Guide to Veterans Benefits for Assisted Living & Long-Term Care

Updated February 27, 2023

Whether you are a Veteran or not, long-term care costs can add up fast. Fortunately, help may be available for Veterans and their surviving spouses in need of in-home care or living in a facility.

Much of your medical support will come from participation in the Department of Veterans Affairs (VA) health care system, which comprises nearly 1,300 health care facilities, including medical centers and outpatient sites.

Beyond the VA-paid services, payment for in-home or in-facility long-term care will come from several sources, starting with a Department of Veterans Affairs VA pension and its two “enhanced programs” called Aid and Attendance (A&A) and Housebound.

Depending on your chosen care solution, you may also need to look beyond VA-related sources and call on Medicare, Medicaid, private insurance and your own funds.

This report aims to explain the available VA-related payment sources and the long-term care options available to Veterans and their surviving spouses.

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Sources of Funding for Long-Term Care for Vets 

The VA offers a wide array of long-term care options to eligible Veterans. For the out-of-pocket portion of such services, VA pension benefits provide a primary source of funding, starting with its basic pension program. This needs-based benefit is paid to wartime Veterans and their survivors and includes two “enhanced programs” available to those who qualify, but that cannot be used together.

Basic Pensions

The Veterans pension program makes monthly payments to wartime Veterans who fulfill certain age or disability requirements. In addition, their income and net worth must be within certain limits, where net worth includes your and your spouse’s assets at fair market value and your annual income. The basic pension is also available to a not-remarried surviving spouse of a qualifying Veteran.

What’s Covered

The monthly pension payments are intended to apply to Veterans’ needs. They “top up” the Veteran’s family income to a maximum amount determined by Congress. That maximum is affected by a Veteran’s number of dependents (spouse and children) or having a spouse who is also a Veteran.

Benefit Amount

Your pension benefit is the difference between your specific Maximum Annual Pension Rate (MAPR) and your family’s countable income. This income includes earned income, Social Security, investments, retirement benefits and dependents’ income, minus certain non-reimbursable medical expenses. The MAPR is the maximum amount of pension that can be paid for your situation. In 2022, the MAPR for the basic pension alone (with no enhancement programs) is:

  • $16,037 for a single person with no dependents.
  • $21,001 with one dependent spouse or child (plus $2,743 per additional dependent), including if your spouse is a Veteran.
  • $10,757 for a surviving spouse with no dependents.
  • $14,078 for a surviving spouse with one dependent child (plus $2,743 per additional dependent).   

Eligibility

To be eligible for a Veteran basic pension, you cannot have received a dishonorable discharge, and Congress limits your family income and net worth. Until November 30, 2022, the upper net worth limit is $138,489, and the maximum income depends on marital status and dependents. You also have active duty requirements:

  • An exception exists for officers after October 16, 1981.)
  • One of these must be true:
    • You’re at least 65 years old,
    • You have a permanent and total disability,
    • You are in a nursing home or long-term care because of a disability, or
    • You receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Resources

Aid and Attendance Benefit

Aid and Attendance (A&A) is an enhancement to the basic pension of an eligible Veteran or surviving spouse who needs additional third-party help with everyday activities.

What’s Covered

The additional funds can be spent as you choose but are intended to get you the support you need because of your physical condition.

Benefit Amount

This benefit is the difference between your specific Veteran’s Maximum Annual Pension Rate (MAPR) with the A&A enhancement and your family’s countable income (made up of earned income, Social Security, investments, retirement benefits and dependents’ income, minus certain non-reimbursable medical expenses). In 2022, the MAPR with A&A is:

  • $26,752 if you have no dependents.
  • $31,714 with one dependent spouse or child (plus $2,743 per additional dependent).
  • $31,714 with a Veteran spouse (up to $42,433 if you both qualify for A&A).
  • $17,888 for a surviving spouse with no dependents.
  • $21,130 for a surviving spouse with one dependent child (plus $2,743 per additional dependent).    

