VA HEALTH PRIORITY GROUPS
Priority Groups Table
The number of Veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up Priority Groups to make sure that certain groups of Veterans are able to be enrolled before others.
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 range from 1-8 with 1 being the highest priority for enrollment. Some Veterans may have to agree to pay copay to be placed in certain Priority Groups.
You may be eligible for more than one Enrollment Priority Group. In that case, VA will always place you in the highest Priority Group that you are eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled Veterans.VA determines your eligibility for VA’s comprehensive medical benefits package through our patient enrollment system, which is based on Priority Groups from 1 through 8.
During enrollment, each veteran is assigned to a priority group. VA uses priority groups to balance demand for VA health care enrollment with resources. Changes in available resources may reduce the number of priority groups VA can enroll. If this occurs, VA will publicize the changes and notify affected enrollees. A description of priority groups follows:
Chapter 10 Special Groups of Veterans
Federal Benefits for Veterans, Dependents and Survivors
VA's homeless programs constitute the largest integrated network of homeless assistance programs in the country, offering a wide array of services to help Veterans recover from homelessness and live as self-sufficiently and independently as possible.
The VA Health Care for Homeless Veterans (HCHV) Program provides a gateway to VA and community supportive services for eligible Veterans. Through the HCHV Program, Veterans are provided with case management and residential treatment in the community. The program also conducts outreach to homeless Veterans who are not likely to come to VA facilities on their own.
Homeless Veterans Supported Employment Program (HVSEP) provides vocational assistance, job development and placement, and ongoing employment supports designed to improve employment outcomes among homeless Veterans. HVSEP is coordinated between CWT and the continuum of Homeless Veterans Programs for the purpose of providing community-based vocational and employment services. All of the HVSEP vocational rehabilitation specialists (VRS) hired to provide employment services for the program consists of homeless, formerly homeless, or at risk of homelessness Veterans.
The National Call Center for Homeless Veterans (NCCHV) assists homeless Veterans, at-risk Veterans, their families and other interested parties with linkages to appropriate VA and community-based resources. The call center provides trained VA staff members 24 hours a day, seven days a week to assess a caller's needs and connect them to appropriate resources. The call center can be accessed by dialing 1-877-4AID VET (1-877-424-3838).
The VA's Homeless Providers Grant and Per Diem Program provides funds to non-profit community agencies providing transitional housing (up to 24 months) and/or offering services to homeless Veterans, such as case management, education, crisis intervention, counseling, and services targeted towards specialized populations including homeless women Veterans. The goal of the program is to help homeless Veterans achieve residential stability, increase their skill levels and/or income, and obtain greater self-determination.
The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) Program provides permanent housing and ongoing case management for eligible homeless Veterans who would not be able to live independently otherwise. This program allows eligible Veterans to live in Veteran-selected housing units with a "Housing Choice" voucher. These vouchers are portable to support the Veteran's choice of housing in communities served by their VA medical facility where case management services can be provided. HUD-VASH services include outreach and case management to ensure integration of services and continuity of care. This program enhances the ability of VA to serve homeless women Veterans, and homeless Veterans with families.
Through the Supportive Services for Veteran Families Program, VA aims to improve very low-income Veteran families' housing stability by providing supportive services in, or transitioning to, permanent housing. VA funds community-based organizations to provide eligible Veteran families with outreach, case management and assistance in obtaining VA and other benefits. Grantees may also provide time-limited payments to third parties (e.g., landlords, utility companies, moving companies and licensed child care providers) if these payments help Veterans' families stay in or acquire permanent housing on a sustainable basis.
In VA's Compensated Work Therapy/Transitional Residence (CWT/TR) Program, disadvantaged, at-risk, and homeless Veterans live in CWT/TR community-based supervised group homes while working for pay in VA's CWT Program, to learn new job skills, relearn successful work habits, and regain a sense of self-esteem and self-worth.
The Health Care for Re-Entry Veterans (HCRV) Program offers outreach, referrals and short-term case management assistance for incarcerated Veterans who may be at risk for homelessness upon their release.
