Paying for Veterans Care: Complete Funding Guide

Veterans have access to multiple funding sources for home care that civilians don't have, including VA Aid & Attendance (up to $2,431/month), VA health care programs, TRICARE for Life, Veterans Directed Care, and state veteran benefits. Understanding which programs you qualify for and how to combine them strategically can reduce home care costs by 50-90%, making professional care affordable while you maintain independence at home.

VA funding options for home care

The Department of Veterans Affairs offers several programs specifically designed to help veterans pay for home care services.

VA Aid & Attendance pension benefit

The most valuable VA benefit for funding home care. Aid & Attendance is a tax-free monthly pension paid to veterans who need assistance with activities of daily living.

Who qualifies:

• Wartime veteran with 90+ days active service (at least 1 day during wartime)
• Honorable discharge
• Age 65+ or permanently disabled
• Need help with ADLs (bathing, dressing, eating) or housebound
• Income below MAPR (countable income after medical expenses)
• Net worth below approximately $160,194 (2025)

How it works: The VA pays this benefit directly to you as cash. You choose how to spend it—hire any home care provider, pay family caregivers (in some situations), or use for assisted living or nursing home costs.

Complete VA Aid & Attendance guide →

VA Home Based Primary Care (HBPC)

• Cost: Free for eligible veterans enrolled in VA health care
• Services: Comprehensive medical care delivered at home by VA interdisciplinary team
• Includes: Primary care physician visits, nursing, social work, physical therapy, occupational therapy, dietary counseling, medical equipment
• Eligibility: Enrolled in VA health care, homebound or have difficulty traveling to VA facility, complex medical needs
• Limitation: Medical services only—does not cover custodial personal care like bathing or dressing assistance

Veterans Directed Care (VDC)

• Cost: VA-funded (no cost to veteran)
• What it is: Program that lets you hire, train, and manage your own caregivers with VA funding
• Key benefit: You can hire family members, friends, or neighbors as paid caregivers (unlike many programs)
• How it works: VA assesses your needs, sets monthly budget; you recruit caregivers; fiscal intermediary handles payroll
• Availability: Not available in all states—check with your local VA medical center
• Eligibility: Must be enrolled in VA health care and meet clinical eligibility for VA community nursing home care

VA skilled home health care

• Cost: Free through VA health care system
• Services: Skilled nursing, physical therapy, occupational therapy, speech therapy
• Who provides: VA contracts with home health agencies or VA staff provide services
• Eligibility: Enrolled in VA health care, homebound, need skilled services ordered by VA physician
• Limitation: Short-term, part-time care only (not 24/7 or long-term custodial care)

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

• For: Post-9/11 veterans with serious injuries requiring caregiver assistance
• Benefits: Monthly stipend to family caregiver, health insurance (if caregiver not otherwise covered), training, respite care, mental health services
• Stipend amount: Varies based on level of care needed and geographic location (typically $1,500-3,500/month)
• Eligibility: Veteran served on or after 9/11/2001 with serious injury incurred or aggravated in line of duty
• Caregiver requirements: Must be family member, pass VA training, provide personal care services

TRICARE coverage for veterans

TRICARE benefits are available to military retirees, not all veterans. If you retired from active duty military service (20+ years), you may have TRICARE coverage.

TRICARE for Life

• For: Military retirees age 65+ who have Medicare Part A and B
• Cost: No premiums (but must pay Medicare Part B premium)
• How it works: Medicare pays first, TRICARE pays second (covers most copays and deductibles)
• Home health coverage: Covers Medicare-approved skilled home health services (nursing, PT, OT, speech)
• Limitation: Like Medicare, does not cover custodial care or personal care assistance

TRICARE for Life + VA benefits

You can use both TRICARE for Life and VA benefits. Many military retirees use TRICARE/Medicare for medical care and VA Aid & Attendance to pay for non-medical personal care assistance at home.

Medicare coverage for veterans

Most veterans age 65+ are eligible for Medicare just like other Americans. Veterans can use both Medicare and VA benefits.

What Medicare covers

• Medicare Part A & B: Skilled home health care when medically necessary and doctor-ordered
• Covered services: Skilled nursing, physical therapy, occupational therapy, speech therapy, medical social services
• Requirements: Must be homebound, need intermittent skilled care, under physician's care plan
• Cost: $0 copay for Medicare-covered home health services (if you have Part A or B)

What Medicare does NOT cover

• Custodial care (help with bathing, dressing, eating, using bathroom)
• 24-hour care at home
• Meals delivered to home
• Homemaker services (cleaning, laundry, shopping)
• Personal care when that's the only care you need

Bottom line: Medicare helps with short-term skilled care (recovery from surgery, illness) but doesn't cover ongoing daily assistance. Veterans use VA Aid & Attendance or other VA programs to pay for the personal care Medicare excludes.

Medicaid for veterans

Medicaid is a state-federal program for individuals with limited income and assets. Some veterans qualify for both VA benefits and Medicaid.