Eligibility

Besides qualifying for a basic pension, to receive the A&A enhancement, you or your surviving spouse must have specific needs. You must meet one or more of these:

  • Need help from another person to perform regular activities of daily living (such as bathing, feeding or grooming).
  • Be bedridden.
  • Be visually impaired.
  • Be a patient in a nursing home.

You do not need to have service-related disabilities to qualify.

Resources

Housebound Benefits

Housebound is an enhancement to the basic pension of an eligible Veteran or surviving spouse who spends most of the time at home due to a permanent disability. You cannot get both A&A and Housebound benefits at the same time.

What’s Covered

While the additional funds can be spent as you choose, they are intended to allow you to get the support you need because you are housebound.

Benefit Amount

This benefit is the difference between your specific Veteran’s Maximum Annual Pension Rate (MAPR) with the Homebound enhancement and your family’s countable income (made up of earned income, Social Security, investments, retirement benefits and dependents’ income, minus certain non-reimbursable medical expenses). In 2022, the MAPR with Housebound is:

  • $19,598 if you have no dependents.
  • $24,562 with one dependent spouse or child (plus $2,743 per additional dependent), including a Veteran spouse.
  • $28,121 with a Veteran spouse if you both qualify for Housebound.
  • $13,147 for a surviving spouse with no dependents.
  • $16,462 for a surviving spouse with one dependent child (plus $2,743 per additional dependent).

Eligibility

To receive the Housebound enhancement, besides qualifying for a basic pension, a Housebound beneficiary must be confined to the home with a 100% permanent disability or one disability rated as 100% disabling and another at 60% disabling or more.

Resources

Geriatric Patient Aligned Care Team (GeriPACT)

Suppose you are an older Veteran with complex care needs (for example, age-related cognitive or physical decline). In that case, the Geriatric Patient Aligned Care Team (GeriPACT) provides traditional health services together with offerings from the community to maximize your independence and quality of life. It is primary care with an emphasis on interdisciplinary elder care.

What’s Covered

GeriPACT evaluations of a Veteran’s physical, mental and psycho-social health status result in a treatment plan that includes resources and support services for current and future problems. Offerings also include:

  • Chronic care management
  • Routine mental health care
  • Management of common acute and chronic pain conditions
  • Deployment-related health concerns
  • Advance care planning
  • Informational support for the caregiver
  • Preventive health services

Benefit Amount

Veterans receive primary care in PACT clinics. GeriPACT evaluations (which involve Veterans’ caregivers) are part of the VA’s health care support system and are available in about two-thirds of the VA’s medical centers. Teams reach out to home health, home hospice and community agencies where needed.

Eligibility

Geriatric evaluations and coordinated health care through multi-disciplinary teams are provided to every Veteran who receives care at the VA through the standard VA health care package, and who has one or more of these conditions:

  • More than one chronic disease
  • Declining physical abilities
  • Challenges with memory or thinking

Resources

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Types of Long-Term Care Available to Vets

As a Veteran, you can select among several long-term care environments based on the severity of your needs, what is available in your area, the level and source of funding available and your personal preferences. These options include:

Nursing Homes

Community Living Centers

Community Living Centers are VA-owned nursing homes where Veterans can receive nursing-home level care for the short or long term. The environment can vary, but these centers aim to resemble “home” as much as possible.

Type of Care Provided

Eligible Veterans with the VA Medical Benefits Package have access to skilled nursing and medical care, as well as help with activities of daily living (such as bathing, eating and grooming). Services include:

  • 24-hour skilled nursing care
  • Restorative care
  • Access to social work services
  • Geriatric evaluation and management

Some centers offer care related to mental health recovery, dementia, respite, palliative and hospice.

How it Works

Community Living Centers are often close to a VA medical center. You may stay in a center for a short time, but sometimes for the rest of your days. The goal is to restore you to your highest level of well-being, manage any decline in health or provide end-of-life comfort. The list of 100+ locations can be found here.

