Woman Doctor

How Do I Apply for VA Healthcare?

This is a question that many Veterans have. How do I apply for VA Healthcare? What does it take to get VA Healthcare? Am I eligible for VA Healthcare?

We will attempt to answer all of these questions here.  The first thing to know is that not all Veterans are entitled to VA health care automatically. At the same time, Veterans are not required to enroll in VA Health Care at all. Veterans are free to seek their health care anywhere they want to. That being said, in order to receive care at the VA a Veteran generally must be both eligible for VA Healthcare and enrolled.

Eligibility for VA Health Care

There are three basic requirements to be eligible for VA Healthcare.

  • You served in the Active military, naval, air service or qualifying Reserve and National Guard members.
  • If you enlisted after Sept 7, 1980 you must have served 24 continuous months or for the full period for which you were called to active duty, UNLESS:
> You were discharged for a disability caused or aggravated by active duty, or
> You were discharged for a hardship (early out), or
> You served prior to Sept 7, 1980
  • You must have been released under conditions other than dishonorable

Enhanced Eligibility

It is possible for a Veteran to qualify for enhanced eligibility status. The requirements are:

  • Receive service-connected disability from the VA
  • Discharged from the service for a disability resulting from something which happened on active duty.
  • Discharged for a disability which was aggravated by active duty
  • Recently discharged combat veteran
  • Receiving a VA Pension
  • Former Prisoner of War (POW)
  • Received a Purple Heart
  • Received a Medal of Honor
  • Qualify for Medicaid benefits
  • Served in Vietnam between Jan 9, 1962 and May 7, 1975
  • Served in SW Asia during the Gulf War between Aug 2, 1990 and Nov 11, 1998
  • Served at least 30 days at Camp Lejeune between Aug 1, 1953 and Dec 31, 1987

Applying for VA Healthcare

All of this information is nice, but how do you actually go about applying for VA Healthcare? The process is quite simple. Call the VA phone number at 1-877-222-8387. Alternatively, you can apply online at https://www.va.gov/health-care/apply/application/introduction.

It is best if the Veteran has a copy of their DD214 available when applying for VA Healthcare benefits. The online form or the representative on the phone will ask for dates of service as well as discharge characterization. In addition, they will most likely ask for financial information. This is due to the fact that the VA has an income threshold for each location. If the Veteran is earning less than the threshold they will be in a higher group than if they are over the threshold.

VA Healthcare Priority Groups

The VA has 8 priority groups with Category 1 having the highest priority for enrollment and Category 8 having the lowest priority for enrollment. Below are the 8 groups:

Group 1.  Veterans with a service-connected disability rating of 50% or more or on individual unemployability and Veterans who were awarded the Medal of Honor.

Group 2. Veterans with service-connected disability rating of 30% or 40%.

Group 3. Veterans who are former POW or have been awarded the Purple Heart. Also Veterans with 10% or 20% service-connected disability ratings. Veterans discharged from active military service for a disability that they received or had aggravated in the line of duty.

Group 4. Veterans who receive VA Pension based on their need for Aid and Attendance or because they are Housebound, or other Veterans deemed catastrophically disabled.

Group 5. Veterans who don’t fall into Groups 1 – 4 and whose income is below the VA’s income threshold.

Group 6. All other Veterans who are not required to pay a co-pay. This can include Veterans with special eligibilities based on exposures to certain toxins (Agent Orange, radiation, etc if they aren’t in a higher category), veterans with a disorder that may be associated with service in SW Asia during the Gulf War and Veterans discharged / released on or after Jan 28, 2003 who have an illness that may be associated with service in combat in a war after the Gulf War. Also, it includes Camp Lejeune Veterans and Veterans who are 0% but receive compensation, including Veterans receiving compensation for inactive tuberculosis.

Group 7. Veterans who agree to pay the co-payment if their income for the previous year constitutes “low income” under the US Housing and Urban Development geographical income limits.

Group 8. Veterans who are service connected at 0% or who are not service connected. Group 8 has six subcategories which can be viewed here.

That is really all there is to applying for VA Healthcare Benefits. Once you have applied, the VA will decide based upon your service, VA disabilities if present, discharge characterization, and income level. You will receive a letter and VA Health Benefits Book if the decision is favorable. The letter will let you know which priority group you are in.

As always, if you have any questions, you can email us or drop a comment below.

God Bless,

from NWAVet

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