Combat Veterans
The Department of Veterans Affairs provides cost-free health care services and community living center care
for conditions possibly related to military service to veterans with combat service after November
11, 1998 for a period of two years beginning on the date of their separation from active military
service.Who’s Eligible
Veterans, including activated Reservists and National Guard members, are eligible if they served on active duty in a theater of combat operations during a period of war after the Gulf War or in combat against a hostile force during a period of “hostilities” after November 11, 1998 and have been discharged under other than dishonorable conditions.
“Hostilities” is defined as conflict in which Armed Forces members are subjected to the danger comparable to that faced in a period of war. For purposes of establishing this special eligibility VA accepts service documentation that reflects service in a combat theater, receipt of combat service medals and/or receipt of imminent danger or hostile fire pay or tax benefits.
What Combat Veterans Are Eligible For
Public Law 105-368 [Title 38 USC 1710(d)(D)] authorizes VA to provide combat veterans costfree care for conditions potentially related to their combat service for up to two years following their discharge or release from active duty. These veterans will be enrolled into Enrollment Priority Group 6 if not otherwise qualified for a higher enrollment priority group assignment. VA provides full access to the Medical Benefits Package by virtue of this enrollment status.
What Happens After the Post Two Year Authority Expires?
Veterans who enroll with VA under this authority will retain enrollment eligibility even after the two-year post discharge period ends under current enrollment policies. In other words, at the end of that two year period VA will reassess the veteran’s information (including all applicable eligibility factors) and make a new enrollment decision. If the veteran was in Priority Group 6 and no other eligibility factors apply then he/she will continue enrollment in either Priority Group 7 or Priority Group 8 depending on income level.
What if a Combat Veteran Does Not Enroll During the Two Year Period?
For veterans who do not enroll with VA during this post two-year discharge period, eligibility for enrollment and subsequent care is based on other factors such as a compensable service connection rating, VA pension status, catastrophic disability determination or financial circumstances.
Co-payments
Veterans who qualify under this special eligibility are not subject to co-pay requirements for conditions potentially related to their combat service. Unless otherwise exempted, veterans must either disclose their prior year household income or decline to provide their financial information and agree to make applicable co-payments for care or services VA determines are clearly unrelated to military service. This disclosure may provide additional benefits such as eligibility for travel reimbursement, cost-free medication and/or medical care for services unrelated to duty in the theater of combat operations.
The VA health care provider is responsible for determining if treatment is possibly related to military service. In making this determination, the health care provider must consider that the following types of conditions are not ordinarily considered to be due to military service: (1) congenital or developmental conditions, for example, scoliosis, (2) conditions which are known to have existed before military service, and (3) conditions have a specific and well-established cause and that began after military combat service.
Dental Care
Eligibility for VA dental benefits is based on very specific guidelines and differs significantly from eligibility requirements for medical care. Combat veterans may be authorized dental treatment as reasonably necessary for the one-time correction of dental conditions if:
- They served on active duty and were discharged or released from active duty under conditions other than dishonorable from a period of service not less than 90 days and
- The certificate of discharge or release does not bear a certification that the veteran was provided, within the 90-day period immediately before the date of such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental service and treatment indicated by the examination to be needed and
- Application for VA dental treatment is made within 90 days of discharge or release
Additional information is available at the nearest VA facility or Veterans Service Center and by calling toll-free at 1-800-827-1000 or 1-877-222-8387