Costs

The VA provides Community Living Center care if you meet specific eligibility criteria involving your service-connected status, level of disability and income. The same information is used to determine if you will be charged a copay for such care. For example, starting on the 22nd day of care in 12 months, you could be charged a daily copay of up to $97. You may get help paying copays from TRICARE for Life (wraparound insurance that supplements Medicare for veterans) or CHAMPVA for Life (a VA health insurance program for over-65 family members of disabled or killed Veterans).

Eligibility

Eligibility is based partly on clinical need and space availability. In addition, you must be enrolled in the VA health care system before applying and be medically and psychiatrically stable.

Resources

Community Nursing Homes

Community Nursing Homes are not VA-owned, although they are under contract with the VA to provide Veterans with a broad range of locations to live full time and to receive skilled nursing home care 24/7. (They are what we think of when we say “nursing home.”)

Type of Care Provided

Eligible Veterans with the VA’s health care package have access to skilled nursing and medical care, plus help with activities of daily living. Services include:

  • 24-hour skilled nursing care
  • Physical and occupational therapy
  • Access to social services

Some homes offer short-term rehabilitation services, special dementia care and end-of-life care such as hospice and palliative.

How it Works

The VA’s goal is to provide a wide range of locations so Veterans can receive care near their families and friends. A VA social worker can help you with eligibility and devising a payment plan for these vital care services.  

Costs

If you don’t meet the VA’s eligibility requirements, you will have to pay for nursing home care on your own, possibly with some Medicare and Medicaid benefits if you can’t afford to pay. However, you can use your Aid and Attendance enhancement to your basic pension if you have it.

Eligibility

Clinical need and space availability play a role in determining your eligibility. The eligibility criteria related to your service-connected status, level of disability and income are also essential in determining the help you will receive.

Resources

State Veterans Homes

State Veterans Homes are owned, operated and managed by state governments, not the VA. In many states, these homes were created after the Civil War to shelter homeless and disabled Veterans.

Type of Care Provided

State Veterans Homes can provide nursing home, domiciliary or adult day health care, or a combination of those services. Services are similar to those provided in Community Living Centers and Community Nursing Homes.

How it Works

The VA must formally recognize and certify a state-government facility as a State Veterans Home before the facility can serve that purpose. It will survey all facilities each year to be sure they still meet VA standards. At least one State Veterans Home is available in each state (and Puerto Rico). A list of locations is available here.

Costs

The VA may make payments to a State Veterans Home to defray the cost of providing care to eligible Veterans. Costs vary by state, so interested Veterans should contact individual homes directly to ask about costs and available funding. In addition to VA health care coverage, payment may come from Medicare, Medicaid and your Aid and Attendance enhancement if you receive it.

Eligibility

Eligibility for State Veterans Homes is determined by clinical need and available space. Specific eligibility and admission criteria are established by each state, not at the national level. Some homes admit Veterans only, while others may accept non-Veteran spouses and Gold Star parents.

Resources

Residential Settings

Assisted Living Facilities

Assisted Living Facilities provide options for Veterans to live in rented rooms or apartments. Rooms may be shared or private. In addition, facilities may provide shared living spaces such as dining rooms or include individual kitchens or kitchenettes in apartments or rooms.

Type of Care Provided

A trained caregiver is on duty 24 hours a day, seven days a week, to help Veterans with any activities of daily living (such as bathing, dressing or mobility). The VA may also arrange for a nurse or other health professional to visit and provide extra care. A VA social worker can help define the need for a nurse or aide. Some services come with the cost of the room, and others may be provided by the VA or the Assisted Living Facility.

  • Most Assisted Living Facilities provide Veterans with:
  • Help with activities of daily living
  • Help taking medications
  • Some nursing assistance (depending on the state and facility)
  • Some or all meals (depending on the state and facility)
  • Recreational and social activities

Family caregivers benefit from 24/7 help with the Veteran’s care, which is particularly burdensome when the Veteran’s Home and Community-Based Services are no longer enough. They also now have a place to spend time with the Veteran outside of the caregiver role.

