The VA’s Homemaker and Home Health Aide Care (HHHA) program is the VA’s non-medical in-home care benefit, designed to help veterans stay safe and supported in their own homes. These caregivers assist with:

• Bathing, dressing, grooming
• Transfers and mobility
• Meal preparation
• Light housekeeping and laundry
• Medication reminders
• General daily living tasks and safety

It’s part of the VA Standard Medical Benefits Package, which means:

• No wartime requirement
• No asset limits
• Aid & Attendance is not required
• Many Puget Sound veterans qualify even if they’ve never used VA healthcare before

This veteran home care benefit is one of the most practical ways veterans in Seattle, Tacoma, Everett, Bothell, and surrounding areas can receive home care support.

The VA system is structured, and HHHA follows a specific sequence. Most delays happen because families don’t know:

• Enrollment in VA healthcare must come first
• A VA Primary Care Provider (PCP) is required
• The VA social worker is the one who makes home care referrals
• HHHA and Aid & Attendance are entirely different programs
• Income doesn’t always determine eligibility
• Veterans have full provider choice

Once families understand the correct order, the process is far less confusing.

Many veterans assume they won’t qualify for VA healthcare because their household income is too high.
Income limits only apply to some categories of veterans, and others qualify through different pathways — including clinical needs or service-related considerations.

For example, common conditions such as hearing loss or tinnitus are part of what the VA may review when determining eligibility. Veterans who are unsure which category they fall into can contact the VA’s eligibility office directly to get accurate information and learn what documentation, if any, is needed.

We don’t determine VA eligibility, but we always encourage families to speak directly with the VA for reliable answers specific to their situation.

Step 1 — Enroll in VA Health Care

Veterans must be enrolled in VA healthcare to qualify for HHHA. Enrollment can be completed:

• Online at va.gov/health-care/how-to-apply 
• By phone
• In person at Seattle VA or American Lake VA

If there are questions about documentation or eligibility categories, the VA’s eligibility office can assist directly.

Step 2 — Get Assigned a VA Primary Care Provider (PCP)

Once enrolled, veterans need a VA PCP.
After the first PCP appointment, the veteran is assigned to a clinic team — and that team includes the VA social worker who handles HHHA referrals.

Step 3 — Request a Referral for VA In-Home Care (HHHA)

Once the veteran has met with their VA PCP:

• Ask to speak with the VA social worker
• Request an evaluation for Homemaker Home Health Aide services
• The social worker will assess ADL needs and determine clinical eligibility
• They will also determine the number of hours to authorize

Hours depend on clinical need — some veterans receive a few hours a week, others receive more based on safety, functioning, and daily support requirements.

In some cases, such as post-hospitalization or a rapid decline, veterans may bypass waitlists.

Step 4 — Choose Your Home Care Provider

One of the most important points:

The VA does NOT assign a home care agency. The veteran chooses.

Acti-Kare is an approved HHHA provider in:

• Seattle
• King County
• Pierce County
• Snohomish County
• Eastside and North Puget Sound communities (including Bothell, Kenmore, Woodinville, Everett)

If you prefer our team, simply tell your VA social worker when the referral is processed.

Step 5 — Authorization & Start of Care

Once approved:

• The VA issues Form 10-7080
• Authorization is sent to your chosen agency
• We contact the veteran or family to schedule care
• Services begin according to the authorized hours

This stage typically moves quickly once the referral is complete.

In the Puget Sound region, veterans in the hospital may qualify for expedited authorization.
Hospital case managers and VA coordinators can use a peer-to-peer authorization process to speed up approval for home care after discharge — especially after surgeries, fractures, or acute declines.

Your downloadable guide explains how to request this and what to say to hospital staff.

Families are usually navigating this process during already stressful circumstances.

Inside the guide, you’ll find:

• A step-by-step roadmap
• Enrollment links
• Seattle & American Lake VA contact details
• Practical expectations for each stage
• How referrals work
• How provider choice works
• What to expect once care is approved
• Common pitfalls to avoid

It gives veterans and families a sense of control during a complex process.

Our team supports veterans across Seattle, King County, Pierce County, Snohomish County, and Eastside/North Puget Sound communities like Bothell, Kenmore, Woodinville, Shoreline, Edmonds, Seattle, Lake Forest Park, and Everett.

Acti-Kare Responsive In-Home Care
Seattle • King County • Pierce County • Snohomish County
https://inhomecarewashington.com

Is HHHA medical care?

No. It provides non-medical personal care and daily living support at home.

How long does the process take?

Timelines vary, but following the correct order — enrollment → PCP → social worker referral — speeds things up significantly.

Does the VA pay for all approved HHHA hours?

Yes. The VA covers 100% of the authorized hours.

Is Aid & Attendance required to receive HHHA?

No. They are completely separate programs.

Do I need a high disability rating to qualify?

No. Eligibility for HHHA is based on clinical need, not disability percentage.

Can I choose my home care agency?

Yes. Veterans have full provider choice for HHHA services.

Can families add private-pay hours?

Yes. Many families combine VA hours with private-pay support for additional care.

What if I’m unsure about my VA healthcare eligibility?

The VA’s eligibility office can review your situation and explain which rules apply and what documentation is needed.