Who is eligible?
- Veterans who are service connected disabled.
- Veterans who are not service connected disabled must fall under $80,000 in Net Worth AND meet Financial Income Thresholds.
- Veterans awarded the Purple Heart, POW’s & OIF/OEF Veterans.
- Veterans receiving aid and attendance or housebound benefits and/or veterans determined by VA to be catastrophically disabled.
- Veterans seeking treatment for certain presumptive conditions from radiation exposure, Project 112/Project SHAD.
VA Health Care 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. 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 non service-connected veterans and non-compensable,
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 during
atmospheric testing or during the occupation of Hiroshima and Nagasaki; for any illness associated with participation in tests
conducted by the Department of Defense (DoD) as part of Project 112/Project SHAD; veterans with zero percent service-connected
disabilities who are receiving disability compensation benefits and veterans who served in a theater of combat operations
after Nov. 11, 1998 as follows:
Veterans discharged from active duty on or after Jan. 28, 2003, who were enrolled as of Jan. 28, 2008 and veterans who apply
for enrollment after Jan. 28, 2008, for 5 years post discharge
Veterans discharged from active duty before Jan. 28, 2003, who apply for enrollment after Jan. 28, 2008, until Jan. 27, 2011
Group 7:Veterans with income and/or net worth above the VA national income threshold and income below the geographic income threshold
who agree to pay co-pays.
Group 8:Veterans with income and/or net worth above the VA national income threshold and the geographic income threshold who agree
to pay co-pays.
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