Health Benefits

Eligibility

Eligibility for most VA benefits is based upon the status of discharge from active military service. Benefits are available to veterans only if they were discharged from the service under other than dishonorable conditions. Active service means full-time service as member of the Army, Navy, Air Force, Marine Corps, Coast Guard, or as a commissioned officer of the Public Health Service, the Environmental Services Administration or the National Oceanic and Atmospheric Administration.

Current and former members of the Selected Reserve may be eligible for certain benefits if they meet the criteria; this typically requires that the reservist served in an active duty capacity, either from being activated or through ADSW. Honorable and general discharges qualify a veteran for most VA benefits. Other than honorable and bad conduct discharges make a veteran ineligible for VA benefits.

In addition, eligibility for health benefits, are impacted by the cause of the disability.  A disability will be deemed to be "Service-Connected" (SC) if it was incurred or aggravated in the line of duty in the military service. This also applies to a veteran's death, should it be the result of a disability incurred or aggravated in the line of service in the Armed Forces. If the veteran's disability or death is not shown to be related to military duty, it is defined as "Non service-connected" ( NSC ).

Priority Categories

While the VA provides a multitude of benefits to a large number of veterans, not everyone is entitled to all benefits. This is especially true with medical care. The type, degree and origin of disability, the availability of specialized services at local facilities, the financial status of the veteran, and other factors play a part in the level of entitlement each veteran has to medical care.

In October 1996, Congress passed Public Law 104-262, the Veterans' Health Care Eligibility Reform Act of 1996. This legislation paved the way for the creation of a Medical Benefits Package - a standard enhanced health benefits plan available to all enrolled veterans. The availability of services to each particular individual depends on several factors, which, when aggregated, define a "Priority status”.

Like other standard health care plans, the Medical Benefits Package emphasizes preventive and primary care, offering a full range of outpatient and inpatient services, with a focus on improved veteran satisfaction. Our goal is to ensure the quality of care and service that our veterans receive is consistently excellent in every location and in every program. Under the Medical Benefits Package, VA offers a comprehensive health care plan to the veteran, according to their priority group.

Priority groups have been labeled by number, ranging from 1-8 with. Priority 1 is the highest eligibility for enrollment. According to availability of resources, care is provided to all applicants in Priority 1, continuing with each group as possible. Due to budgetary restrictions, VA is not accepting new Priority Group 8 veterans for enrollment as of January 17, 2003 .