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Long-Term Care For Veterans: What Is and Isn't Covered by TRICARE

Long-Term Care For Veterans: What Is and Isn't Covered by TRICARE

October 20, 2023

More than 16.5 million veterans live in America, as reported by the U.S. Census. Along with the veterans’ need for long-term care, the aging general population has increased demand for long-term care, creating pressure on available resources. The need for veteran-focused long-term care is greater than ever.1

TRICARE is a component of the U.S. Military Health System providing some health care services for veterans. Not all care services are covered by TRICARE. For example, TRICARE does not cover long-term care.2

Veterans and their loved ones may find themselves wondering how to pay for the needed level of care. Here are some of the long-term care options available to U.S. veterans and what TRICARE does and does not cover.

Care Through Veterans Affairs

The Department of Veterans Affairs (VA) offers various long-term care services, including 24/7 nursing and medical care, physical therapy, help with tasks of daily living (like feeding, dressing, taking medicine, and bathing), comfort and hospice care, and respite care for caregivers. This care may be provided through a VA facility for qualifying veterans who live nearby.

TRICARE covers skilled nursing care, the cost of durable medical equipment, home health care, and hospice care. This means that some of the levels of care available at a VA facility may be covered by TRICARE, while others may not.

VA Care Through a Private Facility

If there are no qualifying VA facilities nearby and the VA determines the veteran needs specific care, the VA may work to fund long-term care run by VA-approved state or community organizations. These include nursing homes, assisted-living facilities, private group homes, adult day care centers, and perhaps care provided in the veteran's home.

A veteran must be signed up for VA health care to qualify for this care. In addition, the VA must conclude that the veteran requires a specific service to aid with their ongoing treatment and personal care and that the service (or bed space) is available nearby.

Private Long-Term Care

If a veteran is not eligible for care in a VA center or VA care in a private facility, private long-term care might be another option. TRICARE does NOT cover the cost of this care. Nevertheless, long-term care insurance policies may help defray some of the costs associated with long-term care. Be sure to review any long-term care insurance policy carefully to ensure you understand what is and is not covered.

It is important to plan and prepare carefully because paying for long-term care could be complicated, even for those who qualify for TRICARE medical benefits. To put together a plan that may work for you and your loved ones, a financial professional offers help evaluating your assets. You may benefit by learning about the services available in your area and when getting help estimating your potential long-term care needs for the future.

Important Disclosures:

Content in this material is for educational and general information only and not intended to provide specific advice or recommendations for any individual.

All information is believed to be from reliable sources; however, LPL Financial makes no representation as to its completeness or accuracy.

This article was prepared by WriterAccess.

LPL Tracking #1-05378014

Footnotes

1 What are the basics on veterans?
https://usafacts.org/topics/veterans/

2 TRICARE Covered Services
https://www.tricare.mil/CoveredServices/IsItCovered/LongTermCare