WA Senior Resources
All programs
Health promotion · federal

VA Health Care (VHA enrollment)

U.S. Department of Veterans Affairs

VA Health Care is the umbrella benefit that covers enrollment in the Veterans Health Administration (VHA) system. Veterans who served in the active military, naval, or air service and were not dishonorably discharged may qualify. Reservists and National Guard members may qualify if they were called to active duty by a federal order. Once enrolled, veterans are assigned to 1 of 8 priority groups based on military service history, disability rating, income level, Medicaid eligibility, and other VA benefits received (such as VA pension). Priority group drives both how soon enrollment is completed and how much (if anything) the veteran pays in copays. The PACT Act expanded eligibility to all veterans exposed to toxins or other hazards (burn pits, Agent Orange, etc.), including everyone who served in the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11. VHA delivers care at VA Medical Centers (VAMCs), Community-Based Outpatient Clinics (CBOCs), Vet Centers, and via Community Care contracts.

Who qualifies

Active military/naval/air service with non-dishonorable discharge. Post-9/7/1980 enlistees: 24 continuous months or full call-up period (with hardship/disability/early-out exceptions). Reserves/Guard: must have been federally activated and completed full ordered period; training-only does not qualify. Enhanced eligibility (higher priority group) if any of: receiving VA service-connected disability compensation; discharged for line-of-duty disability; combat veteran discharged on/after 9/11/2001; receiving VA pension; former POW; Purple Heart; Medal of Honor; eligible for Medicaid; toxic-exposure history; Gulf War service in Southwest Asia 8/2/1990-11/11/1998; Camp Lejeune 30+ days between 8/1/1953-12/31/1987; Vietnam-era service in qualifying locations. Income-based eligibility available even without other qualifying factors. Veterans with other-than-honorable, bad-conduct, or dishonorable discharge may apply for a discharge upgrade or VA Character of Discharge review. Priority groups (summary): PG1 = SC disability rated 50%+ or unable to work due to SC disability, or Medal of Honor; PG2 = SC disability 30-40%; PG3 = POW, Purple Heart, line-of-duty disability discharge, SC 10-20%, or Title 38 USC 1151 special eligibility; PG4 = receiving VA Aid & Attendance or housebound, or catastrophically disabled determination; PG5 = no SC disability or 0% non-compensable SC + income below adjusted limits, or receiving VA pension, or eligible for Medicaid; PG6 = compensable 0% SC, Project 112/SHAD, WWII service, Persian Gulf service 1990-1998, Camp Lejeune 30+ days, veterans who served in a combat theater after 11/11/1998 and were discharged on or after 10/1/2013 get the 10-year enhanced eligibility window under PG6; veterans discharged on or after 9/11/2001 but before 10/1/2013 may also get the 10-year window under a related PACT Act provision, TERA participants, qualifying toxic-exposure deployments, ionizing-radiation exposure, Agent Orange exposure locations; PG7 = income below GMT geographic limits and agrees to copays; PG8 = income above VA limits and agrees to copays (subpriority a/b/c/d/e/f/g rules apply).

What it covers

Comprehensive medical care including primary care, specialty care, mental health, hospital care, prescription drugs, geriatrics and extended care (CLCs, community living, HBPC, ADHC, hospice, respite, etc.), preventive eye exams, vision care, limited dental in some cases, emergency care, and care for PTSD, MST, and other conditions. Combat veterans returning from OEF/OIF/OND can receive free medical care for any service-related condition for 10 years after discharge.

Cost

Cost depends on assigned priority group. PG1-4 generally have no copays for most VA care; PG5-6 have limited copays; PG7-8 pay copays for inpatient hospital care, outpatient care, prescriptions, and extended care. See VA copay rates page (current) for figures, they change annually and are not reproduced here.

How to apply

Apply online at va.gov/health-care/apply, by phone at 877-222-VETS (8387), in person at any VA Medical Center, or by mailing VA Form 10-10EZ. Get help from an accredited VSO representative or your state's veterans agency (in WA, that's WDVA or a County Veterans Service Officer).

Where to get this in Washington

3 organizations deliver this program. Coverage varies, so check the area each one serves.

Source www.va.gov/health-care/eligibility/