How it Works

Assisted Living Facilities provide a living environment that is more community-like than Community Living Centers and Community Nursing Homes, but they also provide less care. Veterans can often choose how engaged they want to be in eating options and recreational or social activities. The VA does not offer its own assisted living facilities, nor does it pay for them directly. However, Veterans may have access to payment assistance from the VA through other means.

Costs

The VA typically does not pay room and board for a Veteran, even though the rent may include basic services. Some facilities bill Veterans separately for services, which may allow the VA to pay for what it deems necessary services. Veterans will frequently cover assisted living costs with the A&A enhancement to their basic pension.  

Eligibility

Assisted Living eligibility will vary by facility, so check with the administrator of the facilities that interest you to confirm you are eligible.

Resources

Medical Foster Homes

Medical Foster Homes are private homes inspected and approved by the VA for Veteran care. They are a smaller, more personal version of a nursing home. A trained caregiver provides services to residents, starting with the Home-Based Primary Care an eligible Veteran receives. Residents are not necessarily Veterans, and the homes are neither provided by nor paid for by the VA.

Type of Care Provided

The caregiver – and relief caregivers – provide supervision and care 24/7, including help with activities of daily living such as bathing and dressing. The VA ensures that the caregiver has the necessary training, so the Veteran receives VA-planned care.

Services vary from one Medical Foster Home to another. In addition to the primary care that eligible Veterans receive, the following services may also be provided by the caregiver:

  • Help with activities of daily living
  • Help taking medications
  • Some nursing assistance
  • All meals
  • Recreational and social activities

Family caregivers enjoy the peace of mind of receiving 24/7 help with the Veteran and having a place to spend time with the Veteran outside the caregiver role.

How it Works

Medical Foster Homes are a good alternative to nursing homes for Veterans needing that level of care but preferring a less-institutional, smaller facility. A Veteran will continue to receive the Home-Based Primary Care that was available in their home, with a VA physician supervising a health care team that provides the services. These services are available to Veterans whose complex health care needs make routine clinic-based care ineffective.

Costs

The VA does not pay for the cost of a Medical Foster Home. Instead, that responsibility lies with the Veteran to pay out-of-pocket or through insurance. The typical cost of $1,500-3,000 per month depends on the Veteran’s income and the level of care needed. It should be negotiated with the facility’s caregiver in advance. A Veteran’s health benefit can pay for primary care, medication management and help with activities of daily living. In addition, a Veteran can apply funds from the basic pension’s A&A enhancement towards the room-and-board cost of a foster home.

Costs

The VA does not pay for the cost of a Medical Foster Home. Instead, that responsibility lies with the Veteran to pay out-of-pocket or through insurance. The typical cost of $1,500-3,000 per month depends on the Veteran’s income and the level of care needed. It should be negotiated with the facility’s caregiver in advance. A Veteran’s health benefit can pay for primary care, medication management and help with activities of daily living. In addition, a Veteran can apply funds from the basic pension’s A&A enhancement towards the room-and-board cost of a foster home.

Eligibility

A Veteran must be enrolled in Home-Based Primary Care through the VA health care plan to be eligible for a Medical Foster Home, and a facility must be available. A VA social worker or case manager can help with eligibility and additional financial resources.

Resources

Adult Foster Homes

Adult Foster Homes (or Adult Family Homes) offer Veterans a rented room in a private home with six or fewer residents. They are smaller versions of Assisted Living Facilities. These homes offer shared common spaces and may mean a Veteran will share a bedroom and bathroom with someone else. The VA does not provide or pay for Adult Foster Homes.