Medicaid home care benefits

• Coverage varies by state: Some states have robust home care benefits, others minimal
• Typical services: Personal care, homemaker services, skilled nursing, medical equipment
• Key advantage: Medicaid DOES cover custodial personal care (unlike Medicare)
• Eligibility: Must meet state income and asset limits (varies by state)

Medicaid waivers for home care

Many states offer Medicaid waiver programs that pay for home care as an alternative to nursing home placement:

• Aged & Disabled waivers: Allow Medicaid to pay for home care for seniors who would otherwise need nursing home care
• Self-directed care options: Some waivers let you hire your own caregivers (including family in some cases)
• Waiting lists: Many waiver programs have waiting lists (months to years in some states)

VA benefits + Medicaid

You can receive both VA benefits and Medicaid, but coordination can be complex. VA Aid & Attendance is counted as income for Medicaid eligibility in most states. Work with a benefits counselor or elder law attorney to maximize both programs.

State veteran programs

Many states offer additional benefits for veterans beyond federal VA programs.

State Veterans Homes

• What they are: State-run nursing homes and assisted living facilities for veterans
• Cost: Significantly subsidized (often 50-70% below private facilities)
• Funding: Combination of state funding, VA per diem payments, and resident co-pays
• Some offer home care: A few state veteran homes operate home care programs

State-specific veteran benefits

Benefits vary widely by state. Examples:

• Property tax exemptions: Many states offer property tax breaks for disabled veterans (frees up income for care)
• Emergency financial assistance: Some states provide one-time grants for veterans in crisis
• State veteran homes with home care: Limited states operate home care programs through their veteran homes
• Enhanced Medicaid benefits: Some states provide enhanced Medicaid for veterans

Check your state's Department of Veterans Affairs website or contact county veterans service office for state-specific programs. (Ohio resources | Maryland resources)

Long-term care insurance

If you purchased long-term care insurance (LTC insurance) before needing care, it can significantly help pay for home care.

What LTC insurance covers

• Home care services: Most policies cover in-home personal care and companionship
• Daily/monthly benefit: Policies typically pay $100-300/day or $3,000-9,000/month
• Benefit period: Usually 2-5 years of coverage (some have lifetime benefits)
• Elimination period: Waiting period (30-90 days typically) before benefits start

Military-affiliated LTC insurance

• Federal Long Term Care Insurance Program (FLTCIP): Previously available to military members (closed to new applicants in 2009)
• MOAA, USAA, Navy Mutual: Military organizations that historically offered LTC insurance to members
• Check your policy: If you have an old policy, review what's covered and how to file claims

Private pay and family support

Even with VA benefits and other programs, many veterans pay part of their home care costs privately.

Private pay advantages

• Immediate start: No waiting for benefit approvals
• Full choice: Select any provider and any schedule
• Flexibility: Adjust care hours as needed
• Tax deductions: Home care expenses may be deductible as medical expenses (consult tax professional)

Family caregiver arrangements

• Unpaid family care: Many veterans receive unpaid care from spouse or adult children
• Paid family caregivers: Some programs allow paying family members (Veterans Directed Care, some Medicaid waivers)
• Caregiver support: VA offers respite care and support services for family caregivers
• Legal considerations: If paying family, consider caregiver agreements to document arrangement

Strategic approach to maximizing benefits

Most veterans use a combination of funding sources. Here's a strategic approach:

Steps to maximize your funding

1. Get a benefits assessment: Contact VA-accredited VSO or county veterans service office for comprehensive benefits review
2. Apply for all eligible VA programs: Even if you think you might not qualify, apply and let VA decide
3. Coordinate Medicare/TRICARE: Use for skilled services they cover
4. Check state programs: Don't overlook state veteran benefits
5. Review old insurance policies: You may have LTC coverage you forgot about
6. Document everything: Keep receipts for medical expense deductions (helps with VA Aid & Attendance and taxes)
7. Work with veteran-friendly providers: They understand VA benefits and can help maximize funding

Getting help navigating veteran benefits

Veteran benefits are complex. Free accredited help is available:

• Veterans Service Organizations (VSOs): VFW, DAV, American Legion provide free accredited representatives
• County Veterans Service Offices: Local offices in most counties with free benefits counselors
• VA social workers: Available at VA medical centers to explain benefits
• State veterans agencies: State-level veteran departments offer benefits assistance
• Elder law attorneys: Specialize in coordinating VA, Medicare, Medicaid (paid service)

Important: Beware of "pension poachers" who charge upfront fees to help with VA benefits. Legitimate help is free through VSOs and county offices. Never pay for VA benefit applications.

Related Resources

• VA Aid & Attendance Benefit →

  Detailed guide to the most valuable VA benefit for home care funding

• Veterans Home Care Cost →

  Understand typical costs and how benefits reduce out-of-pocket expenses

• Choosing a Veteran-Friendly Provider →

  Find providers who understand VA benefits and maximize your funding