VA Home Care for Veterans: Support Beyond the Pension

Many families think the VA only offers a monthly pension check. In truth, veterans who are enrolled in VA health care can get real, hands-on care at home. These are called Home and Community Based Services, and they are meant to help a veteran stay safe at home instead of moving to a nursing home.

Here in Southern California, these services are run through your local VA medical center and its community partners. Availability can vary by area, so ask your VA team what is offered near you.

The VA Caregiver Support Program helps the family members who do the daily caring. It has two parts. The general program (PGCSS) offers training, peer support, and a Caregiver Support Line for caregivers of veterans from any era.

The bigger benefit is the Program of Comprehensive Assistance for Family Caregivers, or PCAFC. If you and the veteran qualify, the Primary Family Caregiver can receive a monthly stipend (a payment) for the care they provide, plus other support.

Beyond the stipend, a Primary Family Caregiver may also get education and training, mental health counseling, travel benefits, access to CHAMPVA health insurance if not otherwise covered, and at least 30 days of respite care each year.

PCAFC has rules for both the veteran and the caregiver. The stipend amount is based on where the veteran lives (it follows a federal pay scale for the local area), so it is not the same everywhere.

The veteran must meet all of these: enrolled in VA health care, a VA disability rating of 70% or higher (single or combined), discharged from the military or have a date of medical discharge, and needing at least 6 months of continuous, in-person personal care.

The caregiver must be at least 18 years old, and either be family (spouse, child, parent, stepfamily, or extended family) or live full time with the veteran (or be willing to). You do not have to be a spouse to qualify.

The first step is almost always the same: the veteran must be signed up for VA health care. Services are set up through your local VA medical center, not through a separate pension office.

Start with one of these steps, whichever is easiest for your family:

Cost depends on the service and the veteran's VA priority group. Some services are free; for others, a veteran may owe a copay, just like other VA health care.

The PCAFC stipend is a payment to the caregiver, not a bill to the family. Respite and homemaker services may have small copays for some veterans.

If a service is not covered by the VA, your team can point you toward Medicare, Medi-Cal (California's Medicaid), or private insurance. A VA social worker can help you sort out what applies to your situation.