HomeVA ProstheticsVA Handbook 1173.1 - Prosthetics EligibilityEligibility

1.2. Eligibility

a. General. The Veterans' Health Care Eligibility Reform Act of 1996, Public Law 104- 262, significantly changed the eligibility of veterans to receive hospital care and outpatient medical services, including prosthetics, medical equipment, and supplies. For complete details on eligibility rules and the Department of Veterans Affairs (VA) enrollment system, reference should be made to the regulations governing VA's enrollment system and medical benefits package. They are published in Title 38 Code of Federal Regulations (CFR) Sections 17.36-17.38. Generally all veterans enrolled in the VA health care system are eligible for all needed prosthetics, medical equipment, and supplies. Certain veterans are eligible for needed prosthetics, medical equipment, and supplies even though not enrolled. The two most significant groups of veterans who do not need to be enrolled are:

(1) Veterans needing prosthetics, medical equipment, and supplies for a service connected disability, and

(2) veterans with a service connected disability rated at least 50 percent.

b. Special Eligibility for Children with Spina Bifida. VA provides needed health care benefits, including prosthetics, medical equipment, and supplies to certain children of Vietnam veteran, i.e., children who are suffering from spina bifida or a disability associated with such condition. For complete details on eligibility rules for such benefits, reference should be made to 38 CFR Sections 17.900-17.905.

c. Special Eligibility for Veterans Participating in Vocational Rehabilitation. Veterans participating in VA's vocational rehabilitation program may receive VA health care benefits including prosthetics, medical equipment, and supplies. For complete details on eligibility rules for such benefits, reference should be made to 38 CFR Section 17.47(j).

d. Limitations on Benefits Available to Veterans Outside the United States (U.S.). Veterans outside the U.S. are eligible for prosthetics, medical equipment, and supplies only for a service connected disability, except as otherwise provided in Title 38 United States Code (U.S.C.) Section 1724.







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