How to Enroll in VA Health Care

The Veterans Affairs (VA) medical benefits package provides health care to veterans who qualify. Veterans that qualify for VA health care should enroll in the priority group they fit into so they can receive medical benefits as soon as possible. There are eight categories, with Group 1 as the highest priority for enrollment in the VA health care system.

If you’re eligible for more than one group, the VA places you in the highest group (category) for which you are eligible.

  • Group 1, 50 percent disabled: Veterans whom the VA has rated as 50 percent or more disabled with a service-connected disability. Also included are veterans whom the VA has determined to be unemployable.

  • Group 2, 30 percent disabled: Veterans with VA-rated service-connected disabilities of 30 or 40 percent disabling.

  • Group 3, 10 percent disabled: Veterans whom the VA has determined have a 10 or 20 percent service-connected disability. Also included in this category are:

    • Veterans who are former prisoners of war (POWs)

    • Veterans awarded a Purple Heart

    • Veterans whose discharge was for a disability that happened or was aggravated in the line of duty

    • Veterans who became disabled because of treatment or vocational rehabilitation from a VA facility

  • Group 4, Veterans receiving aid: Veterans who receive a VA pension, along with additional monthly compensation from the VA because they require in-home aid and assistance or are housebound.

    Also included in this category are veterans whom the VA considers to be catastrophically disabled, even if the disability is not service-connected.

    Catastrophically disabled means a severe, permanent disability that requires personal or mechanical assistance to leave the bed or house, or requires constant supervision to avoid harm.

  • Group 5, Veterans receiving pensions: Veterans who receive a VA pension or those eligible for one. Also included are veterans who have income and assets below the VA’s national income limit, or are eligible for state Medicaid programs.

  • Group 6, Special periods of service: World War I veterans and veterans who served in a combat zone after November 11, 1998, as follows:

    • Veterans discharged from active duty on or after January 28, 2003, who were enrolled in the VA health care system as of January 28, 2008.

    • Veterans who apply for enrollment after January 28, 2008.

      Such veterans may enroll and be placed automatically in Group 6 for five years post-discharge.

    • Veterans discharged from active duty before January 28, 2003, who apply for enrollment after January 28, 2008, until January 27, 2011.

    To be automatically qualified for Group 6 placement for service after November 11, 1998, you must have served at least one day in a designated combat zone.

    Also included in Group 6:

    • Veterans who have a service-connected medical condition or disability that is rated as zero percent disabling.

    • Veterans who were exposed to ionizing radiation as a result of testing, development, or employment of the atom bomb in World War II.

    • Veterans exposed at a nuclear device testing site or during the occupation of Hiroshima and Nagasaki, Japan.

    • Vietnam veterans who were exposed to Agent Orange while serving in Vietnam. To be eligible, you must have served on active duty in Vietnam between January 9, 1962, and May 7, 1975.

      In addition, you must suffer from one of these illnesses: acute and subacute peripheral neuropathy, adult-onset (Type 2) diabetes, chloracne, chronic lymphocytic leukemia (CLL), Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, porphyria cutanea tarda, primary amyloidosis, prostate cancer, respiratory cancers (cancer of the lung, bronchus, larynx, or trachea), or soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma).

    • Gulf War veterans, including those who served in Operations Desert Shield, Desert Storm, and Iraqi Freedom, who suffer from any of the several medical conditions grouped together into what is called “Gulf War Illness”.

    • Veterans who participated in Project 112/SHAD.

    Project SHAD, an acronym for Shipboard Hazard and Defense, was part of a larger effort called Project 112, which was conducted during the 1960s.

    Project SHAD consisted of tests designed to identify U.S. warships’ vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability. Participants on Navy ships were exposed to various chemical and biological “simulates.” Unfortunately, it was later found that many of these “simulates” weren’t as medically harmless as was thought at the time.

  • Group 7, Veterans with low incomes: This category is for veterans who don’t qualify for Groups 1 through 6 and who have an annual income or net worth above the VA’s national income limit, but below the Department of Housing and Urban Development’s (HUD) income threshold for the area in which they live.

    Veterans with income limits below both the national income limits and HUD’s geographic income threshold are placed in Group 5.

    Veterans placed in Group 7 must agree to pay co-pays.

  • Group 8, All others: Veterans who don’t fit into one of the first seven categories. It mostly includes veterans who have an annual income or net worth above both the VA’s national income limit and HUD’s geographic income threshold.

    As with Group 7, veterans in Group 8 must agree to pay for a portion of their medical care.

    Effective January 16, 2003, the VA no longer accepts new enrollments in Group 8. Veterans who enrolled in the VA health care system before this date, and remain enrolled, are still eligible for this category. For example, if you were enrolled in Group 7, but your income level increases beyond the limits required for that category, you can still be moved to Category 8. This policy only affects new enrollments.

  • Add a Comment
  • Print
  • Share
blog comments powered by Disqus
Advertisement

Inside Dummies.com