VA Dementia Care Benefits – Patient Information Sheet
For Veterans and Families
This guide explains how to figure out what benefits a Veteran may qualify for and how dementia care is supported within the VA system. It is written for families who may be exploring VA benefits for the first time.
Take Home: If you are 70% service connected, you may be eligible to get additional money to pay for caregiving (paid through the VA).
1. First Step: Confirm Your Service Connection Status
To understand what benefits you qualify for, you must know your Service Connection (SC) percentage. If you're not sure—or have never checked—here are the most reliable ways:
A. Call Your VA Regional Benefits Office (Most Accurate)
The Veterans Benefits Administration (VBA) is the only department that can provide the official and up-to-date service-connection rating.
Example for Oakland: • Website: https://www.va.gov/oakland-va-regional-benefit-office/ • You can call the phone number listed on that page and ask: “Can you tell me my current service-connected disability percentage and what conditions I am rated for?”
B. Ask Your VA Healthcare Team (Convenient but Not Always Up-to-Date)
You or your caregiver can call your VA primary care clinic and ask any team member to check your chart for the service-connected rating listed there.
Important:
The healthcare system and the benefits system are separate.
If your SC rating has changed recently, your healthcare team may NOT be notified.
The Veteran receives updates directly from the VBA.
If you want the definitive rating → call your Regional Benefits Office.
2. After You Find Out Your Service Connection: What to Do Next
Once you know your official VA service-connected status, here are the next steps to get help with dementia care:
A. Enroll or Confirm Enrollment in VA Health Care
Before using most VA services (especially caregiver programs and home-based care), the Veteran must be enrolled in VA health care.
• If not enrolled, apply through VA Form 10-10EZ online or at your local VA facility. This opens the door to clinical services, referrals, and care planning.
B. Connect with Your VA Caregiver Support Team
Each VA medical center has a Caregiver Support Program (CSP) team that can:
Explain benefits and services available to you based on your service-connection and care needs
Help you connect with PGCSS and PCAFC caregiver programs (see chart below)
Provide training, peer support, education, and referrals to community care services Veterans Affairs+1
How to contact them:
Call the VA Caregiver Support Line: 1-855-260-3274 (TTY: 711) Veterans Affairs
Ask your VA doctor, nurse, or social worker to refer you to the CSP team.
C. Explore Caregiver Support Programs (see chart below)
Program of General Caregiver Support Services (PGCSS)
Support and training for all caregivers of enrolled Veterans.
You do not need a formal application; just contact your local caregiver support team.
Offers peer mentoring, coaching, and caregiver resources.
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Offers enhanced support (including possible stipend and CHAMPVA health care for the caregiver), if the Veteran meets eligibility, including typically a service-connected rating requirement (e.g., ≥70% combined SC) and a need for ongoing personal care. Veterans Affairs+1
You must apply together with the Veteran using VA Form 10-10CG (online, by mail, or in person). Veterans Affairs
D. Consider Other Related VA Services
Depending on the Veteran’s needs, your CSP team can help you learn how to access other VA supports such as:
Respite care (short-term caregiver breaks)
Home-based services and medical equipment
Memory care and long-term care planning
Mental health and caregiver coping support
They’ll work with you to map what’s available based on the Veteran’s SC rating and clinical needs. Veterans Affairs
E. Track and Appeal Decisions
If you apply for caregiver support or other VA benefits and are denied:
You can request a review or appeal of decisions (for caregiver program decisions, there are specific review processes with forms like VA Form 10-306). Veterans Affairs
Contact VA or a Veterans Service Organization (VSO) (like DAV, VFW, American Legion) for help with appeals and claims.
