VA Health Care Enrollment and Eligibility
Quickly Find Out If You May Be Eligible For Enrollment
Use the online VA Health Benefits Explorer at hbexplorer.vacloud.us to answer a few questions about yourself (you will be asked no more than 15 questions) and learn about the VA health care benefits you could receive as an enrolled Veteran. Afterwards, you will be given an opportunity to apply for enrollment.
If you wish, you may skip the Explorer and simply apply for enrollment using one of the options below.
Easy Ways to Apply for Enrollment
Veterans can complete applications for enrollment in VA health care by telephone. To apply, call 1-877-222-VETS (8387) Monday through Friday between 8 a.m. and 8 p.m. ET. VA staff members will collect the needed information and process the application for an enrollment determination.
Veterans can fill out the application online at Vets.gov,and electronically submit it to VA for processing. VA will search for your supporting documentation through its electronic information systems and contact you if it is unable to verify your military service. For help filling out the application, call 1-877-222-VETS (8387) Monday through Friday between 8 a.m. and 8 p.m. ET.
The application form can be downloaded from www.vets.gov/healthcare/apply/. Mail the completed and signed form to:
Health Eligibility Center
Enrollment Eligibility Division
2957 Clairmont Road Suite 200
Atlanta, GA 30329-1647
You may also apply in person at any VA health care facility.
You Select Where You Want to Receive Your Care
As part of the enrollment process, Veterans will be given the opportunity to select the VA Medical Center (VAMC) or Community Based Outpatient Clinic (CBOC) where they prefer to been seen. To find a facility near you, visit VA’s directory at www.va.gov/directory.
VA Veterans Choice Program
Enrolled Veterans can receive care by a community health care provider closer to home rather than wait for a VA appointment or travel a long distance to a VA facility. The Veterans Choice Program temporarily authorizes enrolled Veterans to receive health care from community providers. Any of the following conditions must apply:
- Veteran told by his or her local VA medical facility that they will not be able to schedule an appointment for care within 30 days of the date the Veteran’s physician determines he/she needs to be seen or within 30 days of the date the Veteran wishes to be seen if there is no specific date from his or her physician;
- Veteran lives more than 40 miles driving distance from the closest VA medical facility with a full- time primary care physician;
- Veteran needs to travel by air, boat or ferry to the VA medical facility closest to his/her home;
- Veteran faces an unusual or excessive burden in traveling to the closest VA medical facility based on geographic challenges, environmental factors, a medical condition, the nature or simplicity or frequency of the care needed and whether an attendant is needed. Staff at the Veteran’s local VA medical facility will work with him/her to determine if the Veteran is eligible for any of these reasons; or
- Veteran lives in a state or territory without a full-service VA medical facility. These locations include Alaska, Hawaii, New Hampshire (excluding New Hampshire Veterans who live within 20 miles of the White River Junction VAMC) and the United States territories (excluding Puerto Rico, which has a full service VA medical facility).
Community care is only covered by VA for medical needs that have been approved by a VA physician. Veterans who choose to use their Choice Card should coordinate pre-approved care by calling 1-866-606-8198. For more information, visit www.va.gov/opa/choiceact/.
Enrollment Priority Groups - What are they and how do they work?
VA administers its medical benefits through an annual patient enrollment system. The enrollment system is based on Priority Groups (PG) to ensure health care benefits are readily available to all enrolled Veterans. Complementing the expansion of benefits and improved access is our ongoing commitment to providing the very best in quality health care service to our patients when it is needed during that enrollment period, regardless of the treatment program or the location.
Priority Group 1
- Veterans with service-connected disabilities rated by VA as 50% or more disabling.
- Veterans determined by VA to be unemployable due to service-connected conditions.
- Veterans who have been awarded the Medal of Honor (MOH).
Priority Group 2
- Veterans with service-connected disabilities rated by VA as 30% or 40% disabling.
Priority Group 3
- Veterans who are former Prisoners of War (POWs).
- Veterans who have been awarded a Purple Heart medal.
- Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty.
- Veterans with service-connected disabilities rated by VA as 10% or 20% disabling.
- Veterans who have been awarded special eligibility classification under Title 38, U.S.C., § 1151, "benefits for individuals disabled by treatment or vocational rehabilitation."
Priority Group 4
- Veterans who receive aid and attendance or housebound benefits from VA.
- Veterans who have been determined by VA to be catastrophically disabled.
Priority Group 5
- Veterans with a nonservice-connected or non-compensable service-connected disability and Veterans rated by VA as 0% disabled and who have an annual income below the VA’s geographically-adjusted income limit (based on your resident ZIP code).
- Veterans receiving VA pension benefits.
- Veterans eligible for Medicaid programs.
Priority Group 6
- Veterans with a compensable 0% service-connected disability.
- Veterans exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki.
- Project 112/SHAD participants.
- Veterans of the Mexican border period or of World War I
- Veterans who served in the Republic of Vietnam between January 9, 1962, and May 7, 1975.
- Veterans of the Persian Gulf War who served between August 2, 1990, and November 11, 1998.
- Veterans who served on active duty at Camp Lejeune for at least 30 days between August 1, 1953, and December 31, 1987.
- Currently enrolled Veterans and new enrollees who served in a theater of combat operations after November 11, 1998, and those who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits for five years post discharge
Note: At the end of this enhanced enrollment priority group placement time period, Veterans will be assigned to the highest PG for which their status at that time qualifies.
Priority Group 7
- Veterans with gross household income below the geographically-adjusted VA income limit for their resident location and who agree to pay copayments.
Priority Group 8
- Veterans with gross household incomes above the VA income limits and the geographically- adjusted income limits for their resident location, and who agree to pay copayments.
Veterans eligible for enrollment: Veterans who are rated with a noncompensable 0% service-connected and are:
- Subpriority a: enrolled as of January 16, 2003, and who have remained enrolled since that date and/or were placed in this subpriority due to changed eligibility status.
- Subpriority b: enrolled on or after June 15, 2009, and whose income exceeds the current VA income limits or the geographically-adjusted VA income limits by 10% or less.
Veterans eligible for enrollment:Veterans who are nonservice-connected and:
- Subpriority c: enrolled as of January 16, 2003, and who have remained enrolled since that date and/or were placed in this subpriority due to changed eligibility status.
- Subpriority d: enrolled on or after June 15, 2009, and whose income exceeds the current VA income limit and geographic income limit by 10% or less.
Veterans not eligible for enrollment: Veterans not meeting the criteria above:
- Subpriority e: noncompensable 0% service-connected (eligible for care of their service-connected condition only).
- Subpriority g: nonservice-connected.