
- You will need your DD Form 214 (discharge papers) and current financial records to start the process with the VA.
Aid and Attendance benefits for nursing home costs
The most common way the VA helps pay for nursing home care is through Aid and Attendance (A&A) benefits. This is a monthly payment added to a veteran's disability compensation or pension if they need help with eating, bathing, dressing, or using the toilet. The payment goes directly to the veteran or their representative, who then pays the nursing home.
To receive A&A, you must have a disability rating from the VA and meet one of these conditions: a 70% or higher rating for any disability, a 60% rating for a single disability, or a lower rating combined with a medical need for personal care. The VA doctor who reviews your case will look at your current health status and what kind of help you actually need each day.
The monthly A&A payment amount varies by year and changes each October. It is not the same as the cost of the nursing home — it is an additional payment on top of your regular VA benefit. Many veterans use A&A to cover part of the nursing home bill, but not all of it, so you may need other resources as well.
VA-operated nursing homes and admission
The VA operates its own nursing homes across the country. These facilities are free to may be able to access veterans, though "free" means the VA covers the full cost — you do not pay a daily rate. Admission to a VA nursing home requires a referral from a VA doctor, usually after you have been treated at a VA medical center.
Waiting lists for VA nursing homes vary by location and can be long in some areas. The VA prioritizes veterans with service-connected disabilities rated at 70% or higher, though veterans with lower ratings may also be admitted depending on bed availability and medical need. You cannot walk in and request admission; the process starts with your VA primary care doctor or a VA social worker.
To find out whether a VA nursing home is available in your area and how to request admission, contact your nearest VA medical center and ask to speak with a social worker or care coordinator. They will review your medical records and help determine whether a VA facility is the right fit for your needs.
State veterans homes and how the VA pays
State veterans homes are nursing facilities run by individual states, not the federal government, but the VA reimburses states for the care of may be able to access veterans. These homes often have shorter waiting lists than VA facilities and may be closer to your home. The veteran or their family pays a daily rate based on income and assets; the VA then reimburses the state for its portion.
Each state sets its own daily rate and reimbursement rules. Some states charge nothing to low-income veterans; others charge a percentage of income. You will need to contact the state veterans home directly to learn the current rate and what financial documents they require. The VA does not set the price — the state does — so costs vary widely.
To find state veterans homes near you, search the National Association of State Veterans Homes website or contact your state's veterans affairs office. Once you identify a facility, call and ask about their current admission process, waiting list, and what the VA will and will not cover for your situation.
Private nursing homes paid by the VA
The VA can pay for care at a private nursing home if two conditions are met: a VA doctor has determined you need nursing home care, and no VA or state veterans home bed is available. This is called community nursing home care. The VA does not pay the full bill directly to the facility in most cases; instead, it pays you a daily rate, and you or your family arranges payment with the home.
The daily rate the VA pays is set by the VA and does not always match what the nursing home charges. If the home costs more than the VA rate, you or your family covers the difference. If it costs less, you keep the difference. The VA will require documentation from the home showing that it is licensed, meets safety standards, and has agreed to accept VA patients.
To pursue private nursing home placement through the VA, start by asking your VA doctor or social worker whether they believe you need nursing home-level care. If they agree, they will document this in your medical record and help you explore whether a VA or state facility is available first.
What you need to explore and what to expect
To begin the process, gather your DD Form 214 (your military discharge papers), current bank statements, proof of income, and a list of any assets you own. The VA will review your finances to determine whether you meet income limits for certain benefits. Have your VA medical record number ready, or be prepared to provide your full name, date of birth, and Social Security number.
Contact your nearest VA medical center and ask to speak with a social worker or care coordinator. Tell them you are interested in nursing home care and ask what the next step is. They may schedule you for a medical evaluation, review your current disability rating, or refer you directly to a facility. The timeline varies: some decisions take weeks, others take months, depending on how busy the VA office is and whether your medical records are complete.
If you are already receiving VA benefits, log into VA.gov or call the VA benefits hotline at 1-800-827-1000 to check your current rating and ask about A&A. If you are not yet a VA patient, you will need to enroll first by visiting a VA medical center or explore online at VA.gov.
When to talk to a doctor about nursing home care
Discuss nursing home care with your doctor if you are having trouble managing daily tasks like bathing, dressing, or taking medications, or if you have fallen multiple times at home. You do not need to wait until a crisis happens. Early conversations with your VA doctor or primary care doctor give you time to explore options and understand costs before you are in an emergency situation.
If you are supporting a veteran parent or spouse, watch for signs that they may need more help: repeated falls, confusion about medications, weight loss, or withdrawal from activities. Bring these observations to their doctor. The doctor can then refer them to a social worker who specializes in long-term care planning.
Frequently Asked Questions
Will the VA pay for my spouse to live in a nursing home?
No. VA nursing home benefits are for veterans only. Your spouse may be able to use their own health insurance, Medicare, or Medicaid to pay for nursing home care. If your spouse is also a veteran, they can pursue VA benefits on their own service record.
What if I have a low disability rating — can I still get VA nursing home help?
Yes, if you need help with daily activities. The VA looks at both your disability rating and your actual medical need. A veteran with a 20% rating who cannot bathe or dress without help may may have access to for Aid and Attendance. Ask your VA doctor to evaluate your functional needs, not just your rating.
Does the VA pay for assisted living, or only nursing homes?
The VA primarily covers nursing home care, not assisted living. However, Aid and Attendance benefits can be used for any type of care setting, including assisted living, if you meet the medical requirements. Contact the VA to discuss whether your situation qualifies.
How much does the VA pay per day at a private nursing home?
The daily rate varies by location and changes each year. Contact your VA social worker or call 1-800-827-1000 to learn the current rate for your area. The rate is typically lower than what private nursing homes charge, so you may need to cover the difference.
What happens if I cannot afford the nursing home even with VA help?
Ask the VA social worker about Medicaid, which may cover nursing home costs if your income and assets fall below your state's limits. Some states allow you to use both VA benefits and Medicaid together. Your state's Medicaid office can tell you whether you meet their requirements.