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, Space Force, Marines, Coast Guard (or Merchant Marines during WWII), National Oceanic and Atmospheric Administration (NOAA) Commissioned Officer Corps (or its predecessor, the Coast and Geodetic Survey), or as a commissioned officer of the Public Health Service Commissioned Corps and a discharge under other than dishonorable conditions. Army Reserve and Army National Guard Soldiers who were called to active duty (other than for training only) 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.

The following four categories of Veterans are not required to enroll, but are urged to do so to permit better planning of health resources:

1. Veterans with a service-connected disability of 50% or more.

2. Veterans seeking care for a disability the military determined was incurred or aggravated in the line of duty, but which VA has not yet rated, within 12 months of discharge.

3. Veterans seeking care for a service-connected disability only.

4. Veterans seeking registry examinations (Ionizing Radiation, Agent Orange, Gulf War/Operation Enduring Freedom/ Operation Iraqi Freedom/ Operation New Dawn (OEF/OIF/OND) depleted uranium, airborne hazards and Airborne Hazards and Open Burn Pit Registry).

Learn more about Priority Groups: https://www.va.gov/health-care/eligibility/priority-groups/

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 but not limited to:Eye Exam

Preventive Care Services

  • Immunizations

  • Periodic health exams

  • Routine vision testing and eye-care services

  • Maintenance of drug-use profiles, drug monitoring, and drug use education

  • Mental health and substance abuse preventive services

  • Prevention of musculoskeletal deformity or other gradually developing disabilities of a metabolic or degenerative nature

  • Genetic counseling concerning inheritance of genetically determined diseases

  • Periodic reexamination of members of high-risk groups for selected diseased and for functional decline of sensory organs and the services to treat these diseases and functional declines

  • Health Education Programs

Ambulatory (Outpatient) Diagnostic and Treatment Services

  • Primary and Specialty Care

  • Emergency care

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

  • Mental Health

  • Substance Abuse

  • Durable medical equipment

  • Prosthetic and orthotic devices including eyeglasses and hearing aids (for qualifying Veterans)

Hospital (Inpatient) Diagnostic and Treatment Services

  • Medical

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

  • Mental Health

  • Substance Abuse

Prescription Drugsveteran shaking hands with a dog
Prescription Drugs, including over-the-counter drugs and medical and surgical supplies, are available under the VA national formulary system when prescribed by a VA health care provider.

Counseling
Members of the Veteran’s household, including immediate family, legal guardian or the individual in whose household the Veteran certifies an intention to live, may be eligible for consultation, professional counseling, marriage and family counseling, training and mental health services as necessary and appropriate in connection with the Veteran’s treatment.

Rehabilitation
Comprehensive rehabilitative services other than vocational services provided under 38 U.S.C. chapter 31.

Meeting Women Veterans’ Unique Needs
VA delivers the highest quality health care in a setting that ensures privacy, dignity and sensitivity. Your local VA facility offers a variety of services, including:

  • Women’s gender-specific health-screening and disease prevention
  • Routine gynecologic and fertility treatment
  • Reproductive health
  • Screening Mammograms
  • Pregnancy and delivery services
  • Newborn care, post-delivery (date of birth plus seven calendar days after the birth of the child)

Women Veterans are eligible to receive care provided in the community when authorized by VA. Contact your local VA medical facility’s Women Veterans Program Manager for more information on available services or call 855-VA-WOMEN (855-829-6636).

Long-Term Care Standard Benefits

  • VA Community Living Centers (VA Nursing Home) Programs

  • Domiciliary Care

  • Medical Foster Home

  • State Veterans Homes

  • Additional Services

    • Geriatric Evaluation

    • Geriatrics and Extended Care

    • Adult Day Health Care

    • Respite Care

    • Home Health Care

    • Home Telehealth

    • 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 their enrollment status. Based on their specific eligibility status, they 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 While many Veterans qualify for enrollment and cost-free health care services based on a compensable service-connected condition or other qualifying factors, certain Veterans will be asked to complete a financial assessment at the time of enrollment to determine their eligibility for cost-free medical care, medications and/or travel benefits. The assessment is based on the Veteran's, (spouse and dependents, if any) previous year gross household income. This financial information may also be used to determine the Veteran's enrollment priority group. Higher-income Veterans (Veterans whose income exceeds established national income limits) that are treated for nonservice-connected conditions may be required to share in the expense of their care by paying copayments.

Note: Unreimbursed medical expenses (what you paid out of pocket after medical insurance pays) may be deducted from your total gross household income. Unreimbursed medical expenses include travel expenses, cost of a long term care institution or assisted living, health related insurance premiums (including Medicare premiums), diabetic supplies, private caregivers, incontinence supplies, prescriptions and dialysis not covered by any other health plan. Only the portion of the unreimbursed medical expenses that exceed 5% of the basic pension may be deducted (see Medical Expense Deductible).

Once enrolled, VA will automatically match income information obtained from the Internal Revenue Service (IRS) and Social Security Administration (SSA) to confirm the Veteran's continued health care eligibility. VA will send Veterans a letter only when clarification is needed regarding the financial information obtained. For more information, visit https://www.va.gov/health-care/about-va-health-benefits/cost-of-care/, call VA's toll-free number at 1-877-222-VETS (8387) or contact the Enrollment Coordinator at your local medical facility.

Foreign Medical Program (FMP)

The Foreign Medical Program (FMP) is a U.S. Department of Veterans Affairs (VA) health care benefits program for U.S. Veterans who are residing or traveling abroad and have VA-rated, service-connected disabilities. Under FMP, VA assumes payment responsibility for certain necessary health care services received in foreign countries and associated with the treatment of service-connected disabilities, or any disability associated with and held to be aggravating a service-connected condition. (FMP administers all aspects of the program in Canada, except claims for service-connected care are filed with the Foreign Countries Operations in Canada.) Additionally, VA may authorize necessary foreign medical services for any condition for a Veteran participating in the VA Veteran Readiness & Employment (VR&E) Program.

Eligibility: The eligibility requirements for medical services for Veterans outside the United States are different from those for Veterans within the United States. VA may authorize foreign medical services for Veterans only for a VA-rated, service-connected disability, or any disability that is associated with and held to be aggravating a VA-rated service-connected disability. This means that disability percentages have no bearing when determining eligibility for foreign medical services.

Additional Information

For more information, please visit the official Veterans Affairs Medical Benefits webpage maintained by the Department of Veterans Affairs:
https://www.va.gov/health-care/about-va-health-benefits/

VA Health Care:
https://www.va.gov/health-care/

Health Care Benefits Overview:
https://www.va.gov/healthbenefits/resources/publications/IB_10-185_Health_Care_Overview_2023.pdf

For more information on the Foreign Medical Program (FMP), please visit:
https://www.va.gov/health-care/foreign-medical-program/

Annual Income Limits:
https://www.va.gov/COMMUNITYCARE/docs/pubfiles/brochures/FMP_brochure.pdf

Document Review Date: 11 April 2024