Basic Eligibility

If you served in the active military service and were separated under any condition other than dishonorable, you may qualify for VA health care benefits. Current and former members of the Reserves or National Guard who were called to active duty by a federal order and completed the full period for which they were called or ordered to active duty may be eligible for VA health benefits as well.

Enhanced Eligibility

Certain Veterans may be afforded enhanced eligibility status when applying and enrolling in the VA health care system. Veterans who:

  • Are a Former Prisoner of War (POW)
  • In receipt of the Purple Heart Medal.
  • In receipt of the Medal of Honor.
  • Have a compensable VA awarded service-connected disability of 10% or more.
  • In receipt of a VA Pension.
  • Were discharged from the military because of a disability (not preexisting), early out, or hardship.
  • Served in a Theater of Operations for 5 years post discharge.
  • Served in the Republic of Vietnam from January 9, 1962 to May 7, 1975.
    U.S. Navy and Coast Guard ships associated with military service in Vietnam
  • Served in the Persian Gulf from August 2, 1990 to November 11, 1998.
  • Were stationed or resided at Camp Lejeune for 30 days or more between August 1, 1953 and December 31, 1987.
  • Are found by VA to be Catastrophically Disabled.
  • Previous years’ household income is below VA’s National Income or Geographical-Adjusted Thresholds

Veterans with VA-rated service-connected disabilities 50% or more disabling and/or

Veterans determined by VA to be unemployable due to service-connected conditions

Veterans with VA-rated service-connected disabilities 30% or 40% disabling

Veterans who are Former Prisoners of War (POWs)

Veterans awarded a Purple Heart medal

Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty

Veterans with VA-rated service-connected disabilities 10% or 20% disabling

Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”

Veterans awarded the Medal Of Honor (MOH)

  • Veterans who are receiving aid and attendance or housebound benefits from VA
  • Veterans who have been determined by VA to be catastrophically disabled
  • Nonservice-connected Veterans and non-compensable service-connected Veterans rated 0% disabled by VA with annual income below the VA’s and geographically (based on your resident zip code) adjusted income limits
  • Veterans receiving VA pension benefits
  • Veterans eligible for Medicaid programs
  • Compensable 0% service-connected Veterans
  • Veterans exposed to Ionizing Radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki
  • Project 112/SHAD participants
  • 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.

Veterans with gross household income below the geographically-adjusted income limits (GMT) for their resident location and who agree to pay copays

  • Veterans with gross household income above the VA and the geographically-adjusted income limits for their resident location and who agrees to pay copays

 

Veterans eligible for enrollment:

Noncompensable 0% service-connected:

  • Subpriority a:  Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub priority due to changed eligibility status
  • Subpriority b:  Enrolled on or after June 15, 2009 whose income exceeds the current VA or geographic income limits by 10% or less

Nonservice-connected and:

  • Subpriority c:  Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub priority due to changed eligibility status
  • Subpriority d:  Enrolled on or after June 15, 2009, whose income exceeds the current VA or geographic income limits 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 SC condition only)
  • Subpriority g: Nonservice-connected