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VA Health Care Benefits

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The Veterans Administration provides a Medical Benefits Package, a standard enhanced health benefits plan available to all enrolled veterans. This plan emphasizes preventive that primary care that offers a full range of outpatient and inpatient services within VA health care system.

To apply for VA health care benefits, including enrollment you must fill out an application.

The number of veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up priority groups to make sure that certain groups of veterans are able to be enrolled before others.

Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a priority group. The priority groups range from 1-8 with 1 being the highest priority for enrollment. Some veterans may have to agree to pay copay to be placed in certain priority groups.

 

VA Priority Groups


Group 1: Veterans with service-connected disabilities rated 50 percent or more and/or veterans determined by VA to be unemployable due to service-connected conditions.

Group 2: Veterans with service-connected disabilities rated 30 or 40 percent.

Group 3: Veterans with service-connected disabilities rated 10 and 20 percent, veterans who are former Prisoners of War (POW) or were awarded a Purple Heart medal, veterans awarded special eligibility for disabilities incurred in treatment or participation in a VA Vocational Rehabilitation program, and veterans whose discharge was for a disability incurred or aggravated in the line of duty.

Group 4: Veterans receiving aid and attendance or housebound benefits and/or veterans determined by VA to be catastrophically disabled.

Group 5: Veterans receiving VA pension benefits or eligible for Medicaid programs, and nonservice-connected veterans and noncompensable, zero percent service-connected veterans whose gross annual household income and net worth are below the established VA means test thresholds.

Group 6: Veterans of World War I; veterans seeking care solely for certain conditions associated with exposure to radiation; for any illness associated with combat service in a war after the Gulf War or during a period of hostility after Nov. 11, 1998; for any illness associated with participation in tests conducted by the Department of Defense (DoD) as part of Project 112/Project SHAD; and veterans with zero percent service-connected disabilities who are receiving disability compensation benefits.

Group 7: Nonservice-connected veterans and non-compensable, zero-percent service-connected veterans with household income and/or net worth above VA’s national income threshold, but whose household income is below the geographically-based income threshold for their resident location.

Group 8: All other nonservice-connected veterans and zero percent, non-compensable service-connected veterans who agree to pay copays. (Note: Effective Jan. 17, 2003, VA no longer enrolls new veterans into priority group 8).


VA Guide

Download the complete VA Benefits Guide

 

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