VA to Expand Long-Term Health Care Options for Eligible Vets

Qualified veterans will soon have access to extended care services outside of traditional nursing homes. A new plan through the VA will allow senior veterans to age in their homes or live in home-like settings as alternatives to elder care facilities.

The Department of Veterans Affairs Office of Geriatrics and Extended Care is expanding its Home-Based Primary Care, Medical Foster Home and Veteran-Directed Care programs to make them available at all VA medical centers by the end of the fiscal year 2026.  

The VA will add 58 medical foster homes and 70 Veteran-directed care programs across the nation and add 75 home-based primary care teams to areas with the highest unmet need. 

Aging in Place Beneficial

“These evidence-based programs allow Veterans to age-in-place, avoid or delay nursing home placement and choose the care environment that aligns most with their care needs, preferences and goals,” said Executive Director of VA Office of Geriatrics and Extended Care Scotte Hartronft, M.D.

"Veterans using these programs have experienced fewer hospitalizations and emergency department visits, reduced hospital and nursing home days and fewer nursing home readmissions and inpatient complications,” Hartronft said.

According to VA’s Policy Analysis and Forecasting Office, the number of Veterans of all ages eligible for nursing home care is estimated to expand from approximately 2 million Veterans in 2019 to more than 4 million by 2039. As this population grows, VA remains steadfast in providing the highest levels of care to Veterans in the least-restrictive settings. 

These programs provide an in-home or smaller care setting than traditional institutionalized long-term care. Long-term health care in smaller settings reduces the risk of COVID-19 infection and other infectious diseases.

Avoiding Institutional Care

Many Veterans have chosen these programs instead of institutionalized care during the pandemic for more flexibility in care preferences and less risk of COVID transmission.

The Department of Veterans Affairs has been required since 1999 to provide nursing home services to veterans who qualify. Vets can be eligible if they have a service-connected disability rating of 70% or higher or are considered unemployable and have a disability rating of 60% or higher.

The VA service-connected disability status and income are reviewed to determine VA long-term care services eligibility. Extended care services are provided through rehab and long-term nursing home facilities, respite care, VA community living centers, private assisted living facilities, state veteran’s homes, and the Medical Foster Home program.

Medical foster homes are places where veterans live full time in a home setting with a caregiver licensed to provide 24-hour support, including help with daily living activities and, if necessary, supervision, meals, companionship services, in addition to housing. Licensed caregivers provide the services.

VA Comprehensive LTC Benefits

The VA does offer comprehensive long-term health care benefits for those who are eligible. These services include:

• Comfort care and help with managing pain
• Help with daily tasks (like bathing, dressing, making meals, and taking medicine)
• Support for caregivers who may need skilled help or a break so they can work, travel, or run errands
• 24/7 nursing and medical care
• Physical therapy

Services must be available where the veteran lives, or they may have to relocate to obtain the service. Vets who are not eligible for free coverage can still use the benefits by using Medicare (limited to skilled care for a short period of time), Medicaid (if eligible), or private Long-Term Care Insurance. 

Spouses Could Be Eligible

Surviving spouses of qualified veterans may also be eligible; however, there are income and asset limitations for both veterans (outside of service-related need) and their spouses.

A veteran or spouse must not have more than $138,489 in assets (2022 number). A home (and the land up to two acres) will not count as an asset even if they are in the nursing home.

Many veterans who do not have service-related health problems but have savings and investments elect to purchase private Long-Term Care Insurance, giving them access to a wide choice of care services.