The Department of Veterans Affairs provides veterans with access to an array of medical services at little to no cost, including inpatient and outpatient care, prescription coverage, mental health services, dental services, home healthcare visits, eye care services and many others. Eligible veterans may benefit from services including inpatient and outpatient care, mental health services, dental services, home healthcare visits and eye care among many more.
Accessing these benefits may be restricted by income. The VA uses different thresholds of income to determine eligibility for various levels of health care coverage; veterans with lower incomes will have copayments while those with higher incomes must pay additional amounts towards their care.
Income for VA benefits eligibility purposes means any cash or equivalent that enters a household each year, such as Social Security payments and monthly retirement pensions, investments such as IRAs and 401(k)s, wages, rental income, inheritances and gambling winnings; counting expenses such as medications, doctor visits, wheelchairs and other healthcare items is also part of income calculation.
Since 2022, the Veterans Administration (VA) has implemented national and geographic income thresholds that determine eligibility for specific health services. These thresholds help establish priority groups which determine copayment responsibilities; those falling into priority groups 7 or 8 do not meet compensable service-connected disabilities that qualify for disability compensation, yet have gross household income that falls below both thresholds.
Priority groups 1 and 2 serve veterans who qualify for disability compensation due to service-connected disabilities. Priority group 3 includes veterans whose conditions meet certain criteria and have high enough impairment ratings that they qualify for disability payments, while veterans in priority group 4 still meet criteria but do not fulfill requirements necessary for compensation; at least 30% disability must exist and five years have passed since moving into their local communities.
Priority group 5 serves veterans with service-connected conditions who do not meet a rating of 30% disability but whose income exceeds VA thresholds, but are willing to make full copayments for healthcare services. Priority group 6 comprises men and women who do not fulfill the income criteria to qualify for full Medicaid coverage and cannot afford copayments. This group can access family planning exams for both men and women, pap tests, sexually transmitted infection testing, over-the-counter contraceptives and transportation to family planning clinics. In addition to these health services, the VA offers various long-term care services for eligible veterans – these may include nursing homes, adult day care centers and assisted living facilities. Eligible veterans can apply for these services based on their medical needs and proximity to available services. Additional requirements, such as participation in special health registries that document exposures to Agent Orange, depleted uranium and other toxic materials may also apply.