Nursing Care Benefits Legally Available to Veterans
If you do not need to be in the hospital, but you are unable to care for yourself, you may need to seek short-term or even long-term care in a nursing home. Veterans in this situation may be able to get benefits from the VA to cover these costs. (Meanwhile, the VA will reduce your monthly pension to $90 if you are living in a nursing facility at which Medicaid covers the care, and you have no dependents.) If you are suffering from a disability related to your service, you will have priority. You also will have priority if you have a disability rating of 70 percent or greater, or if you have a disability rating of 60 percent or greater and are either unemployable or permanently and totally disabled. If you do not fit into any of these categories, VA benefits will cover you only if the groups above have not exhausted the available resources.
There are three main types of nursing care to which VA benefits may apply. Sometimes a VA medical center will have a Community Living Center located in it or near it. In other cases, a state may run a nursing home for veterans that the VA approves. Also, the VA may cover some costs for nursing care in public or private nursing facilities. If you are not seeking care for a service-related disability and do not have a disability rating of 70 percent or greater, this last type of benefits may be difficult to obtain.
Community Living Centers
Veterans must enroll in VA health care before applying for VA nursing care benefits.
Your doctor can help you complete the application for receiving care in a CLC. As a threshold matter, you must show that you are eligible for care in a CLC by proving that you are enrolled in the VA Health Care System and have priority to receive nursing care benefits. You also must be in a stable medical and psychological condition. A veteran will need to choose between short-term and long-term care and inform the CLC of when they expect to be discharged. The availability of CLC care is limited, so the facility does not automatically grant admission if a veteran meets these requirements. It may further evaluate whether it can provide the services that the veteran needs.
You may need to make co-payments if you do not have a service-related disability with a rating of at least 10 percent, and your income is higher than the maximum annual pension rate provided by the VA. Otherwise, you will not need to pay any costs.
State Veterans Homes
The VA may provide per diem aid indefinitely if a state veterans home meets its standards for care, and the veteran is eligible under VA rules for the type of care that they are seeking. Benefits may cover half of the costs of care.
A state may provide its own requirements for receiving care in a state veterans home. These requirements usually relate to the veteran’s residency in the state.
Contract Nursing Home Care (Community Nursing Home Care)
If you have a disability related to your service, or you need home health care after being released from a VA hospital, you should be automatically eligible for contract nursing home care benefits. You would need your VA doctor or an authorized private doctor to state that nursing home care is needed.
A veteran also may be able to receive benefits if they are receiving care at a VA hospital or nursing home or if they have been receiving outpatient care through the VA. If you are an active servicemember who needs nursing care after being in a DOD hospital, you will be able to receive these benefits if you will be an eligible veteran after your discharge.
If you are not in a priority group, you should be able to receive up to six months of free care. However, you may be able to receive benefits for only 30 to 60 days, depending on the availability of resources. If you are in a priority group, you should be able to receive free care indefinitely, although unfortunately even veterans in these groups may find that their benefits are limited due to lack of resources.
Services that are not covered by VA health care may be covered by Medicare, Medicaid, or private insurance.