Understanding Long-Term Care Benefits for Military Spouses
Military spouses have access to several programs that can help cover the cost of nursing home and long-term care services. These programs exist because of the unique circumstances military families face, including frequent relocations, time spent away from home during deployments, and the physical and mental health challenges that can result from military service. A nursing home stay can cost anywhere from $100 to $300 per day depending on the facility and the level of care needed, which adds up to $36,500 to $109,500 per year. Understanding what programs may be available helps military families plan for potential future care needs.
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The Department of Veterans Affairs (VA) offers several pathways for military spouses to receive long-term care services, either in VA facilities or through private providers with VA funding. Additionally, military families may have options through TRICARE, the military health insurance program, and through state Medicaid programs. Each program has different rules about who can use it and what services are covered. Some programs are specifically designed for spouses of service members with service-connected disabilities, while others are available to all military families regardless of disability status. Knowing the differences between these programs helps families understand what options to explore.
It is important to understand that military spouses are not automatically included in all VA benefits. Unlike service members themselves, spouses must meet specific conditions to receive VA-funded long-term care. The most common pathway is through the Caregiver Support Program or through spousal benefits based on the service member's disability rating. Some spouses may also receive benefits through survivor programs if they are the surviving spouse of a deceased service member. Military families should research each program individually because the rules, costs, and coverage areas differ significantly.
Practical takeaway: Military spouses interested in long-term care should gather information about all available programs rather than assuming they are covered under one particular plan. Taking time to understand the different pathways now can help reduce confusion later if long-term care becomes necessary.
TRICARE Coverage and Long-Term Care Services
TRICARE is the health insurance program for military families, retirees, and survivors. The program operates differently depending on which TRICARE plan a family has chosen. For long-term care services like nursing home stays, TRICARE coverage depends on whether the care is considered skilled nursing care (requiring a nurse or therapist) or custodial care (assistance with daily activities like bathing or dressing). TRICARE plans cover skilled nursing care in certain situations, but they provide limited or no coverage for custodial care, which is the most common type of care provided in nursing homes.
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Under TRICARE, skilled nursing facility care is typically covered for a limited time following a hospital stay. For example, if a military spouse has surgery and needs rehabilitation at a nursing home afterward, TRICARE may cover a portion of those costs for 20 to 100 days depending on the specific plan and the medical necessity. However, long-term custodial care—such as help with meals, bathing, or medication reminders for someone with dementia—is usually not covered by TRICARE. This limitation means that families need to explore other funding sources for extended nursing home stays that are primarily custodial in nature.
TRICARE also offers some coverage for home health care services, which allows some military spouses to receive nursing support at home rather than in a facility. This option may be less expensive and allows people to remain in their homes longer. Military spouses should review their specific TRICARE plan documents or contact TRICARE directly to understand exactly what services are covered under their plan, as coverage rules can vary between TRICARE Prime, TRICARE Select, and other plan types. Reviewing the plan annually ensures that families understand any changes in coverage.
Additionally, military spouses aged 65 and older who are TRICARE-eligible may become covered under Medicare as their primary insurance, with TRICARE becoming secondary coverage. Medicare has its own rules for nursing home coverage that may provide different benefits than TRICARE alone. Understanding how Medicare and TRICARE work together is important for older military spouses planning for long-term care.
Practical takeaway: Review your TRICARE plan details in writing to understand what nursing home or skilled nursing care is covered. Make note of any time limits or cost-sharing requirements, and ask TRICARE for clarification on any parts you do not understand.
VA Long-Term Care Programs and Services
The Department of Veterans Affairs provides long-term care services to eligible military spouses through several programs. The primary way military spouses can receive VA-funded long-term care is if they are the spouse of a service member or veteran who has a service-connected disability rated at 70 percent or higher, or who requires aid and attendance (meaning they need help with daily activities). The Aid and Attendance benefit is a monthly payment that can be used to pay for nursing home care, assisted living, or in-home care services. In 2024, the maximum Aid and Attendance benefit for a married couple was approximately $5,000 per month, though the exact amount depends on family income and the service member's disability rating.
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The VA also runs its own long-term care facilities called Community Living Centers in many parts of the country. These facilities provide nursing home care, short-term rehabilitation, and hospice services. Military spouses of eligible veterans may be admitted to these facilities, though availability can be limited and there may be waiting lists. VA Community Living Centers typically charge less than private nursing homes because they are federally funded. The cost to the family is usually based on a percentage of the veteran's income, and families with limited resources may pay very little or nothing.
Another important VA program for military spouses is the Caregiver Support Program, which provides services and financial support to caregivers who are caring for eligible veterans at home. If a military spouse is caring for a veteran with a service-connected disability, the caregiver may receive stipends, training, health insurance, and respite care (temporary relief from caregiving duties). This program helps keep spouses at home rather than in nursing facilities, though it requires that a veteran be available to supervise the care arrangement. The Caregiver Support Program is administered through VA medical centers across the country.
Surviving spouses of deceased service members may also receive long-term care benefits through the VA's Survivor Benefit Plan or other survivor programs. Eligibility depends on how the service member died, their rank, and other factors. Surviving spouses should contact their nearest VA medical center to understand what programs may be available to them.
Practical takeaway: If a military spouse is seeking VA-funded long-term care, contact the nearest VA medical center or call the VA benefits hotline at 1-800-827-1000 to learn what specific programs the family may explore. Having the service member's disability rating information available when you call will help the VA representative provide relevant details.
State Medicaid Programs and Long-Term Care
Medicaid is a joint federal and state program that pays for medical services and long-term care for people with limited income and resources. Military spouses with low income may be able to receive nursing home coverage through their state's Medicaid program. Medicaid is the largest payer of nursing home care in the United States, accounting for nearly 40 percent of all nursing home spending. Unlike TRICARE, which typically covers only short-term skilled nursing care, Medicaid can pay for long-term custodial care in nursing homes if the person meets financial and medical requirements.
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Each state operates its own Medicaid program with different rules about income limits, asset limits, and covered services. For example, a military spouse in California may have different Medicaid coverage rules than a military spouse in Texas. Some states are more generous with income allowances for nursing home residents, while others have stricter financial limits. A few states have higher asset limits, meaning a person can keep more savings and property and still receive Medicaid. Conversely, many states require people to spend down their savings to very low levels before Medicaid will pay for nursing home care.
One important Medicaid rule that affects many nursing home residents is the "spousal impoverishment" protection. This rule prevents the healthy spouse from becoming impoverished if the other spouse needs long-term nursing home care paid for by Medicaid. The rule allows the well spouse to keep a certain amount of income and assets while Medicaid pays for the nursing home resident's care. The exact amounts vary by state, but in 2024 the federal minimum was about $2,500 in countable assets for the well spouse and up to $1,715 in monthly income. These amounts increase each year.