Enrollment Application Processing Statistics
The Veterans Health Administration’s (VHA) Health Eligibility Center (HEC) determines Veterans’ eligibility for enrollment by providing eligibility and enrollment guidance to the nation’s VA medical centers as well as the following additional services:
- Process applications for enrollment in VA's health care system.
- Verify Veterans’ self-reported household income information with the IRS/SSA to establish eligibility for health care services, copayment status, and enrollment priority assignment.
- Produce and distribute informational material to include the individualized Health Benefits Handbooks and the Health Benefits Overview Booklet
- Manage Veteran Health Identification Card (VHIC) program
- Manage VA Dental Insurance Program (VADIP)
- Provide training to VA medical center staff on health benefits eligibility and enrollment
HEC’s goal is to process all applications within five (5) business days. If the enrollment application is complete and contains all necessary information, the application is processed and the newly-enrolled Veteran will receive a personalized Handbook in the mail welcoming him/her to the VA health care system. The handbook contains health benefits information the Veteran is specifically eligible for as well as information on copay responsibility, if any, and other services available.
The following information provides the number of enrollment applications received and processed at HEC from October through August 2015:
|Enrollment Applications Processed as of August 31, 2015|
|Enrollment Applications Received||51,594|
|Processed within Five Business Days||44,866||87%|
Applications Pending an Enrollment Determination
Sometimes applications for enrollment are not complete and missing information needed to fully process the application to a final enrollment determination, such as military information or income information. These applications are given a ‘pending’ status while VA attempts to locate necessary information in its electronic databases or receive the needed military information from the Department of Defense (DoD) or from the Veteran. If unable to obtain the missing information via its databases or from DoD, VA will contact the Veteran via letter to request the missing information.
VA medical centers also process applications for enrollment. The following represents the total number of applications received nationally (including those received at HEC), that are pending a final enrollment determination:
|Applications Pending as of August 31, 2015|
|Total Pending Applications||822,351|
|Missing verified military service information||173,075||21%|
|Missing financial information||649,276||79%|
Efforts to Complete the Application Process
To ensure that applications pending enrollment are processed to a final enrollment determination, as of August 31, 2015, VA has outreached to more than 319,681 Veterans with mailed letters requesting the required documents necessary to establish a final enrollment determination. As a result of this outreach effort, VA has received 38,173 responses and enrolled 35,878 Veterans in the VA health care system.
VA is making every effort to ensure that all applications are processed fully and timely, and will continue its outreach efforts to help reduce the number of application in a pending status.
For immediate assistance or to inquire on the status of their application, Veterans may call toll free 1 877-222-VETS (8387).