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In October 1996,
Congress passed Public Law 104-262, the Veterans' Health Care
Eligibility Reform Act of 1996. This legislation paved the way for the
creation of a Medical Benefits Package - a standard enhanced health
benefits plan available to all enrolled veterans. Like other standard
health care plans, the Medical Benefits Package emphasizes preventive and
primary care, offering a full range of outpatient and inpatient services.
VA places a priority
on improved veteran satisfaction. Our goal is to ensure the quality of
care and service you receive is consistently excellent, in every location,
in every program. Under the Medical Benefits Package, VA offers you, the
veteran, a comprehensive health care plan that provides the care you
need.
What are the Priority Groups?
Once you apply for
enrollment, your eligibility will be verified. Based on your specific
eligibility status, you will be assigned a priority group.
The priority groups
are as follows, ranging from 1-7 with 1 being the highest priority for
enrollment. Under the Medical Benefits Package, the same services are
generally available to all enrolled veterans.
Priority Group 1
Veterans with
service-connected disabilities rated 50% or more
Priority Group 2
Veterans with
service-connected disabilities rated 30% or 40%
Priority Group 3
- Veterans who are former
POWs
- Veterans with
service-connected disabilities rated 10% or
20%
- Veterans discharged from
active duty for a disability incurred or aggravated in the line of
duty
- Veterans who received the
Purple
Heart
- Veterans awarded special
eligibility classification under 38 U.S.C., Section 1151, "benefits for
individuals disabled by treatment or vocational rehabilitation"
Priority Group 4
- Veterans who are receiving
aid and attendance or housebound
benefits
- Veterans who have been
determined by VA to be catastrophically
disabled
Priority Group 5
Nonservice-connected veterans and noncompensable
service-connected veterans rated 0% disabled, whose annual income and net
worth are below the established dollar thresholds
Priority Group 6
All other eligible
veterans who are not required to make copayments for their care, including:
- World War I and Mexican
Border War
veterans
- Veterans seeking care solely
for disorders associated with: exposure to herbicides while serving in
Vietnam; or exposure to ionizing radiation during atmospheric testing or
during the occupation of Hiroshima and Nagasaki; or for disorders
associated with service in the Gulf War; or for any illness associated
with service in combat in a war after the Gulf War or during a period of
hostility after November 11,
1998
- Compensable 0% service-connected veterans
Priority Group 7
Nonservice-connected
veterans and noncompensable 0% service-connected veterans with
income and net worth above the established dollar thresholds and who agree
to pay specified copayments
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