Congress passed the Veteran's Health Care Eligibility Reform Act in 1996. This law made health benefits available to almost all veterans. The health program encourages preventative care and provides for outpatient and inpatient services. The law simplified the process by which veterans can receive services.
Eligibility under the Act
All veterans are potentially eligible. Eligibility for most veterans' health care benefits is based on active military service in the Army, Navy, Air Force, Marines, or Coast Guard (or Merchant Marines during WW II), and discharged under other than dishonorable conditions.
Reservists and National Guard members who were called to active duty by a Federal Executive Order may qualify for VA health care benefits. Returning service members, including Reservists and National Guard members who served on active duty in a theater of combat operations have special eligibility for hospital care, medical services and nursing home care for five years following discharge from active duty.
Health care eligibility isn't just for those who served in combat. Other groups may be eligible for some health benefits. Also, veteran's health care is not just for service-connected injuries or medical conditions. Veteran's health care facilities are for men and women.
Apply for VA Health Benefits
You can apply for benefits by completing VA Form 10-10EZ. The VA will let you know what benefits you qualify for. Once you apply for enrollment, your eligibility will be verified. Based on your status, you'll be assigned a priority group. The priority groups range from 1 to 8, with 1 being the highest.
Annual Enrollment System
There is an annual enrollment system that monitors eligibility for benefits. The VA applies many factors in determining whether veterans are eligible for enrollment. However, once a veteran is enrolled, that veteran remains enrolled in the system. All enrolled veterans are able to use their benefits at any VA hospital or VA health care facility.
Veterans who receive free or reduced medical care are required to update their financial information on an annual basis or when their income changes. You will be notified in writing of any change to your enrollment status.
Funding the Program
Congress appropriates funds each year for the VA to provide health care services. There is no guarantee that Congress will appropriate sufficient funds for VA to provide care for all veterans. Since demand is often greater than supply, veterans assigned to lower priorities may not receive care.
Questions for Your Attorney
- How frequently are the income thresholds updated?
- How do I object to the priority group that I was assigned to?
- What income is counted in determining whether I can get free care?