For more information on VA homeless programs and services, Veterans currently enrolled in VA health care can speak with their VA mental health or health care provider. Other Veterans and interested parties can find a complete list of VA health care facilities at www.va.gov, or they can call VA's general information hotline at 1-800-827-1000. If assistance is needed when contacting a VA facility, ask to speak to the Health Care for Homeless Veterans Program or the Mental Health service manager. Information is also available on the VA Homeless program website at www.va.gov/homeless.
World War II era Filipino Veterans are eligible for certain VA benefits. Generally, Old Philippine Scouts are eligible for VA benefits in the same manner as U.S. Veterans. Commonwealth Army Veterans, including certain organized Filipino guerrilla forces and New Philippine Scouts residing in the United States who are citizens or lawfully admitted for permanent residence, are also eligible for VA health care in the United States on the same basis as U.S. Veterans.
Certain Commonwealth Army Veterans and new Philippine Scouts may be eligible for disability compensation and burial benefits. Other Veterans of recognized guerrilla groups also may be eligible for certain VA benefits. Survivors of World War II era Filipino Veterans may be eligible for dependency and indemnity compensation. Eligibility and the rates of benefits vary based on the recipient's citizenship and place of residence. Call 1-800-827-1000 for additional information.
VA Benefits for Veterans Living Overseas
VA monetary benefits, including disability compensation, pension, educational benefits, and burial allowances are generally payable overseas. Some programs are restricted. Home loan guaranties are available only in the United States and selected U.S. territories and possessions. Educational benefits are limited to approved, degree-granting programs in institutions of higher learning. Beneficiaries living in foreign countries should contact the nearest American embassy or consulate for help. In Canada, contact an office of Veterans Affairs Canada. For information, visit www.vba.va.gov/bln/21/Foreign/index.htm.
World War II Era Merchant Marine Seamen
Certain Merchant Marine seamen who served in World War II may qualify for Veterans benefits. When applying for medical care, seamen must present their discharge certificate from the Department of Defense. Call 1-800-827-1000 for help obtaining a certificate.
Allied Veterans Who Served During WWI or WWII
VA may provide medical care to certain Veterans of nations allied or associated with the United States during World War I or World War II if authorized and reimbursed by the foreign government. VA also may provide hospitalization, outpatient care and domiciliary care to former members of the armed forces of Czechoslovakia or Poland who fought in World War I or World War II in armed conflict against an enemy of the United States if they have been U.S. citizens for at least 10 years.
World War Service by Particular Groups
A number of groups who provided military-related service to the United States can receive VA benefits. A discharge by the Secretary of Defense is needed to qualify. Service in the following groups has been certified as active military service for benefits purposes:
What is the Affordable Care Act?
The Affordable Care Act, also known as the health care law, was created to expand access to coverage, control health care costs and improve health care quality and care coordination. The health care law does not change VA health benefits or Veterans’ out-of-pocket costs.
Three things you should know:
1 VA wants all Veterans to receive health care that improves their health and well-being.
2 If you are enrolled in VA health care, you don’t need to take additional steps to meet the health care law coverage standards. The health care law does not change VA health benefits or Veterans’ out-of-pocket costs.
3 If you are not enrolled in VA health care, you can apply at any time.
Veterans Enrolled in VA Health Care
The good news is that Veterans enrolled in VA health care programs have health coverage that meets the new health care law’s standard. You do not have to take any additional steps to have health coverage.
Veterans not currently enrolled in VA health care program can apply for enrollment at any time.
VA offers health care benefits for certain family members of Veterans through programs such as the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) and the Spina Bifida program. Read more about VA family programs…
Your family members who are not enrolled in a VA health care program should use the Marketplace to get coverage.
We understand you may have questions about the health care law and how it might affect you and your family. We compiled basic information about the health care law to help you make informed decisions about your health care. Let us know if you have questions regarding the health care law and your VA health care at 1-877-222-VETS (8387). After all, ensuring you receive quality health care is not just our obligation, it’s also our privilege.