Quick Contacts
VA Caregiver Support Line: 1-855-260-3274 (TTY: 711) Veterans Affairs
Local VA Social Worker or Care Team: Ask your VA primary care provider
Types of VA Caregiver Support Services
Category
Program of General Caregiver Support Services (PGCSS)
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Program purpose
Education, training, and support services for caregivers
Financial and health benefits for primary caregivers of seriously injured or ill Veterans
Primary focus
Training and support resources for all caregivers
Financial and health benefits for caregivers of seriously disabled Veterans
Financial support
Non-financial caregiver supportNo stipend
Stipend ($$$) tied to locality and GS pay scale
Health insurance
Not included
CHAMPVA health insurance for eligible primary caregivers
Caregiver support features
• Peer support mentoring• Skills training (e.g., online workshops, VA S.A.V.E. training)• Individual & group coaching• Telephone and online support• Referrals to VA & community resources (e.g., respite care)• Self-care & resilience courses
• Mental health support• Travel reimbursement when attending appointments with the Veteran• Well-being and financial coaching
Respite care
Referrals to respite resources
Up to 30 days per year
VA enrollment required?
Yes
Yes
Type of caregiver assistance
Assistance with personal care, ADLs, or safety
Ongoing personal care services
Care needs requirement
Veteran must:• Have functional impairment limiting daily living activities or• Require supervision/protection due to a neurological or mental health condition
Veteran must require at least 6 months of personal care services
Caregiver of Record requirements
Veteran must agree and list caregiver by name in the EHRCaregiver does not need to be a family member
Caregiver must:• Be at least 18 years old• Be a family member or non-family individual designated by the Veteran• Complete required training & background checks• Participate in ongoing reassessments
Service connection required?
No
Yes (typically ≥70%)
Application required?
No formal application; intake via VA Caregiver Support Program (CSP) team
Yes – VA Form 10-10CGEligibility criteria published by VA
Decision timeframe
Not applicable
May take up to 90 days for a decision
How VA benefits compare to Medicare and Medi-Cal
Medicare
Medi-Cal
VA
Adult Day Program (provide daycare services to adults needing assistance with non-medical activities of daily living and to people who may have cognitive impairments.)
No
No
Yes
VA Medical Centers or VA-contracted community providers. Often part of a broader Home and Community Based Services (HCBS) package.
Assisted Living (Residential facilities that help with some daily care, but not as much help as a nursing home provides. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities.)
No
Some
California operates an Assisted Living Waiver (ALW) under its Home and Community-Based Services (HCBS) waiver program. This allows Medi‑Cal to help pay for care in an assisted living setting—but not for room and board. Specifically, the ALW covers medical and supportive services like assistance with daily living, medication administration, meals, social activities, housekeeping, care coordination, and skilled nursing when needed. It does not cover the cost of the assisted living facility’s room and board. Residents must pay this themselves.
No
No direct coverage of room and board at assisted living facilities. May have indirect help through certain programs that can offset costs, especially for: Veterans with limited income, veterans with service-connected disabilities, and surviving spouses of eligible veterans.
Home Care / Custodial Care (non-medical assistance for daily living activities, such as bathing, dressing, eating, and toileting, provided to individuals unable to perform these tasks independently) - Family can set up at anytime without a doctor's order, care aides can assist with whatever is needed, more time is spent with pateints, generally limited insurance coverage.
No
Yes
Statewide IHSS program. Hours authorized depend on individual need, often ranging from a few hours to 40+ hours per week. Income limits may apply.
Possibly
VA operated facilities
Home Health (Medical care: Nursing, physical therapy, occupational therapy, speech therapy, wound care, and medication management.) Must be ordered by a Doctor/PA/NP, service provider follows a set treatment plan, less time is spent with patient, generally covereed by insurance.
Physical Therapy (PT): focuses on improving the patient's ability to move their body
Occupational Therapy (OT): focuses on improving the patient's ability to perform activities of daily living
Speech and Language Therapy (SLT): focused on evaluating, diagnosing, and treating communication and swallowing disorders in individuals
Yes. A health care provider must assess you face-to-face before certifying that you need home health services. A health care provider must order your care, and a Medicare-certified home health agency must provide it. Skilled nursing care and home health aide services up to 8 hours a day (combined), for a maximum of 28 hours per week. You may be able to get more frequent care for a short time (less than 8 hours each day and no more than 35 hours each week).
