Veterans Affairs (VA) Medical Benefit Program

Regular Army: Active Duty

Benefit Fact Sheet

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Summary:

The Department of Veterans Affairs (VA) provides a Medical Benefits Package, a standard enhanced health benefits plan available to all enrolled Veterans. This plan emphasizes preventive and primary care, and offers a full range of outpatient and inpatient services within the VA health care system.

There is no monthly premium required to use VA care, however Veterans may have to agree to pay copayments. If a Veteran has health insurance, it may cover the cost of co pays. VA will provide combat Veterans free medical care for any illness possibly associated with service during a period of hostility for five years from the Veteran's release from active duty.

Eligibility:

All Veterans are Potentially Eligible. Eligibility for most Veterans' health care benefits is based solely on active military service in the Army, Navy, Air Force, Marines, or Coast Guard (or Merchant Marines during WW II), and a discharge under other than dishonorable conditions. Reservists and National Guard Soldiers who were called to active duty by a Federal Executive Order may qualify for VA health care benefits. Retiring Soldiers, including Army Reserve and Army National Guard Soldiers 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.

Benefit Highlights:

Medical Benefits Package - Standard Benefits. VA's medical benefits package provides the following health care services to all enrolled Veterans, and offers a full range of outpatient and inpatient services within VA health care system, including: 

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

Prescription Drugs (when prescribed by a VA physician)

Long-Term Care Standard Benefits

  • Geriatric Evaluation

  • Adult Day Health Care

  • Respite Care

  • Home Care

  • Hospice/Palliative Care

Enrollment. Veterans can apply for enrollment in the VA health care system by completing VA Form 10-10EZ, Application for Health Benefits. The application form can be obtained by visiting, calling, or writing any VA health care facility or Veterans' benefits office. Forms can also be requested toll-free from VA's Health Benefits Service Center at 1-877-222-VETS (8387). Completed applications must be signed and dated and may be returned in person or by mail to any VA health care facility. If the Veteran applies in person at a VA health care facility, VA staff will assign an initial priority group. After the application is processed, the VA Health Eligibility Center in Atlanta will confirm the enrollment status and priority group and will notify the Veteran of his or her enrollment status. Based on his/her specific eligibility status, he/she will be assigned to one of the following priority groups. The groups range from 1 through 8 with Priority Group 1 being the highest priority and Priority Group 8 the lowest.

Benefits on the Go. VA enrollment allows health care benefits to become portable throughout the entire VA system. Enrolled Veterans who are traveling or who spend time away from their primary treatment facility may obtain care at any VA health care facility across the country without the worry of having to reapply.

Financial Assessment (Means Testing). While many Veterans qualify for enrollment and cost-free health care services based on a compensable service-connected condition or other qualifying factor, certain Veterans will be asked to complete a financial assessment as part of their enrollment application process. Otherwise known as the Means Test, this financial information may be used to determine the applicant's enrollment priority group and whether he/she is eligible for cost-free VA health care. Higher-income Veterans may be required to share in the expense of their care by making copayments. Veterans who choose not to complete the financial assessment must agree to pay the required copayments as a condition of their eligibility. Due to VA's restricting enrollment of new Priority Group 8 Veterans who apply on or after January 17, 2003, Veterans who decline to provide financial information and who agree to copayments will not be accepted for enrollment.

Additional Information:

For more information, please visit the official Veterans Affairs Medical Benefits webpage maintained by the Department of Veterans Affairs:
http://www.va.gov/opa/publications/benefits_book/benefits_chap01.asp

VA Health Benefits Guide:
 http://www.va.gov/healthbenefits/vhbg/IB-10-465_veterans_health_benefits_guide_508.pdf

Health Care Benefits Overview:
https://www.va.gov/healthbenefits/resources/publications/IB10-185-health_care_benefits_overview_2012_eng.pdf


 

Document Review Date: 8 April 2014