Do VA Benefits Cover Assisted Living?

Many senior citizens may be considering assisted living for their long-term care, although figuring out how to pay for their room, board, and care can be confusing for many. Assisted living monthly fees can be expensive, even for homes that offer all-inclusive care packages. 

The national average for assisted living is $4,300 per month, although costs in some states may be a few thousand dollars more per month, while others are much less. Military veterans just like you may be looking for financial assistance to pay for their assisted living fees or wondering if their VA benefits can cover some of their eldercare.

Military veterans aged 65 and older number 8,770,000 individuals, and many of them are using at least one of their VA benefit programs. However, the US Department of Veterans Affairs benefits don’t directly cover the costs for assisted living, although some VA benefits can help seniors pay for long-term care and assisted living. In this guide, we’ll cover how you can use your benefits to cover assisted living and other options for eldercare.

Military veterans have health care through the VA, but those who meet income thresholds can also apply for Medicare coverage, and after you turn 65, Medicaid, as well. Some Medicare benefits can be used to pay for home health care, or you may be eligible for a Medicaid waiver in your state. Recipients can use Medicaid waives to pay for assisted living or an in-home health care attendant if you meet a certain income and functional requirements for that benefit. These waivers aren’t available in all states but can help you avoid accommodations in a nursing home.

Many assisted living communities offer care beyond simple healthcare. However, finding the right VA benefits to cover assisted living can be a little tricky. The Aid and Attendance benefit and the Household benefit may both be used for assisted living fees.

The Aid and Attendance benefit helps veterans and their spouses who need extra assistance with the tasks of daily living, from personal care and grooming to eating, getting dressed, and completing household tasks. In addition, veterans who are homebound may receive additional funds on top of this benefit and their regular pensions. Aid and Attendance benefits are for veterans with both physical and mental health conditions, which can be helpful for veterans experiencing cognitive decline. Surviving spouses may also take advantage of one of these benefits.

A veteran who qualifies for a regular VA pension also financially qualifies for both the Aid and Attendance benefit, so this can make a big difference in whether or not you can pay for your chosen assisted living facility. However, there are additional eligibility requirements beyond just finances for both the Aid and Attendance benefit, though if you need assisted living services, you will likely meet the functional requirements to receive A&A.  

The program gives veterans a budget for these services, which is either managed by you or a designated representative in the event you’re unable to advocate for yourself. A VA counselor can help you find a caregiver in your community to help you in your home or long-term care community.

Generally speaking, all military veterans who were on active duty for at least 90 days, one of which was during a period of active war, and discharged from service for any condition other than dishonorable, have Aid and Attendance and VDC benefits available to them and their spouse. However, there are also functional/clinical requirements, which we will explain in further detail below. 

There are a few different circumstances that qualify you for the Aid and Attendance benefit. These include:

• If you are blind in both eyes or have a concentric contraction of your eyes
• You cannot complete daily activities without someone else’s help
• You have a mental or physical condition that requires you to stay in a nursing home
• You are bedridden

Qualifications for the Household benefit, which can also be used to help pay for assisted living accommodations, include:

• You have a single permanent disability that the VA classifies as “fully disabling,” which renders you unable to leave home.
• You fit the above condition and have other disabilities that are at least 60% disabling, as per the VA standards.
• You can demonstrate, or your surviving spouse can verify, that you cannot pay for assisted living without assistance. The VA requires several documents stating your financial situation.

Like all VA benefits, the VA prioritizes those with service-connected disabilities for approval for Household and Aid & Attendance benefits. If you have a serious service-related disability or permanent medical condition, and you are low-income, then you’ll have top priority.

How to Apply for Aid and Attendance

You, your surviving spouse, or your designated representative can apply for VA benefits through the regional VA office. Representatives here can guide you through the application process, including determining which benefits you’re eligible for, plus help you gather the documents needed to support your application and claim.

For example, you’ll be asked for a letter from your primary care physician or specialist doctor that states your current condition and how it qualifies you for benefits. You’ll also need your VA health system ID number to access your medical records. If you’re currently employing a caregiver, physical therapist or working with a home care agency, then that individual or those individuals will also be required to draft a letter that states how well you’re able to carry out daily tasks independently.

Veteran Directed Care is part of the VHA Standard Medical Benefits Package, and therefore all veterans enrolled in this package are eligible for Veteran Directed Care. As long as you meet the clinical assessment requirements and the benefits package is available in your area, then you’re eligible.

If you’re unable to pay for assisted living on your own, even with your VA benefits, there are other options for long-term care.

A Community Living Center (CLC) is a VA nursing home, and there are over 100 facilities across the country. These facilities are designed to feel more like a home environment than traditional nursing homes’ clinical feel. There are community spaces for family visits or different events, and residents are encouraged to decorate their rooms with personal furnishings and items. Pets are also allowed, which can help veterans be more comfortable in the environment.

Stays can be short-term, for those recovering from illness or an injury, or long-term, for those unable to live independently in their own homes. You’ll receive a nursing-home level of care, which includes help with personal care as well as skilled nursing and medical treatment.