Things to Know about the VA: You may be entitled to additional health care.
composed by Zoe Stein
So you or someone you know actively served in the military. Firstly, you’ve earned our gratitude,
respect, and sincere appreciation. Secondly, if you are separated under any condition other than
dishonorable, you may qualify for Health Care benefits through the VA.
What does that mean?
The Veterans Health Administration is home to the United States’ largest integrated health care system
– serving more than 8 million veterans each year. If you’re eligible, enrollment in the VA health
care system offers many options, essentially providing free or reduced-rate health care, prescriptions,
and items like glasses, hearing aids, and contacts.
Why would I want it?
VA health benefits can include hospital, outpatient medical, dental, pharmacy, and prosthetic services.
There are health and rehabilitation programs for homeless veterans, readjustment counseling,
medical evaluations for disorders associated with military service in the Gulf War, and treatment for
exposure to Agent Orange, radiation, and other environmental hazards, as well as other services.
Aside from quality medical care, if you are enrolled in VA health care, you don’t need to take
additional steps to meet the health care law coverage standards. And you can apply for VA
health care enrollment at any time. There are no enrollment fees, no monthly premiums, and
no deductibles. Many veterans pay nothing out-of-pocket, although some may have to pay
small copays. You are free to use other plans with your VA health care, including Medicare,
Medicaid, TRICARE, or private insurance.
How do I know if I qualify?
An easy way to determine your eligibility is through the VA’s Health Benefits Eligibility Explorer
at http://hbexplorer.vacloud.us/. The site asks about fifteen questions and requests some
basic financial estimates – income, deductible expenses – in order to determine whether you’re
eligible. What you’re eligible for – like whether or what you pay for what services – and how
quickly you’re enrolled is further determined by specific eligibility questions and your level of priority.
Level of Priority? What does that mean?
The number of veterans who can be enrolled in the health care program is determined by the
amount of money Congress gives the VA each year. Since funds are limited, the VA uses what they
call Priority Groups to make sure certain groups of veterans are able to be enrolled before others.
After applying for enrollment, your eligibility is determined based on your specific information, and you
are assigned a Priority Group based on that specific eligibility. The Priority Groups run 1-8, with 1 being
the highest priority for enrollment. An example of level 1 priority would be a veteran determined (by the VA)
to be unemployable due to service-related conditions, or a veteran with VA-rated service-connected
disabilities 50% or more disabling.
An example of level 8 priority would be a veteran with a gross household
income above the VA income limit and above the geographically adjusted income limit for the place in
which they live (who agrees to pay copays). The other levels fall somewhere in between, and can be
found in their entirety in the Priority Groups section of the Health Benefits Overview at http://www.va.gov/healthbenefits/resources/epublications.asp
Factors that impact your Priority Group can include income, service-connected disabilities and the level
of disability, military honors or recognition (like the Purple Heart or Medal of Honor), former POW status,
the receiving of or eligibility for other VA benefits or Medicaid, and specific service dates or combat-related
criteria. It’s important to note that income above VA income limits does not disqualify you, you may just be
asked to pay small copays or – without other priority-granting factors – placed in a group of lower priority.
How do I apply for enrollment?
There are four ways:
Online: At https://www.1010ez.med.va.gov/ veterans fill out an online application
and submit it to the VA for processing. You don’t have to submit any additional
documents to verify your military service – the VA finds those electronically and
will call you if they can’t find your records. Realistically, however, they will call you –
so if you have service records or discharge papers handy, it may help to submit them.
By mail: Using the same website, print and complete the application form and mail it to:
Health Eligibility Center
Enrollment Eligibility Division
2957 Clairmont Road Suite 200
Atlanta, GA 30329-1647
By Phone: If you want to complete the application over the phone or have a paper copy mailed to you,
call 1-877-222-VETS (8387) Monday-Friday between 8am-8pm Eastern Time.
In Person: You can also apply in person at any VA health care facility.
You can also call The Cameron Group for any assistance you may need – or with questions you can’t answer alone.
We’re here Monday through Friday from 8am-5pm Eastern Time, and would love to hear from you! (407) 896-2010
For the comprehensive overview of VA Health Care Benefits, see the Health Care Benefits Overview at the VA’s website: http://www.va.gov/healthbenefits/resources/epublications.asp