Veterans’ Health Services and Long Term Senior Care
Please note that the information that follows is not comprehensive of what the VA provides. A veteran’s health, financial resources and the availability of care are the primary factors determining what care will be provided and at what cost. Veterans need to speak with the VA on a case-by-case basis.
VA Health Care is a medical benefits program offered to all veterans with 24 months of continuous active duty military service and a discharge status other than Bad Conduct or Dishonorable.
During enrollment, each veteran is placed in a Priority Group of 1 - 8. Placement into Priority Groups is dependent on a large number of factors including: length & dates of service, discharge status, service-connected disabilities, financial resources, income and many other factors.
A veteran’s Priority Group determines the level of care offered. However, the availability of VA resources also plays a role in determining what care is offered. Due to the complexity of the Priority Groups and the ever-changing availability of VA resources, it is nearly impossible for veterans to determine the services for which they qualify and the fees for those services without speaking directly with the VA on a case-by-case basis.
For those who qualify, the VA offers a variety of long term care services. Veteran seniors are much more likely to qualify if they have a disability as a result of military service. It is nearly impossible to determine the cost and level of care provided by the VA without speaking with them directly. What follows is some general information about long term services for veteran seniors.
Assisted Living VA offers Assisted Living care through the Community Residential Care Program (CRCP) and at VA Domiciliaries. However, for the majority of veterans, the VA only pays for this program’s administration and clinical services. Care is provided both VA facilities and at approved outside facilities. There are specialized dementia and Alzheimer’s care programs as well.
Skilled Nursing
VA offers skilled nursing care at VA nursing homes, State Veterans home and outside homes when the VA or State homes are not available in locations that would allow the veteran to remain close to their family. Veteran seniors must be assessed by a medical provider and determined to require inpatient nursing care and be medically stable. Payment for care varies dramatically depending on the veteran’s Priority Group
In-Home Care
Some veterans that have been approved to receive skilled nursing care can receive that care at home through the VA’s Homemaker and Home Health Aide program. This is an attractive options for many families should they have someone at home that can provide the necessary supervisor in the absence of the VA interdisciplinary treatment team. As with all VA health care services, cost vary dramatically depending on the veteran’s priority group.
Adult Day Care
Adult Day Health Care programs offer supervision of veteran seniors during daytime hours when the family of the veteran is at work. This is also an attractive option as it allows the senior to remain living at home. Costs vary dramatically depending on the veteran’s priority group.
Veterans' Health Care is Also Known As:
-Veterans Administration Health Care
-VA Health Care
Qualifications for Veterans' Health Care
Veterans must go through a complex eligibility evaluation to receive benefits and often the hard and fast rules change based on the availability of resources. Therefore it is important to check with the VA or a veterans’ benefits consultant.
Age Requirements
There are no age requirements to be eligible for VA Health Care.
Disabilities / Health Requirements
During enrollment in VA Health Care, veterans are assigned into different Priority Groups. A veteran’s disabilities, especially those connected to their service, are one of the primary factors in the assignment. Therefore veterans are not required to have a disability, but having a disability plays a very large role in determining which benefits a veteran receives and how much those benefits cost.
Family Status
A veteran’s family or marital status does not play in a role in determining their eligibility for VA Health Care.
Financial Status Requirements
A veteran’s financial resources are only considered if they have been assigned to a higher number (but lower priority) Priority Group. Higher Priority Group assignment generally means they do not have disabilities resulting from their military service.
Resources are defined as the sum of the veteran and their spouse liquid and fixed assets and their income minus their allowances, such as medical bills. Veterans having resources in excess of the maximums are evaluated case by case to determine their need.
A very general rule of thumb is veterans can have up to $80,000 in resources or up to $30,000 in annual income. Married veterans can deduct $100,000 from their total resources as “spousal resource protection”.
However, there are many, many exceptions and these amounts change based on the veteran’s county of residence. Veterans with resources beyond the maximum allowable amounts here should consult directly with the VA or
veterans’ benefits consultant to determine if they are eligible.
Veteran Status Requirements
Veterans are required to have 24 months of continuous active duty military service and a discharge status other than Bad Conduct or Dishonorable to be eligible for VA Health Care. There are exceptions to the 24 month rule for:
- Reservists or National Guard members that were called to Active Duty and completed their terms.
- Those requiring treatment for a service-connected condition or disability
- Those discharged or released from active duty for a hardship or an “early out”
Geographic Requirements
The veteran’s geographic location does not affect eligibility directly but the maximum allowable amount of resources changes depending on in which county the veteran senior resides.
Benefits of Veterans' Health Care
Types of Benefit Payout
VA Health Care benefits are made in the form of medical care and payment to medical providers. VA Health Care does not provide cash to veteran seniors.
Restrictions on How Payout Can be Used
Benefits are only from medical services and are paid directly to the providers.
Benefits Amounts & Limits
Benefits limits range dramatically depending on the veteran’s Priority Group. For long term care, co-pays can range from $0 - $100 / day. Veterans with a compensable service-connected disability are exempt from long-term care co-pays.
Time to Receive Benefits
The application processing time can take many months. While the VA has a “duty to assist” applicants in the collection of supporting documents, veterans can greatly accelerate the process by providing these documents themselves.
This Source Can Help For
Assisted Living, At-home Care, Skilled Nursing and Adult Day Care, but only for certain qualifying veterans.
Costs of Veterans' Health Care
There are no costs to enroll or monthly premiums. However, some veterans are responsible for co-pays.
How to Apply for Veterans' Health Care
Many veterans find assistance with the application is necessary.
Guidebooks are available. Veterans can also call the VA’s Health Benefits Service Center; toll free at 877-222-VETS (8387).
Should a veteran be concerned they might not be eligible because they exceed the maximum allowable amount of financial resources, it is advisable to speak with a Veterans’ benefit advisor prior to application. Most attorneys offer free initial consultations.
Find a Veterans benefit attorney
-Veterans can apply for VA long term senior care by completing VA Form 10-10EZ.
-Veterans without service-connected disabilities or with 0% service-connected disabilities will also need to complete
VA Form 10-10EC. This is used to measure the veteran’s and family’s current income and assets to determine if they will be charged co-pays for long term care.
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