(This article by Kimberly Lankford originally appeared in the September 2025 issue of Military Officer, a magazine available to all MOAA Premium and Life members, who can log in to access our digital version and archive. Basic members can save on a membership upgrade and access the magazine.)

One of the biggest financial risks in retirement is the possibility that you might need long term care in a nursing home or round-the-clock care in your home. The median cost of a private room in a nursing home is more than $127,000 a year and more than $70,000 for 40 hours of care per week in your home (more than $280,000 for 24-hour care), according to caregiving consultancy Genworth’s most recent Cost of Care Survey results. The median cost of assisted living is $70,800 — and much higher in some areas.

Those who have served in the military have access to special programs, benefits, and assistance to help with these potential needs and costs.

Some key steps you take in your 40s, 50s, or 60s can help protect your retirement savings if you need care decades in the future. If you need care sooner — or if you’re helping aging relatives who are veterans — they might qualify for programs offered by the VA to help pay long term care costs, and they might also be interested in new and improved state veterans homes that are often open to veterans at all income levels.

[RELATED: MOAA-Endorsed Long Term Care Insurance Program]

Here are some ways veterans and their families can prepare for potential long term care needs.

Planning for Future Long Term Care Costs

You can’t ignore potential long term care costs as you’re planning financially for retirement.

“Most people we work with are in their late 40s, 50s, and early 60s, and there’s about a 70% chance that you’ll need some form of long term care in the future,” said Col. Curt Sheldon, USAF (Ret), a certified financial planner; owner of Alexandria, Va.-based C.L. Sheldon and Co.; and a MOAA Life member. “We identify the fact that it is a risk that we need to account for.”

Sheldon includes potential long term care costs when estimating expenses in retirement.

“The first thing we do is put a goal for long term care for the last three years of their expected life,” he said.

These costs can vary significantly by location. “I don’t know if it’s a reason why you decide where to retire, but it’s worth considering,” Sheldon said. In the Genworth data, the median cost of one year in a nursing room is nearly $165,000 in northern Virginia, but $76,000 in San Antonio.

Then Sheldon estimates how much income they’ll have to cover those potential expenses. Military retirees have an advantage because they have several sources of lifetime income, including inflation-adjusted military retirement pay, Social Security benefits, and possibly VA disability pay.

“That can be a tremendous contributor toward paying for long term care,” said Col. Pam Bergeson, USAF (Ret), a certified financial planner in the Tampa area and a member of the Military Financial Advisors Association, an organization of fee-only financial advisors specializing in military finances.

[RELATED: Understand Your Long Term Care Insurance Options]

She recommends using the tool at the Federal Long Term Care Insurance Program website to estimate the cost of care at age 75 in the ZIP code where you expect to live. On average, women need care for 3.7 years and men for 2.2 years, Bergeson said.

“But not all care is created equal. You’re on a gradual increase for most people — you may start out needing someone to grocery shop for you and drive you to doctor’s appointments and maybe cook meals for you — and it gradually increases to needing someone to help with daily activities, like taking a shower, getting dressed, and feeding you,” she said. “At the end, you may need someone to do everything for you. It’s not that all 3.7 years will be the same level of care.”

Also factor in your personal risks when estimating the potential costs. You might want to prepare for more years of care if you have a family history of dementia, Alzheimer’s disease, or Parkinson’s disease, Bergeson said. Or you might want to have more money so you can stay in your own home, even if you end up needing 24/7 care.

“Some people want to be able to afford that,” she said.

[RELATED: VA Leaders Push Back Deadline for Caregiver Program Changes]

Paying for Long Term Care

Compare your guaranteed income with the potential expenses.

“If you look at a retired senior officer who is on Social Security and probably getting VA disability on top of it, that’s going to cover a nursing home stay in most states,” Sheldon said. But, he added, your income might not be enough if both you and your spouse need long term care. You might also have a larger gap if you aren’t receiving military retirement pay.

“A lot of our clients tend to look at it and say: ‘Between my assets and my guaranteed income, I think I’ll be OK,’” Sheldon said. “But if you don’t have that guaranteed income, the insurance becomes more important.”

There are two main insurance choices: a standalone long term care policy; or a hybrid policy that combines long term care coverage with an annuity or life insurance.

Stand-alone long term care insurance pays for care in a nursing home, in an assisted-living facility, or in your home if you need help with at least two activities of daily living (such as bathing, dressing, eating, and toileting) or if you have severe cognitive impairment.

[FROM MILITARY OFFICER MAGAZINE: How to Choose Insurance Policies]

Fewer insurers offer these policies than in the past, and it’s now more expensive and difficult to qualify if you have any medical issues.

They’re also looking more closely at your family medical history, said Kim Natovitz, a long term care specialist in the Washington, D.C., area. “If you have one parent who has Alzheimer’s or dementia, they may limit the benefit period.”

