Most Veterans who do not receive a VA disability or pension payment or have a VA special eligibility, such as a recently discharged Combat Veteran or a Purple Heart recipient, must complete a financial assessment when applying for enrollment to determine their eligibility for enrollment and copay responsibility for VA health care and/or prescription medication. These Veterans must provide their gross household income (which includes spouse and dependent children) for the prior calendar year. This income information will be used to determine the Veteran’s enrollment status and copay responsibility for VA health care and/or prescription medication.
As of March 24, 2014, most Veterans are no longer required to complete the annual financial assessment known as a Means Test. Instead, VA will receive income information from the Internal Revenue Service (IRS) and Social Security Administration (SSA), and will contact the Veterans only if the information received indicates a change in their VA health benefits may be appropriate. The elimination of the annual means test frees enrolled Veterans to enjoy their VA health care benefits without worrying about completing annual income assessment forms. Under the new process, Veterans will be required to have one financial assessment on file – their current file if they’re already enrolled, or the assessment they provide when they apply. That assessment will be maintained and monitored by VA and updated only as substantial income changes occur.
VA will receive income information from the IRS and SSA, and will contact the Veteran only when the information received indicates a change in VA health benefits may be appropriate. Consistent with VA’s current income verification processes, Veterans will still have access to care during the period of review should they dispute what IRS or SSA says about their income.
There is no change in VA's long-standing policy to provide no-cost care to indigent Veterans, Veterans with catastrophic medical conditions, Veterans with a disability rating of 50 percent or higher or for conditions that are officially rated as "service-connected."
VA encourages Veterans to continue to report changes in their income information, as well as their personal information, such as address, phone numbers, dependents, next of kin and health insurance, using VA Form 1010EZR available online or at their local medical center.
In order to ensure the availability of quality and timely health care to Veterans with service connected conditions, special authority based on military service, low income, and those with special health care needs, in January 2003 VA made the difficult decision to stop enrolling new Priority Group 8 (high income) Veterans whose income exceeded VA Income Thresholds.
The new regulations went into effect on June 15, 2009 and enable the Department of Veterans Affairs (VA) to relax income restrictions on enrollment for health benefits. While this new provision does not remove consideration of income, it does increase income thresholds. You may be eligible for enrollment under this new provision.
If no response is received within 75 days, it is assumed the IRS/SSA information is correct and a letter will be sent informing the Veteran that his/her copay status will be changed and of their copay responsibility.