Eligibility for VA health care is dependent upon a number of variables, which may influence the final determination of the services for which you qualify. These factors include the nature of a veteran's discharge from military service (e.g., honorable, other than honorable, dishonorable), length of service, VA adjudicated disabilities (commonly referred to as service-connected disabilities), income level, and available VA resources among others.

Generally, you must be enrolled in VA health care system to receive benefits offered in the Medical Benefits Package. To apply for VA health care benefits, including enrollment you must fill out an application. We use the application to determine:

  • Whether you have qualifying service as a veteran

  • What your veteran status is so that you can be placed into one of the priority groups

The following is a summary of veterans priority for VA Health Care:

VA places a priority on improved veteran satisfaction and maintains that their goal is to ensure the quality of care and service that veterans receive is consistently excellent, in every location, in every program. Under the Medical Benefits Package, VA offers the veteran a comprehensive health care plan that provides the care you need.

What are the Priority Groups?

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 are as follows, ranging from 1-8 with 1 being the highest priority for enrollment. Under the Medical Benefits Package, the same services are generally available to all enrolled veterans.

Ad

Effective January 17, 2003, VA suspended NEW enrollment of veterans assigned to Priority Group 8 (VA's lowest priority group consisting of higher income veterans). If you are a veteran enrolling for the first time on or after January 17, 2003, your income exceeds the current year income threshold, and you have no other special eligibilities such as a compensable service connected condition or recent combat service, you are not eligible for enrollment at this time. Veterans enrolled in Priority Group 8 on or before January 16, 2003, will remain enrolled and continue to be eligible for the full-range of VA health care benefits.

Update: As of January 2008, Combat Veteran Health Care eligibility has been extended.

Be sure to visit the VA Health Care Eligibility website to get the most current information.

Priority Group 1

  • Veterans with service-connected disabilities rated 50% or more disabling, or

  • Veterans determined by VA to be unemployable due to service-connected conditions

Priority Group 2

  • Veterans with service-connected disabilities rated 30% or 40% disabling

Priority Group 3

  • Veterans with service-connected disabilities rated 10% or 20% disabling

  • Veterans who are former POWs

  • Veterans awarded the Purple Heart

  • Veterans whose discharge was for a disability that began in the line of duty

  • Veterans who are disabled because of VA treatment or participation in VA vocational rehabilitation program

Priority Group 4

  • Veterans who are receiving aid and attendance or housebound benefits

  • Veterans who have been determined by VA to be catastrophically disabled

Back to Top

Priority Group 5

  • Veterans receiving VA pension benefits

  • Veterans who are eligible for Medicaid programs

  • Veterans with income and assets below VA Means Test Thresholds

Priority Group 6

  • Veterans with 0% service-connected conditions, but receiving VA compensation

  • Veterans seeking care only for disorders relating to Ionizing Radiation and Project 112/SHAD

  • Veterans seeking care for Agent Orange Exposure during service in Vietnam

  • Veterans seeking care for Gulf War Illness or for conditions related to exposure to during service in the Persian Gulf

  • Veterans of World War I or the Mexican Border War

  • Veterans who served in combat in a war after the Gulf War or during a period of hostility after November 11, 1998 for 2 years following discharge or release from the military

  •  Click here for more information about combat veteran eligibility

Priority Group 7

  • Veterans who agree to pay specified copay with income and/or net worth above VA Income Threshold and income below the Geographic Means Test Threshold


    • Subpriority a: Noncompensable 0% service-connected veterans who were enrolled in VA Health Care System on a specified date and who have remained enrolled since that date

    • Subpriority c: Nonservice-connected veterans who were enrolled in VA Health Care System on a specified date and who have remained enrolled since that date

    • Subpriority e: Noncompensable 0% service-connected veterans not included in Subpriority a above. VA is not currently using Subpriority e.

    • Subpriority g: Nonservice-connected veterans not included in Subpriority c above. VA is not currently using Subpriority g.

Back to Top

Priority Group 8

Veterans who agree to pay specified copay with income and/or net worth above VA Means Test threshold and the Geographic Means Test Threshold.

  • Subpriority a: Noncompensable 0% service-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date

  • Subpriority c: Nonservice-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date

  • Subpriority e*: Noncompensable 0% service-connected veterans applying for enrollment after January 16, 2003

  • Subpriority g*: Nonservice-connected veterans applying for enrollment after January 16, 2003

* Effective January 17, 2003, VA suspended NEW enrollment of veterans assigned to Priority Group 8 (VA's lowest priority group consisting of higher income veterans). If you are a veteran enrolling for the first time on or after January 17, 2003, your income exceeds the current year income threshold, and you have no other special eligibilities such as a compensable service connected condition or recent combat service, you are not eligible for enrollment at this time. Veterans enrolled in Priority Group 8 on or before January 16, 2003, will remain enrolled and continue to be eligible for the full-range of VA health care benefits.

VA Travel Reimbursement

Reimbursement for mileage or public transportation may be paid to the following:

  1. Veterans with service-connected disabilities rated at 30% or more;
  2. Veterans traveling for treatment of a service-connected condition;
  3. Veterans receiving a VA pension;
  4. Veterans traveling for scheduled compensation or pension examinations;
  5. Veterans whose income does not exceed the maximum VA pension rate;

Mileage reimbursement is made at the current rate of 28 cents per mile. The new deductibles are $7.77 for a one way trip, $15.54 for a round trip, with a maximum of $46.62 per calendar month. However, these deductibles can be waived if they cause a financial hardship to the veteran.

The deductible is also waived for veterans traveling for scheduled compensation or pension examinations.