Until recently, active duty servicemembers and retirees could buy policies from the federal long term care insurance program, but that program has been temporarily closed to new customers since December 2022. If you already have the coverage, you can keep it.

Bergeson recommends finding a way to keep the coverage even though premiums have gone up because it can be more expensive and difficult to qualify for a new policy. Despite rate hikes in long-term care, you might be able to keep premiums stable by reducing inflation protection for future years, Sheldon said.

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Hybrid long term care policies combine long term care coverage with life insurance or an annuity. More insurers have been offering these types of policies recently, and they might be easier to qualify for than standalone long term care.

With the hybrid annuity, you’ll receive a set payout based on your age and more if you need long term care. For example, it might double the payout for up to five years, said Sheldon.

With a hybrid life insurance/long term care policy, you can receive long term care benefits that are several times the size of the death benefit. The long term care payouts are subtracted from the death benefit, but your heirs will receive the money if you don’t need much care.

Special Programs for Veterans

If you need care or are helping aging relatives who served in the military, consider some frequently overlooked special programs for veterans.

VA Aid and Attendance can provide up to $2,795 a month in 2025 to help pay for care in a nursing home, in an assisted-living facility, or in your own home. Aid and Attendance adds extra money to the monthly payouts if you’re receiving a needs-based veterans pension.

[RELATED: VA Expands Burial Benefits for Some Veterans]

Veterans and surviving spouses might be eligible for this benefit if they get a VA pension and meet at least one of these requirements:

• Someone helps you perform daily activities, such as bathing, feeding, and dressing.
• You are bedridden or spend a large portion of the day in bed because of illness.
• You are in facility due to mental or physical issues related to a disability.
• Your eyesight is severely limited.
  
  

For example, a veteran with no dependents who meets the service, income, and asset requirements for a veterans pension could receive up to $1,414 a month without Aid and Attendance benefits or up to $2,358 if they need eligible care.

With one dependent (such as a spouse), they could receive up to $1,851 a month from a veterans pension or up to $2,795 per month with Aid and Attendance.

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Veterans who receive a VA pension and spend most of their time in their home because of a permanent disability might be eligible for VA housebound benefits. It’s important to note you can’t get Aid and Attendance benefits as well as housebound benefits simultaneously.

Veterans pensions are only available to people who meet service, asset, and income requirements. If you started on active duty before Sept. 8, 1980, you must have served on active duty for at least 90 days, with at least one day during wartime. (Some people who started on active duty after that need to have served for at least 24 months, including one day during wartime.) Your net worth — including assets and countable income — must be less than $159,240 in 2025. Nonreimbursable medical expenses, including long term care costs, can be subtracted from the income figures.

Some veterans who had too much in savings to receive a veterans pension when they first needed care can eventually qualify after paying expensive nursing home or home care bills for a few years, said Byron Cordes, a San Antonio-based professional focused on aging life care.

“This benefit is phenomenal for folks who need it,” he said.

Veterans service organizations (VSOs) can help with determining eligibility for Aid and Attendance — even veterans and survivors who don’t currently receive any of the prerequisite payments. They might not realize they are eligible for a needs-based veterans pension, or they might be newly eligible for disability or Dependency and Indemnity Compensation benefits because of the PACT Act.

[AT VA.GOV: Find a VSO in Your Area]

Notably, MOAA benefits advisors would caution that many MOAA members do not qualify for Aid and Attendance/homebound benefits based on income/financial asset holdings.

State Veterans Homes

Whether you’re looking into care options for yourself or you’re helping an aging veteran, it’s worthwhile to find out about the state veterans homes in your area. There are 172 state veterans homes across the country, and the number is growing.

“You’re seeing a lot of state veterans homes moving from old institutional-style facilities to more of a small-house living,” said Tracy Schaner, the deputy director for the Idaho division of veterans services and the executive director of the National Association of State Veterans Homes.

Eligibility varies by state, but you usually don’t need to meet disability or income requirements. Some states have longer residency requirements; some also accept a limited number of spouses, although many are only open for veterans.

[RELATED: Aging Veteran Population Places More Demand on State Veterans Homes]

Most state veterans homes provide long term nursing home care, and some also provide services such as rehab after a hospital stay and assisted living. They might also have memory care units or provide adult day programs for veterans who live at home.

Many veterans are attracted to these facilities because of the camaraderie. “They want to be surrounded by people with similar life experiences,” Bergeson said.

There tend to be many more men than women, which is the opposite of most long term care facilities, and they feature special programs for veterans.

On average, state veterans homes tend to cost less than private nursing homes, said Schaner. Veterans might get help with costs if they meet certain disability criteria, or they can use Aid and Attendance and other benefits, if eligible.

Kimberly Lankford is a financial expert based in Virginia and the spouse of a retired Army colonel.