HomeVeterans Guide to VA HealthcareWho's Eligible for VA Healthcare?Enrollment Priority Groups

1.2. Enrollment Priority Groups

Each year, Congress allocates a certain amount of money for VA health care.  Based upon the amount of money, the Secretary of the Department of Veterans Affairs determines the number of veterans who can be enrolled in VA's health care programs.  Enrollment priority groups have been established so that the Secretary can exclude veterans in certain priority groups if inadequate funds are provided by Congress to serve all veterans.

When you enroll for health care, you will be assigned to a priority group.  If you qualify under multiple priority groups based on different criteria, you will be assigned to the highest priority group for which you are eligible.

Priority groups range from 1 (highest eligibility) to 8 (lowest eligibility) and take into consideration any service-connected disabilities, military awards, 1151 benefits, catastrophic disabilities, geographic means tests and other factors.  It is probably easiest to determine your priority group by referencing the table below.

Priority Group Who Qualifies

1

  • Veterans with a VA service-connected rating of 50% or more.
  • Veterans assigned a total disability rating for compensation based on unemployability (TDIU or IU)

2

  • Veterans with a VA service-connected rating of 30% or 40%.

3

  • Veterans who are former prisoners of war (POWs).
  • Veterans who were awarded a Purple Heart.
  • Veterans who were awarded the Medal of Honor.
  • Veterans whose discharge was for a disability incurred or aggravated in the line of duty.
  • Veterans with a VA service-connected rating of 10% or 20%.
  • Veterans awarded special eligibility classification under 38 USC 1151, "benefits for individuals disabled by VA treatment or vocational rehabilitation."

4

  • Veterans receiving increased compensation or pension based upon their need for regular Aid and Attendance or by reason of being permanently housebound.
  • Veterans determined by VA to be catastrophically disabled.  (See related Catastrophically Disabled Veterans page below.)

5

  • Nonservice-connected veterans and noncompensable service-connected veterans rated 0%, whose annual income and/or net worth are not greater than the VA financial thresholds.
  • Veterans receiving VA pension benefits.
  • Veterans eligible for Medicaid benefits.

6

  • Compensable service-connected veterans rated 0%.
  • Veterans exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima or Nagasaki.
  • Project 112/SHAD participants.
  • Veterans who served in the Republic of Vietnam between January 9, 1962 and May 7, 1975.
  • Veterans who served in Southwest Asia theater of operations from August 2, 1990, through November 11, 1998.
  • Veterans who served in a theater of combat operations after November 11, 1998, as follows:
    • Veterans discharged from active duty on or after January 28, 2003, for five years post-discharge.  (See related Combat Veterans page below.)

7

  • Veterans with incomes below the geographic means test (GMT) threshold and who agree to pay the applicable copayments.

8

  • Veterans with gross household incomes above the VA national income threshold and the geographically-adjusted income threshold for their resident location and who agrees to pay copays.  If you are in priority group 8, see sub-priority group table below.

 

Priority group 8, Sub-priority groups

Sub-Priority Groups

Which Priority Group 8 veterans qualify

8a

Veterans who are noncompensable 0% service-connected and who were enrolled for VA healthcare as of January 16, 2003, and who have remained enrolled since that date and/ or placed in this subpriority due to changed eligibility status.

8b

Veterans who are noncompensable 0% service-connected and who enrolled for VA health care on or after June 15, 2009 and whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less.

8c

Veterans who are nonservice-connected and who enrolled for VA health care as January 16, 2003, and who remained enrolled since that date and/ or placed in this subpriority due to changed eligibility status

8d

Veterans who are nonservice-connected and who enrolled for VA health care on or after June 15, 2009 and whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less

8e

Veterans not meeting the criteria above and who are noncompensable 0% service connected.

8f

Veterans not meeting the criteria above and who are nonservice-connected.

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