How To Apply for VA Medical BenefitsUpdated: August 10, 2020
Veterans are able to receive health care from the Veterans Health Administration (VA) that is comprehensive, and portable across the entire VA system. The VA is the largest integrated health care system in the United States, with over 1,700 medical centers and outpatient clinics throughout the country. In order to receive care from the VA, veterans must go through an application and enrollment process.
How Can Veterans Apply For Benefits?
Any veteran who served in the military and separated under any condition besides dishonorable may qualify for health care benefits from the VA. Additionally, those who served in the reserve or National Guard who have completed their full period of active duty are eligible to apply as well.
In order to apply for medical benefits from the VA, there are several documents that veterans must submit. These include:
- Proof of discharge from the military, such as a DD-214
- Information on any additional health insurance, including coverage through a spouse or domestic partner
- Information on wages, including gross income from the previous calendar year for the veteran, as well as their spouse and any dependent children
- Their most recent tax return
In order to enroll, and apply for medical benefits from the VA, veterans must also complete an application for enrollment, the VA Form 1010EZ. Additionally, veterans can apply in the following ways:
- By phone: call toll-free 877-222-8387
- Online: visit the VA website
- Complete the application in person: veterans can obtain an “Application for Health Benefits” at their local VA
Once veterans have been approved and enrolled, the next steps include:
- Wait to receive a welcome call from the VA: this call will provide veterans with necessary information on the VA health program, provide assistance with scheduling a doctor’s appointment, and answer any potential questions veteran have about their health care and medical benefits
- Review the Veterans Health Benefits Handbook: veterans will receive this handbook in the mail after applying for benefits. It includes information on specific health care benefits, as well as what the veteran can expect to pay in copays (this depends on what Priority Group the veteran is placed in)
- Obtain a Veterans Health Identification Card (VHIC): this card is used for ID and to check in for health care appointments at the VA. To get a card, veterans can contact the enrollment coordinator at their local VA medical center
- Attend their first VA doctor’s appointment: veterans can request an appointment when they apply for benefits; if this is the case, the VA will set up an appointment for the veteran with a VA provider and send the veteran an appointment notification in the mail. Veterans can also set up their first appointment during their welcome call
What Benefits are Available to Veterans?
There are many different benefits that veterans can receive from the VA, at little to no cost, including:
- Prescription medication
- Primary and specialty care
- Preventive care
- Medical equipment, such as prosthetics
- Home health care
- Mental health care
- Long term care
- Hearing and vision benefits
- Dental care
- Substance abuse treatment
- Treatment for PTSD
- TBI rehabilitation
How are Costs and Benefits Determined?
Health care from the VA can have different costs, depending on the veteran’s disability rating. If their rating is at least 50 percent, all of their VA medical care is free. If their disability rating is lower than 50 percent, they may be responsible for a copay, depending on what type of services they receive as well as what conditions they are being treated for.
Due to the limited amount of funding that the VA receives from Congress each year, the number of veterans who are able to be enrolled in health care must be prioritized. The VA uses Priority Groups to ensure that veterans who need the most care are able to receive it, and ensures that veterans who are not financially capable of paying copays are eligible for care at a reduced rate. There are eight priority groups for VA health care. They include:
- Priority Group 1: veterans who have a service-connected disability rating of 50 percent or higher, as well as veterans who are determined by the VA to be unable to work due to injuries or disabilities they sustained as a result of their military service
- Priority Group 2: veterans whose service-connected disability ratings are between 30 and 40 percent
- Priority Group 3: veterans who are former Prisoners of War (POWs); veterans who were discharged from the military due to a disability; veterans who were awarded a Purple Heart; veterans whose service-connected disability rating is between 10 and 20 percent; veterans who were awarded the Medal of Honor
- Priority Group 4: veterans who are receiving household benefits or aid and attendance benefits; veterans who have been determined to be catastrophically disabled by the VA
- Priority Group 5: veterans who do not have service-connected disability ratings from the VA; veterans who are receiving VA pension benefits; veterans who are eligible for Medicaid
- Priority Group 6: veterans who have service-connected conditions with a zero percent disability rating; veterans who served in Vietnam between Jan. 9, 1962 and May 7, 1975; veterans of the Persian Gulf War who served between Aug. 2, 1990 and Nov. 11, 1998; combat veterans who were discharged from the military after Jan. 28, 2003
- Priority Group 7: veterans whose gross household income is below the limit set by the VA, and who agree to pay copays for their health care
- Priority Group 8: veterans whose gross household income is above the limit set by the VA, and who agree to pay copays for their health care
Once a veteran is enrolled in the VA healthcare system, they do not have to reapply for those benefits each year. Veterans may need to update their financial information if it changes, in order to keep their enrollment priority group current. If this is the case, the veteran will be contacted by the VA in order to provide any necessary updates.
Heather Maxey works at a non-profit that addresses military ineligibility. She is an Army spouse, and met her husband while working as a Health Educator at Fort Bragg.
|VA Medical Benefits||State Veteran’s Benefits|
|VA Priority Groups||VA Veteran Health ID Card|
|Veteran Affairs Schedule for Rating Disabilities||VA Disability Ratings and Rules|