VA Health Care

VA Health Care.

  Who is eligible?

 A person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable.

 Reservists and National Guard members may also qualify for VA health care benefits if they were called to active duty (other than for training only) by a Federal order and completed the full period for which they were called or ordered to active duty.

 If you enlisted before September 7, 1980 or entered active duty after October 16, 1981 you have to have served for at least 24 continuous months, or the full period for which you were called to active duty.  This may be waived if you got out early for hardship or medical discharges.

 To enroll in healthcare, go here and fill out the form.  You’ll have to print and mail it to your local VA Medical Center or Clinic, which you can find here.

 There are groups that you will be placed in, based on several factors.  These are called “Priority Groups” and are basically how the VA divides up healthcare resources:

Group 1: Veterans with service-connected disabilities rated 50 percent or more and/or veterans determined by VA to be unemployable due to service-connected conditions.

 Group 2: Veterans with service-connected disabilities rated 30 or 40 percent.

 Group 3: Veterans with service-connected disabilities rated 10 and 20 percent; veterans who are former Prisoners of War (POW) or were awarded a Purple Heart medal; veterans awarded special eligibility for disabilities incurred in treatment or participation in a VA Vocational Rehabilitation program; and veterans whose discharge was for a disability incurred or aggravated in the line of duty.

 Group 4: Veterans receiving aid and attendance or housebound benefits and/or veterans determined by VA to be catastrophically disabled.

 Group 5: Veterans receiving VA pension benefits or eligible for Medicaid programs, and non service-connected veterans and non-compensable, zero percent service-connected veterans whose gross annual household income and/or net worth are below the VA national income threshold and geographically-adjusted income threshold for their resident area.

 Group 6: Veterans of World War I; veterans seeking care solely for certain conditions associated with exposure to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki; for any illness associated with participation in tests conducted by the Department of Defense (DoD) as part of Project 112/Project SHAD; veterans with zero percent service-connected disabilities who are receiving disability compensation benefits and veterans who served in a theater of combat operations after Nov. 11, 1998 as follows:

 Veterans discharged from active duty on or after Jan. 28, 2003, who were enrolled as of Jan. 28, 2008 and veterans who apply for enrollment after Jan. 28, 2008, for 5 years post discharge

Veterans discharged from active duty before Jan. 28, 2003, who apply for enrollment after Jan. 28, 2008, until Jan. 27, 2011

Group 7: Veterans with gross household income below the geographically-adjusted income threshold (GMT) for their resident location and who agree to pay copays.

 Group 8: Veterans with gross household income and/or net worth above the VA national income threshold and the geographic income threshold who agree to pay copays.

 BE AWARE, CERTAIN CLASSES OF VETERANS MAY BE REQUIRED TO PAY CO-PAYS.

 You can receive enhanced status if you served in a combat thearter.

 The following link will take you to the VA’s booklet on Health Benefits.

 Here are the VA’s covered services under the Standard Care Package for enrolled veterans:

 Medical Benefits Package (Standard Benefits)

VA’s medical benefits package provides the following health care services to all enrolled veterans.

 Preventive Care Services

Immunizations

Physical Examinations

Health Care Assessments

Screening Tests

Health Education Programs

Ambulatory (Outpatient) Diagnostic and Treatment Services

Emergency outpatient care in VA facilities

Medical

Surgical (including reconstructive/plastic surgery as a result of disease or trauma)

Chiropractic Care

Mental Health

Bereavement Counseling

Substance Abuse

Hospital (Inpatient) Diagnostic and Treatment

Emergency inpatient care in VA facilities

Medical

Surgical (including reconstructive/plastic surgery as a result of disease or trauma)

Mental Health

Substance Abuse

Medications and Supplies

Prescription medications

Over-the counter medications

Medical and surgical supplies

Generally, they must be prescribed by a VA provider and be available under VA’s national formulary system

 Will VA pay for medications written by a non-VA physician?

Generally only veterans with special eligibility, such as veterans receiving Aid and Attendance or Housebound benefits, or who are approved by a VA health care facility for Fee Basis are eligible to receive medications at VA expense.

Special and Limited Benefits

Some health care benefits are offered only to certain veterans or to veterans under special situations. Click on the link below to learn more about each benefit.

       Agent Orange Exposure Treatment and Registry Examination

       Automobile Assistance

       Beneficiary Travel (Including Ambulance)

       Bereavement Counseling

       Blind Veterans Services

       CHAMPVA

       Combat Veteran Eligibility

       Dental Care

       Domiciliary Care

       Emergency Care in Non-VA Facilities

       Eyeglasses

       Foreign Medical Program

       Geriatrics and Long Term Care

       Gulf War Illness

       Hearing Aids

       Home Health Care

       Home Improvement and Structural Alterations

       Homeless Programs

       Hospice and Palliative Care

       Ionizing Radiation Exposure Treatment and Registry Examination

       Long Term Care

       Maternity Care

       Military Sexual Trauma Counseling

       Non-VA Health Care Services (Fee Basis Program)

       Nose or Throat Radium Treatment

       Nursing Home Care

       Project 112/SHAD Participants

       Prosthetic (Medical Equipment and Sensory Aids)

       Readjustment Counseling

       Women Veterans Services

General Exclusions

VA cannot provide the following services or benefits:

       Abortions and abortion counseling

       Cosmetic surgery except where determined by VA to be medically necessary for reconstructive or psychiatric care

       Drugs, biologicals, and medical devices not approved by the FDA unless the treating medical facility is conducting formal clinical trials under an Investigational Device Exemption (IDE) or an Investigational New Drug (IND) application, or the drugs, biologicals, or medical devices are prescribed under a compassionate use exemption.

       Gender alteration

       Health club or spa membership

       In vitro fertilization

       Services not ordered and provided by licensed/accredited professional staff

       Special private duty nursing

       Hospital and outpatient care for a veteran who is either a patient or inmate in an institution of another government agency if that agency has a duty to give the care or services.

Additionally, VA cannot provide certain benefits to veterans and dependents identified as fugitive felons.

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