It may surprise some people that not all military veterans get their health care from Veterans Affairs. Some veterans may not even know that they are eligible for health care from VA.
It may also be a surprise to some people that VA health care is not automatic; veterans must enroll in the system to get care. What should not be surprising, though, is that the benefit is real and worth enrolling in.
“Veterans have earned the world-class health care available to them from VA. We want all who have served to enroll and take advantage of it,” said Dr. Staci Williams, executive director of the VA Illiana Health Care System.
Veterans who apply for the VA health care benefits will be assigned to a priority group. The VA enrollment system is based on priority groups to ensure health care benefits are readily available to all enrolled eligible veterans and to help ensure that they can get the highest quality care as quickly as possible. The priority groups are assigned based on criteria such as level of service-connected disability rating, military service record, and income levels. These priority groups have no impact on the nature, timeliness, or quality of service veterans receive. Veterans in some priority groups are required to pay a co-pay for services. The priority groups identify those veterans who have co-pay requirements and how much the co-payment will be.
The purpose of VA health care is to treat illnesses and injuries incurred or made worse while in the military, prevent future health problems, improve ability to function, and enhance the overall quality of life for veterans. Because every veteran has different health, military service, and income circumstances, each veteran’s health care benefits package is unique to meet their health needs. That is the purpose of the priority groups; to ensure each veteran has access to the care that they need.
“The application and screening process is not to give some veterans the benefit of health care and deny it to others. It is designed so veterans can get the fastest access to care based on their level of service-connected disability and their ability to get access to health care outside of VA,” said Verna Caho, eligibility clerk at the Bob Michel VA clinic in Peoria. “We just want all veterans to know about and have the quality of life that comes from good health.”
There are eight priority groups that veterans are assigned to when enrolled in VA health care. Veterans assigned to the highest priority group are those with a VA disability rating of 50% or more or have any level service-connected disability that makes them unable to work. Veterans who have received the Medal of Honor are also in the highest priority group. Veterans with a service-connected disability rating of 30% or 40% are assigned to the next priority group. Veterans with service-connected disability ratings of less than 30%, including veterans with disabilities rated at 0%, are assigned to lower priority groups. There is also a priority group for veterans who served during specific times and locations, such as in Vietnam between 1962 and 1975 or at Camp Lejeune between 1953 and 1987.
Veterans who have no service-connected disabilities or meet any other criteria can also enroll in VA health care. Those veterans are assigned to priority groups seven or eight based on income thresholds and are required to pay copays for health care.
“The Veterans Health Administration serves veterans and their service-connected health care needs. Those needs vary with each veteran and the priority groups allow VA to get the care to those veterans who have the greatest need in the most timely way possible,” said Caho.
All veterans are encouraged to enroll in the VA health care system, even if they have no service-connected disabilities or have higher incomes. Life circumstances can change which can move a veteran from one priority group to a higher group. For example, veterans with no service-connected disabilities at the time of discharge could develop conditions later in life that could be traced to military service.
Also, job circumstances can change leading to a reduction in income or loss of health insurance for a veteran. Being enrolled in VA health care makes these life changes easier to manage for veterans when they need the health care that VA provides. Veterans can move to higher priority groups as life circumstances change.
“We’ve seen throughout the pandemic that many people have lost their jobs. This impacts their income and health insurance,” said Caho. “Veterans should not have to worry about their health care if these events happen to them. Get enrolled in the Veterans Health Administration even if you think you are not eligible or if you may be in a lower priority group. You never know when you may need it and you will be moved to a higher group.”
Veterans Affairs is the nation’s largest health care system delivering care to more than nine million veterans with more than 367,000 full-time health care professionals and support staff at more than 1,200 health care facilities. Visit www.va.gov for more information and to enroll.