Copayment for Nursing Home Care

The following veterans are exempt from nursing home care copayments: (1) a veteran with a compensable service-connected disability; (2) a veteran whose annual income is under the maximum annual pension rate; (3) a veteran who requires nursing home care for a noncompensable service-connected disability; (4) a veteran whose extended care services began on or before November 30, 1999; (5) certain Vietnam-era herbicide-exposed veterans, radiation-exposed veterans, Persian Gulf War veterans, post-Persian Gulf War combat-exposed veterans, or veterans who served at Camp Lejeune; (6) a veteran requiring care for treatment of sexual trauma; (7) a catastrophically disabled veteran; (8) certain veterans requiring care for cancers of the head or neck; (9) a wartime-era veteran who developed a psychosis and certain Persian Gulf War veterans who developed other mental illnesses, within certain presumptive periods; and (10) Medal of Honor recipients.

A veteran who is not in one of the above categories must pay a copayment for VA nursing home care and other extended care services. Veterans who must pay for VA nursing home care are generally those with income higher than the VA’s health care income limit who are not otherwise eligible for free care. The maximum daily copayment amount for VA nursing home care is $97. However, veterans must pay a copayment only to the extent that they have the resources. The VA maintains that the average daily copayment for nursing home care for veterans with annual income between $9,556 and $24,000 would be about $14.