The VA does pay for nursing home care, but whether it must pay, may pay, or will charge you a copay comes down to your service-connected disability rating and which type of facility you enter. Veterans whose nursing home stay is tied to a service-connected disability, and any veteran with a combined service-connected rating of 70% or more, are entitled to VA-paid nursing home care by law. Everyone else may receive it when beds and funding allow, sometimes with a daily copay capped at $97 in 2026, well below the roughly $355 daily median for a private nursing home room.
Who the VA Must Cover
Federal law splits veterans into two groups: those the VA is required to place in nursing home care, and those it may help if resources allow. The mandate lives in 38 U.S.C. § 1710A, which uses the word “shall.” When a physician determines the care is needed, the VA has no discretion to deny placement to:1Office of the Law Revision Counsel. 38 U.S. Code 1710A – Required Nursing Home Care
- Veterans who need nursing home care because of a service-connected disability. The stay itself must be related to the service-connected condition.
- Veterans with a combined service-connected rating of 70% or more. The care doesn’t need to be for the rated condition; the rating alone triggers the requirement.
Everyone outside those two categories falls into discretionary care. The VA may place you based on bed availability, funding, and clinical need. Priority within the discretionary pool goes to veterans with higher service-connected ratings, former prisoners of war, Purple Heart recipients, and veterans who cannot afford private care.2Office of the Law Revision Counsel. 38 USC 1710 – Eligibility for Hospital, Nursing Home, and Domiciliary Care Veterans rated 60% or higher who are considered unemployable, or who hold permanent and total ratings, also sit high in the queue.
Whichever category you fall into, two prerequisites apply to everyone: you must be enrolled in VA health care, and a VA or authorized private physician must certify that nursing home-level services are medically necessary.3Veterans Affairs. VA Nursing Homes And Assisted Living
What You’ll Actually Pay
If you owe a copay, VA nursing home care is dramatically cheaper than private-pay care. The first 21 days of nursing home care in any 12-month period cost you nothing. Starting on day 22, your copay is calculated from the financial information you report on VA Form 10-10EC, up to a 2026 maximum of $97 per day for inpatient nursing home care.4Veterans Affairs. Current VA Health Care Copay Rates
Many veterans owe nothing at all. Under 38 CFR § 17.111(f), extended care copayments don’t apply to:5eCFR. 38 CFR 17.111 – Copayments for Extended Care Services
- Veterans with any compensable service-connected disability (10% or higher).
- Care for a 0% service-connected condition, even though noncompensable.
- Veterans whose annual income falls below the VA pension threshold.
- Vietnam-era herbicide-exposed, radiation-exposed, Persian Gulf, post-9/11 combat, and Camp Lejeune veterans receiving care under those authorities.
- Care authorized for treatment of military sexual trauma.
- Medal of Honor recipients.
If you have a compensable service-connected rating, that alone eliminates your nursing home copay. The copay only matters if you’re in the discretionary group and none of the exemptions apply.
Where the Care Happens
Facility type shapes location, availability, and how much of the cost the VA actually covers.
Community Living Centers
Community Living Centers are nursing homes the VA owns and operates directly. They handle short-term rehabilitation, long-term nursing care, mental health recovery, dementia care, and hospice in a residential setting.6Department of Veterans Affairs. VA Community Living Centers Overview Fact Sheet Most stays are short-term; long-term placement depends on beds.
Community Nursing Homes
These are private nursing homes under contract with the VA, which lets you receive care closer to home. Any facility under contract must be Medicare- or Medicaid-certified, state-licensed, and pass VA safety and quality inspections.7VA.gov. Residential Settings and Nursing Homes – Paying for Services
State Veterans Homes
State Veterans Homes are owned and run by state governments. The VA contributes a per diem payment set at the lesser of half the daily cost of care or a basic per diem rate the VA sets annually.8eCFR. 38 CFR Part 51 Subpart C – Requirements Applicable to Eligibility, Rates, and Payments Because that payment usually doesn’t cover the full cost, veterans in state homes commonly pay the difference out of pocket, through Medicaid, or through other benefits. State homes may also add their own residency and admission rules on top of VA requirements.
