VA operates the nation’s largest integrated health care system with more than 1,400 sites of care, including hospitals, community clinics, nursing homes, domiciliaries, readjustment counseling centers, and various other facilities. For additional information on VA health care, visit: http://www.va.gov/health.
Basic Eligibility
A person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable may qualify for VA health care benefits. Reservists and National Guard members may also qualify for VA health care benefits if they were called to active duty (other than for training only) by a Federal order and completed the full period for which they were called or ordered to active duty.
Minimum Duty Requirements: Veterans who enlisted after Sept.
7, 1980, or who entered active duty after Oct. 16, 1981, must have served 24 continuous months or the full period for they were called to active duty in order to be eligible. This minimum duty requirement may not apply to veterans discharged for hardship, early out or a disability incurred or aggravated in the line of duty.
Enrollment
For most veterans, entry into the VA health care system begins by applying for enrollment. To apply, complete VA Form 10-10EZ, Application
for Health Benefits, which may be obtained from any VA health care facility or regional benefits office, on line at http://www.va.gov/1010ez.htm or by calling 1-877-222-VETS (8387). Once enrolled, veterans can receive health care at VA health care facilities
anywhere in the country.
Veterans enrolled in the VA health care system are afforded privacy rights under federal law. VA’s Notice of Privacy Practices, which describes how VA may use and disclose veterans’ medical information, is also available on line at http://www.va.gov/vhapublications/View-Publication.asp?pub_ID=1089.
The following four categories of veterans are not required to enroll, but are urged to do so to permit better planning of health resources:
1. Veterans with a service-connected disability of 50 percent or more.
2. Veterans seeking care for a disability the military determined was incurred or aggravated in the line of duty, but which VA has not yet rated, within 12 months of discharge.
3. Veterans seeking care for a service-connected disability only.
4. Veterans seeking registry examinations (Ionizing Radiation, Agent Orange, Gulf War/Operation Iraqi Freedom and Depleted Uranium).
Priority Groups
During enrollment, each veteran is assigned to a priority group. VA uses priority groups to balance demand for VA health care enrollment with resources. Changes in available resources may reduce the number of priority groups VA can enroll. If this occurs, VA will publicize the changes and notify affected enrollees. A description of priority groups follows:
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).
Special Access to Care
Service Disabled Veterans: Veterans who are 50 percent or more disabled from service-connected conditions, unemployable due to service-connected conditions, or receiving care for a service-connected disability receive priority in scheduling of hospital or outpatient medical appointments.
Combat Veterans: Effective Jan. 28, 2008, veterans discharged
from active duty on or after Jan. 28, 2003, are eligible for enhanced enrollment placement into Priority Group 6 (unless eligible for higher enrollment Priority Group placement) for 5 years post discharge. Veterans
with combat service after Nov. 11, 1998, who were discharged from active duty before Jan. 28, 2003, and who apply for enrollment on or after Jan. 28, 2008, are eligible for this enhanced enrollment benefit through Jan. 27, 2011.
Veterans, including activated reservists and members of the National Guard, are eligible if they served on active duty in a theater of combat operations after Nov. 11, 1998, and, have been discharged under other than dishonorable conditions.
Veterans who enroll with VA under this “Combat Veteran” authority will retain enrollment eligibility even after their five-year post discharge period ends. At the end of their post discharge period, VA will reassess the veteran’s information (including all applicable eligibility factors) and make a new enrollment decision. For additional information, call 1-877-222-VETS (8387).
Related Pages:
VA Health Care Introduction
Financial Assessment
Medical Programs – Page 1
Medical Programs – Page 2
Medical Programs – Page 3