Veterans Benefits and Medicare

If you’re a veteran with active-duty service in any branch of the United States Armed Forces, you may qualify for United States Dept. of Veterans Affairs (VA) health benefits.

Eligibility for VA benefits extends to qualifying veterans of the military reserves and National Guardsmen who were called to active duty.

Regardless of which branch of the military you served in, you must have received an honorable discharge or an honorable release from duty in order to qualify for VA health benefits.

Eligibility for Veterans Affairs benefits is also based on:

    • Length of service
    • Service-related injuries
    • Income level
    • Available VA resources

Based on where you stand in relation to these four factors, the VA will determine whether you qualify for Veterans Affairs health benefits.

What is the income threshold for receiving VA benefits?

It varies according to a number of criteria. To get a better idea of where you stand in relation to income requirements specific to your case, you should visit the Dept. of Veterans Affairs website. There, you should be able to determine whether your circumstances and income seem consistent with VA eligibility guidelines.

Your income level (or your household’s), length of service, the nature and cause of any injuries or disability, and the availability of VA resources that may be helpful or necessary to you are all factored into  VA’s decision as to whether you qualify for Veterans Affairs health benefits.

If VA determines that you qualify for health benefits, that’s only the beginning. Everyone who qualifies is placed into a Priority Group, numbered from 1 to 8. Members of Group 1 are given the highest priority based on the qualifying factors for VA benefits eligibility. Generally speaking, veterans with low to modest incomes, longer service, and/or injuries or conditions that are service-related are likely to be placed in high-priority groups, especially if VA determines that sufficient VA benefits are available to serve them. Veterans who meet basic eligibility criteria but whose income and circumstances suggest they’re not in serious need of VA health benefits are likely to be placed in low-priority groups.

If you’re placed in a low-priority group (with Priority Group 8 being the lowest), you can expect to wait at times for medical attention or procedures. Your priority grouping generally determines the nature and speed of your VA healthcare, and being placed in Priority Group 8—in essence, at the back of the line—can definitely test your patience.

Which priority group you’re assigned to also helps determine copayment responsibilities, caps, and other factors impacting your healthcare costs.

Even if you’re in a low-priority group, you’ll have access to the VA Standard Medical Benefits Package, which covers:

Preventive Care Services

• Immunizations

• Physical Examinations (including eye and hearing examinations)

• Health Care Assessments

• Screening Tests

• Health Education Programs

Ambulatory (Outpatient) Diagnostic and Treatment Services

• Medical

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

• Mental Health

• Substance Abuse

Hospital (Inpatient) Diagnostic and Treatment Services

• Medical

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

• Mental Health

• Substance Abuse

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