Type of Care Provided

A trained caregiver is available 24/7 to help a Veteran with activities of daily living  (such as grooming and mobility). Some services come with the room rental. Others may be provided at the VA’s expense, such as a health professional (nurse) who comes to the Adult Foster Home to care for the Veteran. A VA social worker can help a Veteran decide if a nurse is needed.

Most Adult Foster Homes provide Veterans with:

  • Help with activities of daily living
  • Help taking medications
  • Some nursing assistance (depending on the state and facility)
  • Some or all meals (varying among facilities)
  • Recreational and social activities

Family caregivers benefit from 24/7 help with the Veteran, which is particularly burdensome when the Veteran’s Home and Community-Based Services are no longer enough. They also now have a place to spend time with the Veteran outside the caregiver role.

How it Works

Adult Foster Homes are smaller assisted living facilities with up to six residents. Services are similar to larger residences, but social and recreational activities will not be as extensive. However, the cost is also lower in the smaller residences.

Costs

The VA will not cover the cost of a Veteran’s rent, which typically includes some basic services. But it may pay for extra services needed by the Veteran, such as nurses’ visits. However, Veterans have access to VA payment assistance through other means, such as the A&A enhancement to the basic pension paid to Veterans needing help with their activities of daily living. Costs vary significantly due to location but can run from $1,500 to $3,000 per month.

Eligibility

A Veteran’s eligibility is determined by clinical need and room availability in a facility. If an Adult Foster Home seems to provide the solution to a Veteran’s needs, a VA social worker or case manager can help with eligibility and availability issues.

Resources

Home Care Assistance for Vets

As a veteran, you are eligible for various forms of home health care provided by the VA. These supportive medical services help you remain in your home if you are chronically ill or disabled at any age. They are extended care services prescribed by and under the direction of a VA physician. Medical and non-medical services include:

Medical / Skilled Nursing Care Benefits

Medical or Skilled Nursing Care is for Veterans needing skilled nursing, case management, various therapies, wound care or antibiotics IVs at home. Veterans receive this care from community-based home health agencies under contract with the VA and can be used together with other Home and Community-Based Services.

What’s Covered

Services can vary by location and can be as short as helping Veterans transition home from the hospital or nursing home. Based on the level of need, a Veteran can receive the following services at home:

  • Nursing care, including catheter or wound care
  • Physical, occupational or speech therapy visits
  • Patient education around managing medicines and illness
  • Home infusion, including IV antibiotics
  • Home safety evaluations
  • Social work support

Benefit Amount

The cost to a Veteran of skilled medical care at home, including any copays, depends on the Veteran’s priority group (ranked from 1 to 8, as described here). Your group is defined when you enroll for VA health care coverage based on your military service history, disability rating, income, Medicaid eligibility and benefits such as the VA pension. A VA social worker or case manager can help you identify copay amounts. In addition, Medicare coverage may cover medically necessary home care for you, with TRICARE for Life and CHAMPVA for Life picking up whatever Medicare doesn’t.

Eligibility

All Veterans enrolled in VA health care are eligible for Skilled Nursing Care as long as they meet the requirements for community care and clinical criteria. The services must also be available near the Veteran.

Resources

Custodial Care Benefits

Custodial Care Benefits (also called Homemaker or Home Health Aide) involve a trained person who can help Veterans take care of themselves and the activities of daily living. These aides, who work for an organization with a VA contract, are not nurses but receive supervision by registered nurses to assess the Veteran’s needs. These non-medical, personal care services allow Veterans to remain at home in isolated situations far from the VA and can open the door to Veterans receiving Respite Care to relieve overburdened caregivers.

What’s Covered

A Veteran’s assessed needs determine the services provided, such as multiple versus occasional visits by an aide. Services vary by location but can be used together with other Home and Community-Based services. Assistance with activities of daily living can last as long as needed and can include:

  • Eating
  • Dressing
  • Grooming
  • Bathing
  • Toileting
  • Moving from one place to another
  • Shopping for food

Benefit Amount

Different sources of VA funds cover personal care at home. Priority Group determines fees, and a copay may be charged based on a Veteran’s service-connected disability status. Funds can come from a Veteran’s basic pension, an enhancement (A&A or Housebound) or personal resources. TRICARE for Life and CHAMPVA for Life do not pay for personal care in the home.

