Veterans Health Programs

Veterans Medical Benefits Package

Eligibility

The VA will generally provide coverage for all outpatient and hospital services that are deemed necessary to the health and well-being of a veteran. Necessary treatment includes preventative and restorative treatments. Veterans are placed into priority groups based on their incomes and levels of disability. Veterans in higher priority groups receive health care before veterans assigned to lower priority groups. There are eight priority groups, ranging from Group 1 (highest priority) to Group 8 (lowest priority). Following is a list of the groups and their requirements.

  • Priority Group 1
    • Veterans with 50% or more disability
    • Veterans who are unemployable due to their service-connected disability

  • Priority Group 2
    • Veterans with disability ratings of 30-40%

  • Priority Group 3
    • Veterans with a disability rating of 10-20%
    • Purple Heart medal recipients
    • Veterans who were prisoner's of war
    • Veterans discharged for a service-connected disability
    • Veterans disabled by medical treatment or vocational rehabilitation at a VA facility

  • Priority Group 4
    • Housebound Veterans
    • Veterans needing nursing home care or a home-care attendant
    • Veterans who are catastrophically disabled

  • Priority Group 5
    • Low-income Veterans with no disabilities
    • Veterans eligible for Medicaid
    • Veterans receiving a VA pension

  • Priority Group 6
    • Veterans seeking care for radiation or Agent Orange exposure
    • Veterans with no disabilities but receiving a pension
    • World War I Veterans
    • Mexican Border War Veterans
    • Gulf War Veterans
    • Veterans of hostilities taking place after Nov.11, 1998

  • Priority Group 7
    • Veterans who have incomes above the VA Income Threshold and below the HUD Geographic Means Threshold, and who agree to a copayment.

  • Priority Group 8
    • Veterans whose income exceeds the VA Income Threshold and the HUD Geographic Means threshold and agree to pay a copayment.
      • Subpriority A: Veterans with no disabilities and receiving no pension who were enrolled in a VA Health Care program on or before Jan. 16, 2003 and have been enrolled since then.
      • Subpriority C: Veterans enrolled in a VA Health Care program on or before Jan. 16, 2003 and have been enrolled since then.
      • Subpriority E:  Veterans with no disabilities and receiving no pension who are enrolling after Jan, 16, 2003.
      • Subpriority G: Veterans who enrolled in a VA Health Care program after Jan. 16, 2003 and have been enrolled since then.

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Joe's Notes



JoeNote

Veterans in Priority Group 8, Subpriorities E and G whose incomes exceed the income threshold determined for the year are not eligible for VA health care. However, veterans enrolled before Jan. 16, 2003 are still eligible.

JoeSpeak: Catastrophically Disabled

Having a severely disabling injury, disorder or disease that permanently hinders your ability to carry out activities of daily living without assistance. To be considered catastrophically disabled, you must:

  • Need assistance to leave your home or bed.
    or
  • Need constant supervision to avoid physical harm to yourself or others.

JoeSpeak: HUD Geographic Means Threshold Chart

Detailed income chart developed by the Department of Housing and Urban Development that provides information on income levels and cost of living for different geographic areas around the country. This chart is used by the VA along with other criteria to assign Veterans to priority groups and to determine copayments for medical services.


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