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Veterans & Military · Surprise rank #229

Veterans: Get a VA Care Budget You Control—and Use It to Hire Your Spouse

Unlike Medicaid, the VA’s Veteran-Directed Care (VDC) program gives eligible veterans a self-directed budget that *can* legally be used to pay a spouse for daily care.

Who

VA-enrolled veterans who need nursing-home-level or significant long-term support and live in a participating service area.

Where: Available through participating VA medical centers; local availability must be confirmed for NYC/Long Island.

What to do

Start here: Ask the VA social worker or Geriatrics and Extended Care office specifically whether Veteran-Directed Care is available at the veteran's VAMC.

Eligibility: VA health enrollment, clinical need and local VDC availability; service connection is not necessarily required.

What you get

Where offered, Veteran-Directed Care gives an eligible veteran a flexible care budget that can be used to hire a worker, including a spouse or other relative.

Benefit: A participant-directed budget for personal care and supports, with counseling and financial-management help.

Possible value: Potentially substantial monthly value based on assessed needs and local program rules.

Good to know

Important: Not offered at every VA site, budget amounts are individualized and cost sharing may apply.

Availability: Rolling where offered.

Why people miss it: Many veterans and social workers know VA home-care agencies but not the self-directed option.

Sources reviewed: Aug 2, 2026