Eligibility

All Veterans enrolled in VA health care with Home Health Aide Care are eligible for Custodial Care Benefits as long as they meet the requirements for community care and clinical criteria. The services must also be available near the Veteran.

Resources

Hospice Care Benefits

Hospice Care is end-of-life comfort care for a Veteran in the advanced stages of terminal illness with less than six months to live. Treatment is limited to palliative care with no attempts to diagnose or heal. Hospice Care is available through an interdisciplinary agency staff 24/7 in the home or inpatient or outpatient settings.

What’s Covered

In Hospice Care, efforts aim to relieve suffering and manage symptoms while respecting personal, cultural and religious beliefs. A care team works with the Veteran and family members to develop a plan that meets medical, social, spiritual and psychological needs. This care extends to bereavement assistance to the Veteran’s caretaker family.

Benefit Amount

Veterans pay no copays for Hospice Care, regardless of whether it is provided by the VA or a party contracted by the VA.

Eligibility

Veterans receive Hospice Care through the standard VA health care package, so all enrolled Veterans are eligible if they meet the service’s clinical need requirements.

Resources

Household Help Benefits

Older Veterans and those of all ages with disabilities may find they need help to maintain a safe and secure living environment. Personal care or home care aides may provide such tasks as a courtesy, but more structured help can be arranged using resources from the Veteran-Directed Care (VDC) program.

What’s Covered

Veterans can receive the assistance they need through the VDC program. This program’s flexibility lets eligible Veterans determine the services they need to remain at home, including hiring someone to maintain the home and property. A counselor will help them develop a spending and hiring plan that can include family members, friends or neighbors. Services can extend from the activities of daily living (bathing, grooming and dressing, among others) to food shopping and preparation, housecleaning and other indoor and outdoor chores.

Benefit Amount

Based on their assessed need, Veterans in the VDC program are provided a budget for services they or their representatives manage.

Eligibility

All Veterans enrolled in VA health care are eligible for the VDC program, provided they meet the community care and clinical criteria requirements. The service must also be available in their location.

Resources

Respite Care Benefits

For the caregivers of Veterans who need help with activities of daily living, the Respite Care program offers some time away from their caregiving duties to lower everyone’s stress levels.

What’s Covered

Veterans can use Respite Care with other Home and Community-Based Services. Depending on the services in your area and what would be best for your caregiver, you could:

  • Pay a Home Health Aide to come to your home.
  • Attend an Adult Day Health Care center.
  • Go to a Nursing Home or VA Community Living center.

In all cases, trained staff will provide for the Veteran’s needs. Available services vary by location.

Benefit Amount

A Veteran may have to pay a copay for Respite Care based on the Priority Group assigned upon enrollment in VA health care. Starting on the 22nd day of care in 12 months, you could be charged a daily copay of up to $97. VA health care covers up to 30 days per year of Nursing Home Respite Care, but Veterans can opt to spend some of their Veteran-Directed Care budgets on additional Respite Care services.

Eligibility

All Veterans are eligible for Respite Care if they are enrolled in VA health care and meet the clinical criteria. They must also meet Community Care eligibility if the Respite Care is provided by a community agency, Adult Day Health Care center or a nursing home.

Resources

Home Modification Benefits

Financial resources are made available to disabled veterans to make medically necessary home modifications to increase mobility, improve access and maximize the ability to use the house. The primary goals are independence and safety.

What’s Covered

Grants are available to Veterans with specific service-connected disabilities to build or change a home to accommodate their disability and live independently in a safe, barrier-free environment. Modifications range from changing faucet knobs and adding shower grab bars to building ramps, widening doorways and adding an in-law apartment.

