Many veterans leaving the service are unaware of the fact that they are still eligible in many cases for VA health care benefits. These benefits can be lifesaving for returning veterans, either to bridge the gap during transition, or to care for service related injuries. In other cases, veterans can be eligible even for injury or illness not service related, but it can be confusing to figure out your eligibility.
Here are two main categories of veteran health benefits: senior benefits and discharged veterans medical benefits. If you are approaching retirement years, you have to file for your senior veterans benefits. However, if you are ill, or injured as a result of service, you are immediately eligible for health benefits from the Veterans Administration. You can apply online with the United States Department of Veteran Affairs for the fastest way to get your veterans health benefits.
Priority of Health Care
Because there are only a limited number of VA hospitals, and all veterans getting health care through their VA benefits must use a VA hospital for their care, there could be a long wait for important health care. There are eight levels of enrollment priority for veterans that determine your spot in line waiting for health care services. They are:
1) Veterans with service-connected disabilities that are 50% or more disability, or cause total unemployability.
2) Service disabilities that are 30 to 40% disabling.
3) Former prisoners of war, Purple Heart honorees, veterans discharged for a disability in the line of duty, veterans with disabilities that are 10 to 20% disabling, veterans disabled by treatment or rehabilitation and Medal of Honor honorees.
4) Veterans receiving housebound benefits from the VA, or aid and attendance. Veterans determined to be catastrophically disabled.
5) Non-service, non-disabling illness and an annual income/net worth below the VA determined threshold for the resident's location. Veterans on pensions, or veterans eligible for Medicaid.
6) World War I veterans, non-service connected veterans, veterans exposed to ionizing radiation during Hiroshima and Nagasaki, project 112/SHAD participants, exposure to Agent Orange in Vietnam between 1962 and 1975, Persian Gulf veterans who served between August 2, 1990 and November 11, 1998, veterans who served in various combat theaters after November 11, 1998.
7) Veterans with a gross household income less than the GMT for their location, and agreeing to copay.
8) Veterans with a gross household income more than the GMT for their location, and agreeing to copay if they meet one of three requirements as outlined in the VA Health Care Enrollment Priority Groups FAQs
Physical and Mental Health Care
On top of physical health benefits, your veterans benefits cover many psychological health benefits including help for victims of PTSD (post traumatic stress disorder). To find your local PTSD programs you can visit the US Department of Veterans Affairs PTSD program locator. Other physical and mental health issues that may be covered by your local VA outpatient clinic are:
• Emergency care
• Military Sexual Trauma Care
• Blindness Rehabilitation
• Prescription Drug coverage
• Medical/Surgical care
• Bereavement counseling
• Prosthetic devices and medical equipment
• Home health care
• Reconstructive surgery as a result of disease or trauma (not including cosmetic surgery)
• Palliative care and hospice
• Substance Use Disorders
• Evidence-based Psychotherapy Programs
• Disaster Response/Post Deployment Activities
• HIV/AIDS programs
• Homelessness Prevention
• Help for Incarcerated Veterans
• Suicide Prevention
• Violence Prevention
Services Not Provided through VA Health Benefits
There are some medical services not provided through your VA benefits regardless of your priority level, or type of military service. The VA health benefits do not cover:
• Abortions or abortion counseling
• Cosmetic surgery that is not a result of illness, disease or trauma
• Non-FDA approved drug for either recreational or medical use. That includes drugs, biological and devices unless the treatment is a clinical trial in a formal environment, and under an Investigational Device Exemption (IDE), or Investigational New Drug (IND) application.
• Gender reassignment
• Spa or health club memberships
• In vitro fertilization
• Any services not rendered by a licensed/accredited staff
Determining Your Eligibility
There are two helpful calculators to give you the information you need to determine your eligibility. You can fill out this questionnaire to see if you are within the time limits, and other requirements for veterans health benefits. To determine if you meet the financial limitations you can use this online calculator to make it easier to see if you are eligible for veterans health benefits.
When traveling, or moving to a new location, you will need to have your medical records to receive health care. You, or the hospital/doctor you transfer can obtain current medical records only from the VA hospital you previously received care from.
Where to Get Help
If you find the eligibility or services issues confusing, you can seek help from the American Legion, Veterans of Foreign Wars, AMVETS, Disabled American Veterans or the Veterans Health Council. Many of these organizations not only can help you determine your eligibility, but can also help you file for VA health care benefits, and get local assistance as well.
Join your local branch of a service organization like those listed above. They can provide additional information on your health care benefits, and also give you a place to find support, and others who can identify with the problems you face as a former service member.