Health

Veterans Administration Health Care


Healthcare Benefits Eligibility

In order to qualify for enrollment in VA healthcare, the veteran must have:

  • Been discharged from active military service under honorable conditions.
  • Served a minimum of 2 years, if discharged after September 7, 1980 (prior to this date, there is no time limit).
  • If a National Guardsman or Reservist, served the entire period for which called to active duty other than for training purposes only.
  • Priority Groups
Once a veteran applies for enrollment, his or her application eligibility will be verified. Based on the individual's specific eligibility status, he or she is assigned a priority group. The priority groups are as follows, ranging from 1-7 with 1 being the highest priority for enrollment. Under the Uniform Benefits Package, the same services are generally available to all enrolled veterans.

Priority Group 1

  • Veterans with service-connected disabilities rated 50% or more disabling.
Priority Group 2
  • Veterans with service-connected disabilities rated 30% or 40% disabling.
Priority Group 3

Veterans who are former POW's

  • Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty.
  • Veterans with service-connected disabilities rated 10% or 20% disabling.
  • Veterans who are Purple Heart recipients (unless eligible for a higher priority group)
  • Veterans awarded special eligibility classification under Title 38, U.S.C., Section 1151, "benefits for individuals disabled by treatment or vocational rehabilitation"
Priority Group 4
  • Veterans who are receiving aid and attendance or housebound benefits
  • Veterans who have been determined by VA to be catastrophically disabled
Priority Group 5
  • Nonservice-connected veterans and service-connected veterans rated 0% disabled whose annual income and net worth are below the established dollar threshold. (Veterans in this priority group must provide VA with information on their annual income and net worth in order to determine whether they are below the "means test" threshold; or agree to co-payment requirements. The threshold is adjusted annually, and announced in January. In making the assessment, the veteran's household income is considered.
Priority Group 6

All other eligible veterans who are not required to make co-payments for their care, including:

  • World War I and Mexican Border War veterans
  • Veterans receiving care solely for disabilities resulting from exposure to toxic substances, radiation or for disorders associated with service in the Gulf War; or for any illness associated with service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998.
  • Compensable 0% service-connected veterans
Priority Group 7

  • Nonservice-connected veterans and noncompensable 0% service-connected veterans whose needed care cannot be provided by enrolling in any of the groups above and, who agree to pay specified co-payment.

Uniform Benefits Package


The Uniform Benefits Package will generally be provided to all enrolled veterans regardless of their priority group. Public law 104-262 called for VA to provide hospital care and outpatient care services that are defined as "needed". VA defines "needed" as care or service that will promote, preserve and restore health. This includes treatment, procedures, supplies or services. This decision of need will be based on the judgment of the health care provider, and in accordance with generally accepted standards of clinical practice. The following three categories contain a list of healthcare services that are provided under the Uniform Benefits Package, a list of some that are not covered by VA andd a list of other services that are provided under special authority.

Services that are covered under the uniform benefits package:

  • Drugs, Biologicals, and Medical devices approved by the Food and Drug Administration (FDA)
  • Elective Sterilization Tubal Ligation or Vasectomy)
  • Emergency care in VA facilities
  • Home healthcare
  • Hospice care
  • Hospital and Outpatient care
  • Maternity benefits
  • Medical and Surgical care
  • Mental Healthcare
  • Palliative care
  • Preventive care and services
  • Prosthetics and Orthotics
  • Rehabilitation Care and Services
  • Respite Care
  • Substance Abuse Services
Services not covered under the uniform benefits package:

  • Abortions and Abortion Counseling
  • Drugs, Biologicals, and Medical devices not approved by the Food and Drug Administration (FDA)
  • Gender alterations
  • Membership in Health Clubs and Spas
  • Private duty nursing
Services covered under Special Authorities:

  • Adult Day Healthcare
  • Dental Care
  • Domiciliary Care
  • Emergency Care in Non-VA Facilities
  • Homeless Programs
  • Non-VA Care
  • Nursing Home Care
  • Readjustment Counseling Service (Vet Centers)
  • Sensori-Neural Aids (i.e., eyeglasses, contact lenses, hearing aids)
  • Sexual Trauma Counseling

If you have any questions or concerns about this or other Veterans issues, please give us a call at (308) 385-5065