VA Health Care: Who Can Get It and How to Apply — In Plain Words

What this page is about

VA is the U.S. Department of Veterans Affairs.

VA health care is health care through VA.

VA health care is separate from Medicare.

The basic rule

VA says you may be eligible for VA health care benefits if you served in the active military, naval, or air service and didn’t receive a dishonorable discharge.

VA decides on your application.

This page does not say that any one reader qualifies.

The minimum duty requirement

This part is for people who enlisted after September 7, 1980, or entered active duty after October 16, 1981.

VA says you must have served 24 continuous months or the full period for which you were called to active duty.

VA says this minimum duty requirement may not apply if any of these are true:

• You were discharged for a disability that was caused—or made worse—by your active-duty service, or
• You were discharged for a hardship or “early out,” or
• You served prior to September 7, 1980.

Reserves and National Guard

VA says you must have been called to active duty by a federal order.

VA says you must have completed the full period for which you were called or ordered to active duty.

VA says if you had or have active-duty status for training purposes only, you don’t qualify for VA health care.

Expanded eligibility for exposure to toxins and other hazards

VA says it has expanded VA health care to millions of Veterans.

VA says all Veterans who meet the basic service and discharge requirements and who were exposed to toxins and other hazards while serving our country—at home or abroad—are now eligible for VA health care.

VA says this includes all Veterans who served in the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11.

VA also says you’re eligible for VA health care if you served in certain locations and time periods during the Vietnam War era.

VA lists those locations in the enhanced eligibility section below.

Enhanced eligibility

VA says you may qualify for enhanced eligibility status if you meet the minimum active-duty service and discharge requirements and at least one of the descriptions in this section is true for you.

VA says enhanced eligibility means that VA will place you in a higher priority group.

VA says this makes you more likely to get benefits.

VA says at least one of these must be true:

• You receive financial compensation (payments) from VA for a service-connected disability.
• You were discharged for a disability resulting from something that happened to you in the line of duty.
• You were discharged for a disability that got worse in the line of duty.
• You’re a combat Veteran discharged or released on or after September 11, 2001.
• You get a VA pension.
• You’re a former prisoner of war (POW).
• You have received a Purple Heart.
• You have received a Medal of Honor.
• You get (or qualify for) Medicaid benefits.
• You were exposed to toxins or hazards by working with chemicals, pesticides, lead, asbestos, certain paints, nuclear weapons, X-rays, or other toxins. VA says this exposure could have happened while training or serving on active duty, even if you were never deployed.
• You served in Southwest Asia during the Gulf War between August 2, 1990, and November 11, 1998.
• You served at least 30 days at Camp Lejeune between August 1, 1953, and December 31, 1987.

VA says you must also have served in one of these locations during the Vietnam War era, as an added way to meet this list:

• Any U.S. or Royal Thai military base in Thailand from January 9, 1962, through June 30, 1976
• Laos from December 1, 1965, through September 30, 1969
• Cambodia at Mimot or Krek, Kampong Cham Province from April 16, 1969, through April 30, 1969
• Guam or American Samoa or in the territorial waters off Guam or American Samoa from January 9, 1962, through July 31, 1980
• Johnston Atoll or on a ship that called at Johnston Atoll from January 1, 1972, through September 30, 1977
• Republic of Vietnam from January 9, 1962 through May 7, 1975

If none of those descriptions apply to you

VA says if none of these descriptions apply to you, you may still qualify for health care based on your income.

What if you got an other than honorable, bad conduct, or dishonorable discharge?

VA says if you’ve received one of these discharge statuses, you may not be eligible for VA benefits.

VA says there are 2 ways you can try to qualify:

• Apply for a discharge upgrade.
• Ask for a VA Character of Discharge review.

Priority groups 1 to 8

VA says when you apply for VA health care, you’ll be assigned 1 of 8 priority groups.

VA says this system helps to make sure that Veterans who need immediate care can get signed up quickly.

VA says it will base your priority group on:

• Your military service history, and
• Your disability rating, and
• Your income level, and
• Whether or not you qualify for Medicaid, and
• Other benefits you may be receiving (like VA pension benefits).

VA says it assigns Veterans with service-connected disabilities the highest priority.

VA says it assigns the lowest priority to Veterans who earn a higher income and who don’t have any service-connected disabilities qualifying them for disability compensation (monthly payments).

VA says if you qualify for more than one priority group, VA will assign you to the highest one.

VA says your priority group may affect how soon VA signs you up for health care benefits.

VA says it may also affect how much (if anything) you’ll have to pay toward the cost of your care.

This page prints no group-by-group cost detail.

VA assigns your group when VA decides on your application.

What enrollment includes

VA says with VA health care, you’re covered for regular checkups with your primary care provider and appointments with specialists (like cardiologists, gynecologists, and mental health providers).

VA says you can access services like home health and geriatric (elder) care.

VA says you can get medical equipment, prosthetics, and prescriptions.

This section comes only from the VA.gov health care home page named in the Sources box.

How to apply for VA health care

The routes in this section and the next section come from VA’s “How to apply for VA health care” page, named in the Sources box.

VA lists these ways to apply:

• Online. VA lists applying online as a way to apply for VA health care benefits.
• By phone. Call VA’s toll-free hotline at 877-222-8387 to get help with your application. VA says: We’re here Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.
• By mail. Fill out an Application for Health Benefits (VA Form 10-10EZ). Send your completed application here: Health Eligibility Center, PO Box 5207, Janesville, WI 53547-5207.
• In person. Fill out an Application for Health Benefits (VA Form 10-10EZ). Go to your nearest VA medical center or clinic. Bring a signed Application for Health Benefits (VA Form 10-10EZ) with you.

For the mail and in-person routes, VA says you or someone acting as your power of attorney must sign and date the form.

VA says if you’re using a power of attorney, you’ll need to submit a copy of the Power of Attorney form along with your application.

VA says if you sign with an “X,” 2 people you know must witness your signature. They’ll also need to sign and print their names on the form.

VA also lists one more way to get help applying:

• With the help of a trained professional. VA says you can work with an accredited attorney, claims agent, or Veterans Service Organization (VSO) representative to get help applying for health care benefits.

VA also says, on its eligibility page, that you can get help from an accredited representative (a trained professional trusted to help with VA-related claims).

What information you will need

VA says gather the information listed here that you’ll need to fill out an Application for Health Benefits (VA Form 10-10EZ).

VA says you’ll need this information:

• Social Security numbers for you, your spouse, and your qualified dependents.
• Your military discharge papers (DD214 or other separation documents), military service history information, and details about exposure to any toxins or other hazards.
• Insurance card information for all insurance companies that cover you, including any coverage provided through a spouse or significant other. VA says this includes Medicare, private insurance, or insurance from your employer.
• Gross household income from the previous calendar year for you, your spouse, and your dependents. VA says this includes income from a job and any other sources. VA says gross household income is your income before taxes and any other deductions.
• Your deductible expenses for the past year. VA says these include certain health care and education costs.

VA gives this note: You don’t have to tell us about your income and expenses when you apply. But if you’re not eligible based on other factors, we’ll need this information to decide on your application.

How long does it take VA to make a decision?

VA says: Less than 1 week.

VA says if more than a week has passed since you gave VA your application and you haven’t heard back, please don’t apply again.

VA says call the toll-free hotline at 877-222-8387.

VA says: We’re here Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

This page is general information only. It is not legal advice and it is not medical advice.