Benefit Amount

Programs such as Specially Adapted Housing (SAH), Special Home Adaptation (SHA), Home Improvement and Structural Alteration (HISA) and Temporary Residence Adaptation (TRA) vary in the maximum amounts available to disabled Veterans. (In 2023, an SAH grant can pay up to $109,986; SHA up to $22,036; and HISA up to $6,800.) Also, Veterans who receive the Housebound supplement to the basic pension can spend those funds on home modification if they wish.

Eligibility

Housing grants through programs such as SAH, SHA, HISA and TRA have different eligibility requirements. All cover service-connected disabilities, with some covering disabilities unrelated to military service.

Resources

Telehealth Visit Benefits

Telehealth services provide easier access to care, using technology to connect you as a Veteran to your VA specialists and care teams. They can be used with other Home and Community-Based Services to reduce travel by connecting you through the telephone, online televisits, remote monitoring and mobile apps.

What’s Covered

Although not all telehealth programs are available in all locations, Telehealth Visit Benefits can take the following forms:

  • Telephone visits let you share information about test results, plus schedule and confirm appointments using your home phone or mobile device.
  • Telehealth, also called VA Video Connect, lets you use the camera on a computer, tablet or smartphone to meet in a virtual medical room to expand clinical care beyond the traditional office visit.
  • Remote Monitoring, also called Home Telehealth, lets you interact with your VA providers virtually. For example, using home monitoring equipment, you can send your vital signs (such as blood pressure, blood sugar levels, pulse and blood oxygen levels) and other health data to your VA care team through your computer or mobile device without leaving home.
  • The VA is developing mobile apps to enhance the telehealth experience, including the apps available at the VA App Store.

Benefit Amount

No copay is involved with any Telehealth Visit Benefits. However, a copay could be triggered by some in-home video visits provided in addition to standard services.

Eligibility

All Veterans enrolled in VA health care are eligible to use Telehealth Visit Benefits as part of their standard package. You’ll be assessed for the services. If eligible, the VA will provide you with the device you need, plus training and a Home Telehealth care coordinator.

Resources

No copay is involved with any Telehealth Visit Benefits. However, a copay could be triggered by some in-home video visits provided in addition to standard services.

Durable Equipment Benefits

Durable Equipment Benefits refer to prosthetics, orthotics, Durable Medical Equipment (DME) and sensory aid fulfillment services. This is long-lasting and reusable equipment that helps you function independently and manage the activities of daily living.

What’s Covered

DME falls into three groupings:

  • Standalone equipment, such as walkers, wheelchairs and home hospital beds.
  • Fixed items, such as wheelchair ramps and handrails.
  • Small electronic items, including ventilators, nebulizers and home blood testing kits.

DME can be purchased or rented, depending on the time it will be needed. Requests are made through a completed VA Form 10-10172 “Community Care Provider – Request for Service,” which you return to your local VA facility’s community care office.

Benefit Amount

To acquire DME prescribed by a physician, a Veteran can call on a combination of sources for help, such as VA health care, TRICARE and CHAMPVA. (TRICARE and CHAMPVA will help with the 20% copayment that Medicare does not cover.) In addition, funding through Veteran-Directed Care (VDC), basic pensions and their A&A or Homebound enhancements can be applied to DME. Lastly, grants given for home modifications by Special Housing Adaptation (SHA), Specially Adapted Housing (SAH) or Home Improvements and Structural Alterations (HISA) can be used for grab bars and wheelchair ramps, also classified as DME.   

Eligibility

Eligibility for coverage of Durable Medical Equipment requires a physician’s prescription and participation in one or more of the entities that provide such funding.

Resources

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Resources

Additional resources that can assist you in accessing long-term care support include:

If you still have questions after reviewing this report and its resources or need help accessing VA services, call toll-free, 1-877-222-VETS (8387), Monday through Friday, 8 am to 8 pm (ET) or contact your VA social worker.

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