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Learn what the PACT Act means for your VA benefits

Your health care costs

We’re committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and disability ratings of at least 50%, as well as for those who can’t afford to pay for care. Learn more about how we’ll determine if you’ll need to pay for any part of your care.

Understanding VA health care costs

Can I get free VA health care as a Veteran?

You can get free VA health care for any illness or injury that we determine is related to your military service (called “service connected”).

We also provide certain other services for free. These include readjustment counseling and related mental health services, care for issues related to military sexual trauma (MST), and a registry health exam to determine if you’re at risk of health problems linked to your military service.

Find out how to get mental health care

Learn more about services for military sexual trauma

Explore health issues related to service history

Review more services we provide at no cost

You may qualify for additional free VA health care depending on your income, disability rating, or other special eligibility factors. Keep reading below to learn more.

Will I need to pay for any of my care, tests, or medications?

You may need to pay a fixed amount for some types of care, tests, and medications you receive from a VA health care provider or an approved community health care provider to treat conditions not related to your service. This is called a copay (short for “copayment”). 

Whether or not you’ll need to pay copays—and how much you’ll pay—depends on your disability rating, income level, military service record, and which of our 8 priority groups we assign you to when you enroll in VA health care. For example, if you have a service-connected condition that we’ve rated at 50% or more disabling or that we’ve determined makes you unable to work (called unemployable), or if you’ve received a Medal of Honor, we’ll assign you to priority group 1 and you won’t pay copays for any types of care, tests, or medications.

Learn more about priority groups

Review current copay rates

If you haven’t applied for VA health care yet, you can review VA health care eligibility requirements or use our Health Benefits Explorer tool to see what your copays may be if you enroll.

Learn more about VA health care eligibility requirements

Go to the Health Benefits Explorer

For more information, play our Veteran copayments video (YouTube).

How we assess and verify your income to determine eligibility and copays

How does VA determine whether I’ll need to pay copays based on my income?

If you’re not already receiving VA disability compensation or pension payments, or don’t have special eligibility factors (like receiving the Medal of Honor), we’ll ask for information about your income as part of our health care enrollment process. This is called an income assessment or financial assessment (formerly known as a means test). We’re required by law to collect this information. 

We use your income information to help determine:

  •  If you’re eligible for VA health care based on your income, and
  •  Whether you’ll need to pay copays for certain types of care or medications

Learn more about applying for VA health care

Do I have to provide this information?

If you qualify for VA health care enhanced eligibility status, you won’t need to provide your income information.

Review the requirements for enhanced eligibility status

If you don’t qualify for enhanced eligibility status, but you agree to pay copays for your care, you don’t have to provide your financial information. But if you don’t, we may decline your enrollment. We also won’t be able to consider your eligibility for free medications or beneficiary travel pay.

More about providing financial information for specific groups

You’re a recent combat Veteran

If you served in combat after the Gulf War or in combat against a hostile force after November 11, 1998, you don’t have to provide your income to qualify for 5 years of free VA health care for any illness that may be related to your military service.

You can still provide your income to help us determine if you’re eligible for a higher priority group, beneficiary travel pay, or free care for conditions not related to your service.

Learn more about VA health care for returning service members

You were exposed to hazardous materials during service

If you were exposed to Agent Orange in or near Vietnam, ionizing radiation in certain service locations or jobs, or environmental contaminants in the Persian Gulf, you don’t have to provide your income information to qualify for free care related to your exposure. 

You can still provide your income to help us determine if you’re eligible for a higher priority group, beneficiary travel pay, or free care for conditions not related to your service.

Learn more about hazardous exposures

What information do I need to provide?

You’ll need to provide your gross household income for the previous year. So if you’re applying for health care in 2019, you’ll need to provide your gross household income for 2018.

Your gross household income means the total amount of money you—and anyone living with you in your home—earned within one calendar year, before taxes. This includes your income from work as well as any other sources, like money you may have taken from a retirement fund or income from the sale of a house. If you have a spouse, partner, or dependent child who also contributes income to your family, you’ll need to include this income in your application.

Does VA verify the information I provide?

This depends on your situation. If the information you provide shows that your income falls below our limits and qualifies you for free VA health care, medications, or both, we’re required by law to verify the information. We do this by confirming your information with the Internal Revenue Service (IRS) and the Social Security Administration (SSA).

Check our current income limits

Because of tax deadlines, we usually begin this process in July, the year after you report your income. So, for example, if you provide information for the year 2018, we’ll verify it in July of 2019.

More about confirming your IRS and SSA information

What happens if the IRS and SSA information shows you have income above our limits

If the information we receive from the IRS and the SSA shows that you have income above our limits, we’ll send a letter notifying you (and your spouse or partner if their income is part of your household income). You’ll have the chance to dispute (formally express your disagreement with) this information. You can also send documents showing you have additional deductible expenses that we should consider. 

If you don’t respond to our letter:

After 45 days, we’ll send you a reminder letter.

After 75 days, we’ll assume the information from the IRS and the SSA is correct. We’ll send you a letter to explain the changes in your eligibility or copay status. We’ll also explain how you can appeal our decision.

If you respond by disputing the information in our letter:

When we receive your response, we’ll assign an income verification case manager to work with you (and your representative, if you choose to have one). Your case manager will guide you through the process and help you find any authorized deductions that may reduce your total gross household income below our limits. We try to resolve all cases within 75 days.

If our review shows that your income is still above our limits, we’ll send you a final letter explaining that you’ll need to pay copays for future care as well as for any care you received during the year for which we reviewed your income. We’ll also explain how to appeal our decision.

Once I’m enrolled, do I need to update my income information every year?

This depends on your situation:

  • If you completed a financial assessment to find out if you were eligible for cost-free medications or for beneficiary travel pay (but not for free VA health care), you’ll need to provide updated income information each year.
  • If we determine you’re eligible for free VA health care because your household income is below our income limit, you don’t have to provide updated income information each year. 

We’ll receive your income information from the IRS and the SSA each year to confirm that you’re still eligible for free VA health care. We’ll contact you only if this information changes your eligibility or copay requirements. If you disagree with the information, you can keep using VA health care services while we review your situation.

Note: Even when not required, we encourage you to report changes in your income. It’s also important to let us know about changes to your personal information (like your address, phone number, dependents, or other health insurance). You can do this any time by using our Health Benefits Update Form (VA Form 10-10EZR).

Learn how to submit your VA Form 10-10EZR