Help Paying at Assisted Living or in a State Home
When the VA doesn’t cover the full cost, or when you need care in a setting the VA won’t place you in, pension-based benefits can fill part of the gap.
The Aid and Attendance benefit is an increased monthly pension for veterans and surviving spouses who need help with daily activities, are bedridden, or are nursing home patients due to mental or physical incapacity. For 2026, the maximum annual pension with Aid and Attendance is $29,093 for a veteran without dependents (about $2,424 monthly) and $34,488 with one dependent (about $2,874 monthly).9Veterans Affairs – VA.gov. Current Pension Rates for Veterans
The Housebound benefit is a smaller increase for veterans and surviving spouses substantially confined to their home because of a permanent disability. The 2026 maximum is $21,313 without dependents and $26,710 with one dependent. You cannot draw Aid and Attendance and Housebound at the same time.10Veterans Affairs. VA Aid and Attendance Benefits and Housebound Allowance
Both are pension benefits, so a net worth limit applies. From December 1, 2025 through November 30, 2026, your combined income and countable assets (yours and your dependents’) cannot exceed $163,699. Your primary residence, one vehicle, and basic household items don’t count.9Veterans Affairs – VA.gov. Current Pension Rates for Veterans
Do not move assets casually to get under the limit. The VA reviews all asset transfers made within the three years before you file a pension claim. If you gave away or sold assets for less than fair market value during that window, and those assets would have put you over the net worth limit, the VA can impose a penalty period of up to five years during which you cannot receive pension benefits.11VA.gov. Veterans Pension FAQ This is the area where families most often make expensive mistakes on well-meaning but uninformed advice.
How Medicare and Medicaid Fit In
Medicare and VA health care are separate systems. Medicare does not pay for care you receive through a VA facility, and VA benefits generally don’t cover Medicare deductibles or copays at non-VA providers.3Veterans Affairs. VA Nursing Homes And Assisted Living If the VA authorizes some services at a non-VA facility, Medicare can help with additional costs the VA didn’t authorize, but only with prior VA approval.
Medicaid matters most at State Veterans Homes, where the VA’s per diem often falls short of the full cost. Medicaid has its own income and asset rules and its own look-back period, 60 months in most states versus the VA’s 36. If you’re likely to need both VA and Medicaid benefits, planning around both rule sets at once is worth the fee of an elder law attorney or accredited VA claims agent.
How To Apply
Start with a VA social worker or case manager at your local VA medical center. They can assess your situation, tell you which facility types are available near you, and walk you through the paperwork. If you aren’t enrolled in VA health care yet, complete VA Form 10-10EZ first.12U.S. Department of Veterans Affairs. Apply for VA Health Care
The application for nursing home and other extended care services is VA Form 10-10EC, which you can submit online, by mail, or in person.13Veterans Affairs. About VA Form 10-10EC It collects detailed financial information: income, assets, and deductible expenses like mortgage payments, medical costs, and court-ordered obligations. The VA uses this data to set your copay, so fill it out thoroughly. Unreported deductible expenses mean a higher copay.
The VA doesn’t publish a standard processing timeline for extended care applications. If you haven’t heard back within a few weeks, follow up with your assigned social worker.
If the VA Denies You
A nursing home eligibility decision is a health benefits decision, and you have three routes to challenge it:
- Higher-Level Review, where a more senior reviewer re-examines the same evidence. File within one year of the decision.
- Board of Veterans’ Appeals, where a Veterans Law Judge reviews your case. File within one year.
- Supplemental Claim, where you submit new evidence supporting your eligibility. No deadline.
If the dispute is instead clinical, meaning a care team decided you don’t need nursing-level care, you file through the Patient Advocate at your VA medical facility rather than through the benefits appeal system.