All veterans that have an honorable discharge are theoretically eligible for either free or low cost health care at VA hospitals and clinics. This can include many different types of health care, including some personal care services received at home, if medically necessary. Many veterans will utilize the VA health care system in lieu of having health insurance, while other will use the system only for the prescription benefits and the $8 or $9 copays for drugs. In order to qualify for benefits, the veteran must apply for benefits, and be placed into a priority group. Dependent on funding, the VA will close enrollment to higher priority groups (Group 8). These priority groups are as follows:
Priority Group 1:
Veterans with VA Service-connected disabilities rated 50% or more.
Veterans assigned a total disability rating for compensation based on unemployability.
Priority Group 2
Veterans with VA Service-connected disabilities rated 30% or 40%.
Priority Group 3
Veterans who are former POWs.
Veterans awarded the Purple Heart Medal.
Veterans awarded the Medal of Honor.
Veterans whose discharge was for a disability incurred or aggravated in the line of duty.
Veterans with VA Service-connected disabilities rated 10% or 20%.
Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation.”
Priority Group 4
Veterans receiving increased compensation or pension based on their need for regular Aid and Attendance or by reason of being permanently Housebound.
Veterans determined by VA to be catastrophically disabled.
Priority Group 5
Nonservice-connected Veterans and noncompensable Service-connected Veterans rated 0%, whose annual income and/or net worth are not greater than the VA financial thresholds.
Veterans receiving VA Pension benefits.
Veterans eligible for Medicaid benefits.
Priority Group 6
Compensable 0% Service-connected Veterans.
Veterans exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki.
Project 112/SHAD participants.
Veterans who served in the Republic of Vietnam between January 9, 1962 and May 7, 1975.
Veterans who served in the Southwest Asia theater of operations from August 2, 1990, through November 11, 1998.
Veterans who served in a theater of combat operations after November 11, 1998, as follows:
Veterans discharged from active duty on or after January 28, 2003, for five years post discharge.
Priority Group 7
Veterans with incomes below the geographic means test (GMT) income thresholds and who agree to pay the applicable copayment.
Priority Group 8
Veterans with gross household incomes above the VA national income threshold and the geographically-adjusted income threshold for their resident location and who agrees to pay copays
Veterans eligibility for enrollment: Noncompensable 0% service-connected and:
Subpriority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/ or placed in this subpriority due to changed eligibility status.
Subpriority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less
Veterans eligible for enrollment: Nonservice-connected and:
Subpriority c: Enrolled as January 16, 2003, and who remained enrolled since that date and/ or placed in this subpriority due to changed eligibility status
Subpriority d: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less
Veterans NOT eligibile for enrollment: Veterans not meeting the criteria above:
Subpriority e: Noncompensable 0% service-connected and high income
Subpriority f: Nonservice-connected and high income