What Makes a Veteran Eligible for VA Healthcare?

In This Edition

• Are you Eligible for this EXTRA VA benefit?

• H&P Disability Law Trivia

• What Makes a Veteran Eligible for VA Health Care?

This week, we're explaining all the details about VA healthcare benefits.

Want to understand everything about VA healthcare? Let’s get you in the know.

Are you Eligible for this EXTRA VA benefit?

Veterans embody the resilience and courage of our nation, and recognizing their sacrifice, the Department of Veterans Affairs (VA) extends crucial health care benefits. 

Yet, accessing these benefits is not as straightforward as it seems—eligibility hinges on specific criteria. Criteria you need to know!

Why it Matters: Understand what eligibility is required for benefits from experienced members of our team.

H&P Disability Law Trivia

Great job on the quiz question last week! About 30% of our readers got this one right. Here’s a recap:

Let’s test your knowledge on VA disability benefits again this week, with a harder question about VA educational benefits. We’ll talk more about the correct answer next week!

We had a handful of great questions asked as follow-ups to our trivia last week.

Because of this, we are working on a system to select one or two Veterans’ Advantage questions each week for our team to answer on the live stream.

Find out more next week!

For now, here’s an answer from our team to a great question we had.

The veteran stated that they had a pacemaker placed by the VA, got sepsis and nearly died before it was removed. After, they had increased back pain and right shoulder pain. Is this grounds to file another claim?

What Makes a Veteran Eligible for VA Health Care?

Not all veterans automatically qualify for VA health care. 

Key eligibility requirements include:

• Completing 24 continuous months of active duty or the full period for which you were called to active duty, with exceptions for those discharged due to a service-connected disability.

• Veterans can apply in person, by phone, or through submitting VA Form 10-10EZ. While the DD214 form is helpful, the VA can assist in obtaining it if necessary.

Please note: due to recent updates with the PACT Act, more veterans are now eligible for immediate healthcare benefits without filing a VA disability claim. 

What Priority Groups Are There?

Upon application approval, veterans are sorted into one of eight priority groups, determined by factors like service connection, disability ratings, and income levels.

Here’s a brief overview of each group:

• Priority Group 1: Veterans with a 50% or greater service-connected disability, those deemed totally disabled, or recipients of the Medal of Honor. Benefits include full VA health care at no cost and eligibility for free dental care.

• Priority Group 2: Veterans with a 30% to 40% service-connected disability. They receive free healthcare for service-connected conditions, though co-pays may apply for other care.

• Priority Group 3: Includes veterans with a 10% to 20% service-connected disability, those discharged due to disability, former POWs, and Purple Heart recipients. They enjoy similar benefits to Group 2.

• Priority Group 4: For veterans receiving aid and attendance benefits or those considered catastrophically disabled.

• Priority Group 5: Covers veterans with limited income below the poverty threshold and those receiving needs-based benefits like Medicaid.

• Priority Group 6: Encompasses veterans who served in specific conditions or locations, such as Vietnam, the Gulf War, or were exposed to burn pits, under the PACT Act.

• Priority Group 7: Veterans with incomes below a certain threshold, who may face co-pays.

• Priority Group 8: Veterans with incomes above the VA’s financial thresholds, agreeing to co-pays for services.

Why Priority Groups Matter?

These groups ensure the VA can efficiently allocate resources, giving precedence to those with the greatest needs or service-connected health issues.