United States Department of Veterans Affairs
United States Department of Veterans Affairs

VA Healthcare Network Upstate New York - VISN 2

Veterans Healthcare Benefits


Contents
Welcome
How to Apply
Introduction to Your Benefits
Which Veterans Pay for Which Services
Priority Groups - Enrollment Priorities
Combat Veterans
Your VA Health Care Services
Quality Care
Financial/Payment Information
Questions and Answers
Patient Rights and Responsibilities
Enrollment Priorities

These groups are enrollment priorities only. VA services and treatment available to enrolled veterans generally are not based on priority groups. Enrollment will be reviewed each year and veterans will be notified in writing of any change in their enrollment status. Call the nearest VA health care facility or the Health Benefits Service Center, 1-877-222-8387, to obtain the latest information.

Priority Group 1
  • Veterans with service-connected conditions rated 50 percent or more disabling
  • Veterans determined by VA to be unemployable due to service-connected conditions
Priority Group 2
  • Veterans with service-connected disabilities rated 30% or 40% disabling
Priority Group 3
  • Veterans who are former Prisoners of War (POWs)
  • Veterans awarded a Purple Heart medal
  • Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty
  • Veterans with service-connected conditions rated 10% or 20% percent disabling
  • Veterans awarded special eligibility classification under Title 38, U.S.C., Section 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”
Priority Group 4
  • Veterans who are receiving aid and attendance or housebound benefits
  • Veterans who have been determined by VA to be catastrophically disabled
Priority Group 5
  • Nonservice-connected veterans and noncompensable service-connected veterans rated 0% disabled whose annual income and net worth are below the VA established thresholds
  • Veterans receiving VA pension benefits
  • Veterans eligible for Medicaid programs
    * Veterans currently in receipt of cash assistance, medical assistance, food stamp benefits, and/or Home Energy Assistance Program (HEAP) benefits will most likely fall below the established dollar threshold and be eligible for VA Health Care.
Priority Group 6

  • World War I veterans
  • Mexican Border War veterans
  • Compensable 0% service-connected veterans
  • Veterans solely seeking care for disorders associated with:
    • Exposure to herbicides while serving in Vietnam
    • Exposure to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki
    • Service in the Gulf War
    • Illness possibly related to participation in Project 112/SHAD
    • Service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998 are eligible for VA health care for two years following discharge from military service for combat related conditions
      * See combat veteran section for more information
Priority Group 7

Veterans with income and/or net worth above the VA established threshold and income below the HUD geographic index who agree to pay copays
  • Subpriority a: Noncompensable 0% service-connected veterans who were enrolled in the VA health care system on a specified date and who have remained enrolled since that date
  • Subpriority c: Nonservice-connected veterans who were enrolled in the VA health care system on a specified date and who have remained enrolled since that date
  • Subpriority e: Noncompensable 0% service-connected veterans not included in Subpriority a above
  • Subpriority g: Nonservice-connected veterans not included in Subpriority c above
Priority Group 8

Veterans with income and/or net worth above the VA established threshold and the HUD geographic index who agree to pay copays
  • Subpriority a: Noncompensable 0% service-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date
  • Subpriority c: Nonservice-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date
  • Subpriority e**: Noncompensable 0% service-connected veterans applying for enrollment after January 16, 2003
  • Subpriority g**: Nonservice-connected veterans applying for enrollment after January 16, 2003
** Note: Veterans assigned to Priority Groups 8e or 8g are not eligible for enrollment as a result of the enrollment restriction which suspended enrolling new high-income veterans who apply for care after January 16, 2003. Veterans enrolled in Priority Groups 8a or 8c will remain enrolled and eligible for the full-range of VA health care benefits.