VA Form 10-10EC: Application for Extended Care Services – If you’re a U.S. veteran seeking long-term care options through the Department of Veterans Affairs (VA), understanding VA Form 10-10EC (Application for Extended Care Services) is essential. This form helps determine your monthly copayment responsibility for extended care services, including nursing home care, respite care, and other long-term support.
Whether you’re exploring VA Community Living Centers (VA nursing homes) or community-based extended care, this comprehensive guide covers everything you need to know about the form, eligibility, and the application process.
What is VA Form 10-10EC?
VA Form 10-10EC is the official Application for Extended Care Services. Its primary purpose is to collect financial information from veterans and their spouses to estimate monthly copayment obligations for extended care services provided directly by the VA or paid for by the VA.
The form was last revised in July 2017. It is required for most veterans applying for or currently receiving extended care services to assess copay responsibility. Note that there is no copayment for the first 21 days of extended care services in any 12-month period.
Who Should Complete VA Form 10-10EC?
You must complete VA Form 10-10EC if you are applying for extended care services. This includes veterans seeking:
- Community Living Center (VA nursing home) care
- Community nursing home care
- Adult day health care
- Respite care
- Other geriatric and extended care services
If you are already receiving extended care services and experience a change in marital status, dependent status, or financial situation, you must submit a new form to your local VA medical facility within 10 calendar days.
Important: You generally need to be enrolled in VA health care first via VA Form 10-10EZ before applying for extended care services.
Types of VA Extended Care Services
The VA offers a range of extended care services to support veterans’ long-term health needs:
- Community Living Centers (CLC): VA-operated nursing homes providing skilled nursing, rehabilitation, and long-term care.
- Community Nursing Home Care: VA-paid care in private nursing homes when clinically appropriate.
- Adult Day Health Care: Supervised daytime care with health services.
- Respite Care: Temporary relief for caregivers.
- Home-Based Services: Including skilled home health care and hospice.
Eligibility and availability depend on clinical need, service-connected status, and resource availability at your local VA facility.
Eligibility for VA Extended Care Services
Basic requirements include:
- Enrollment in VA health care
- Medical and psychiatric stability
- Clinical need for the specific service
Priority is often given to veterans with service-connected disabilities. Veterans without service-connected conditions or with 0% ratings may face additional financial assessments.
Contact your local VA medical center or a VA social worker to discuss specific eligibility for Community Living Centers or other programs.
How to Fill Out VA Form 10-10EC?
Gather the following information before starting:
- Current gross income (veteran and spouse)
- Deductible expenses (e.g., property taxes, medical costs)
- Value of fixed assets (real property, excluding primary residence and one vehicle in many cases) and liquid assets
- Health insurance and Medicare details (include copies of cards)
- Spouse and dependent information
The form has detailed sections covering general information, insurance, spouse/dependents, assets, income, and expenses. Fixed and liquid assets are primarily considered after 181 days of institutional care.
Complete the form accurately, as it directly impacts your copayment calculation. Many veterans work with a VA social worker or case manager for assistance.
Where and How to Submit VA Form 10-10EC?
Submit the completed form to your local VA medical facility, typically through the enrollment office or a social worker. You can also bring it during an in-person visit when discussing extended care needs.
For general VA health care enrollment (often a prerequisite), use VA Form 10-10EZ online or by mail.
VA Extended Care Copayments and Financial Assessment
Copayments for extended care are based on your income, assets, and family situation as reported on VA Form 10-10EC. Rates can vary and are adjusted periodically. The VA uses this information to determine if you qualify for reduced or no copays.
Always check the latest copay rates on VA.gov, as they are subject to annual updates.
Exemptions from Extended Care Copayments
Several categories of veterans are exempt from completing the form or paying copayments, including:
- Veterans with a compensable service-connected disability
- Those with income below the VA pension rate
- Veterans receiving care for service-connected conditions
- Catastrophically disabled veterans (for certain services)
- Veterans exposed to Agent Orange, radiation, or with specific combat-related conditions
- Those receiving hospice care or care for military sexual trauma
Full exemptions are detailed in the form instructions and VA regulations.
Download VA Form 10-10EC PDF
Download the official VA Form 10-10EC here (PDF).
Always use the most current version from the official VA website to ensure compliance.
Frequently Asked Questions About VA Form 10-10EC
Do I need VA Form 10-10EC if I have a service-connected disability?
Many veterans with compensable service-connected disabilities are exempt from copayments and may not need to complete the full financial sections.
How long does it take to process the form?
Processing times vary by facility. Contact your local VA for timelines specific to your situation.
Can I update my information after submitting?
Yes. Report any significant changes in income, marital status, or dependents within 10 days.
Next Steps and Resources for Veterans
Start by visiting your nearest VA medical center or calling the VA Health Care hotline at 877-222-VETS (8387). VA social workers and eligibility staff can guide you through the process and connect you with appropriate care.
Additional resources:
Applying for extended care services can provide peace of mind and quality support. Don’t hesitate to reach out to the VA for personalized assistance. This information is based on official VA sources as of 2026 and is for guidance only—verify details with the VA for your specific circumstances.