Key Takeaways
- The US Department of Veterans Affairs will now reimburse in-home and community-based services at 100% of comparable VA Community Living Center costs for eligible Veterans.
- The change applies to veterans with spinal cord injuries, amyotrophic lateral sclerosis, and other complex medical conditions, reducing out-of-pocket expenses.
- VA estimates about 200 veterans will benefit in fiscal year 2026 through the skilled home health care program.
The US Department of Veterans Affairs (VA) has announced a major policy update expanding financial support for in-home and community-based care. The change increases the expenditure cap for eligible veterans with complex medical needs, allowing full cost coverage equivalent to care provided in VA Community Living Centers. The announcement was made by VA leadership in Washington and is grounded in recent federal legislation.
VA Policy Update on Skilled Home Health Care
Under the updated policy, VA’s skilled home health care program will reimburse in-home and community-based services at 100% of the cost of similar care delivered in a VA Community Living Center. Previously, reimbursement was capped at 65%, often leaving veterans and families responsible for significant out-of-pocket costs.
The expanded cap applies to veterans with spinal cord injuries, amyotrophic lateral sclerosis (ALS), and other complex medical conditions requiring intensive, long-term support. Covered services include home health aide assistance, home respite care, community adult day health care, Veteran Directed Care, and skilled home health services.
VA officials estimate that approximately 200 veterans will take advantage of the increased expenditure cap during fiscal year 2026. Since its establishment in 2019, the skilled home health care program has enrolled about 1800 veterans nationwide, reflecting steady utilization among those with advanced care needs.
“This important change will enable Veterans with complex medical conditions to continue receiving high quality care while remaining in their homes, surrounded by friends and family,” said VA Secretary Doug Collins. He emphasized that aligning home-based care reimbursement with Community Living Center costs supports veteran independence and continuity of care.
The rate increase stems from Section 120 of the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act of 2025, which directed VA to reassess financial barriers to home- and community-based services for medically complex veterans.
Clinical Implications for Veteran Care
For clinicians working within the VA system or in community partnerships, the updated reimbursement policy may significantly influence care planning and discharge decisions. Higher coverage levels can make home-based care a more viable alternative to institutional placement, particularly for veterans with progressive neurologic or mobility-limiting conditions.
Reducing financial burden may also improve adherence to recommended care plans by ensuring consistent access to skilled services such as nursing support, respite care, and adult day health programs. For caregivers, lower out-of-pocket costs may decrease burnout and improve sustainability of long-term home care arrangements.
From a population health perspective, expanded access to in-home services aligns with broader goals of aging in place, patient-centered care, and avoidance of unnecessary institutionalization. VA encourages veterans and families to consult VA social workers to determine eligibility and coordinate services under the revised cap.
Conclusion
By raising the expenditure cap for in-home and community-based services, the VA is strengthening support for veterans with complex medical conditions. The policy change removes a key financial barrier, potentially expanding access to high-quality, home-based care while preserving independence and quality of life.
Reference
VA increases in-home and community-based services expenditure cap for Veterans with complex conditions. US Department of Veterans Affairs. Press release. Published February 2, 2026. Accessed February 10, 2026. https://news.va.gov/press-room/va-increases-in-home-and-community-based-services-expenditure-cap-for-veterans-with-complex-conditions/