PT, OT, SLT: After you meet the Part B deductible ($257 for 2025), you pay 20% of the Medicare-approved amount.
Yes
Home health visits are approved in blocks (usually 1–3 visits per week per service type: RN, home health aide, OT, etc).
Yes
No set maximum visits or hours: The VA authorizes home health based on a clinical assessment of your needs.
Hospice (specialized form of medical care provided to individuals with terminal illnesses who have opted to focus on comfort and quality of life rather than curative treatments. It aims to alleviate pain, manage symptoms, and support the patient and their family during the end-of-life journey.)
Yes
Yes
Medicare is usually the primary payer if a patient has both.
Yes
Long-term Care / Custodial Care (Long-term care is non medical care for a beneficiary who needs someone to help them with their physical or emotional needs for an extended period of time.)
No
Possibly
Through IHSS and Home and Community-Based Services (HCBS) Waivers.
Possibly
Patient typically needs to be at a VA community living center.
Long-term Hospital Care (Long-Term Care Hospitals are a type of facility for patients who need extensive hospital-level care for complex medical conditions. They provide a continuation of care in a hospital setting for patients too sick for a nursing home or rehabilitation facility)
Yes. Days 1-60: $0 after you meet your Part A deductible ($1,676). Days 61-90: $419 each day. Days 91 and beyond: $838 each day for each lifetime reserve day (up to a maximum of 60 reserve days over your lifetime). Each day after you use all of your lifetime reserve days: You pay all costs.
Yes
Medi-Cal generally covers most of the cost of medically necessary long-term care if you qualify and are enrolled.
Yes
The VA provides long-term hospital and nursing home care through its own Community Living Centers (CLCs) and VA medical centers. Eligible veterans typically pay little to no out-of-pocket cost for care received in VA facilities.
When the VA pays for nursing home care in community (non-VA) facilities, coverage and costs vary: The VA covers the costs of medically necessary care approved by the VA. Veterans typically do not pay out of pocket if the care is VA-authorized. However, room and board charges may apply if the veteran does not qualify for Aid and Attendance or if the VA does not cover them.
Respite (provides temporary relief for a primary caregiver. Can take place at home, at an adult day care center, or in a facility.)
Only if receiving hospice
Yes
Medi-Cal can cover respite care for eligible members under California's CalAIM program and through Community Supports Service limit is up to 336 hours per calendar year. IHSS can also include limited respite care as part of the authorized service hours.
Yes
Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Skilled Nursing Facility (healthcare facility that provides 24-hour medical care and assistance to individuals who require skilled nursing services)
Yes. Medicare Part A (Hospital Insurance) covers skilled nursing facility care for a limited time (on a short-term basis) if you meet all of these conditions: You have Part A and have days left in your benefit period to use. You have a qualifying inpatient hospital stay (inpatient state for at least 3 days). You enter the SNF within a short time (generally 30 days) of leaving the hospital. Your doctor or other health care provider has decided that you need daily skilled care (like intravenous fluids/medications or physical therapy). You must get the care from, or under the supervision of, skilled nursing or therapy staff. You get these skilled services in a Medicare-certified SNF. You need skilled services for one of these: An ongoing condition that was also treated during your qualifying inpatient hospital stay (even if it wasn't the reason you were admitted to the hospital). A new condition that started while you were getting SNF care for the ongoing condition. You need skilled nursing care or therapy to improve or maintain your current condition, or to prevent or delay it from getting worse.
Days 1 – 20: Nothing. (Note: If you're in a Medicare Advantage Plan, you may be charged copayments during the first 20 days. Check with your plan for more information.) Days 21 – 100: $209.50 each day. Days 101 and beyond: You pay all costs. Part A limits SNF coverage to 100 days in each benefit period.
