Health Benefits

Basic Eligibility

If you served in the active military service and were separated under any condition other than dishonorable, you may qualify for VA health care benefits. Current and former members of the Reserves or National Guard who were called to active duty by a federal order and completed the full period for which they were called or ordered to active duty may be eligible for VA health benefits as well.

Minimum Duty Requirements

Most Veterans who enlisted after September 7, 1980, or entered active duty after October 16, 1981, must have served 24 continuous months or the full period for which they were called to active duty in order to be eligible. This minimum duty requirement may not apply to Veterans who were discharged for a disability incurred or aggravated in the line of duty, for a hardship or “early out,” or those who served prior to September 7, 1980. Since there are a number of other exceptions to the minimum duty requirements, VA encourages all Veterans to apply so that we may determine their enrollment eligibility.

Enhanced Eligibility

Certain Veterans may be afforded enhanced eligibility status when applying and enrolling in the VA health care system. Veterans who:

• Are a Former Prisoner of War (POW)
• In receipt of the Purple Heart Medal.
• In receipt of the Medal of Honor.
• Have a compensable VA awarded service-connected disability of 10% or more.
• In receipt of a VA Pension.
• Were discharged from the military because of a disability (not preexisting), early out, or hardship.
• Served in a Theater of Operations for 5 years post discharge.
• Served in the Republic of Vietnam from January 9, 1962 to May 7, 1975.
  U.S. Navy and Coast Guard ships associated with military service in Vietnam
• Served in the Persian Gulf from August 2, 1990 to November 11, 1998.
• Were stationed or resided at Camp Lejeune for 30 days or more between August 1, 1953 and December 31, 1987.
• Are found by VA to be Catastrophically Disabled.
• Previous years' household income is below VA's National Income or Geographical-Adjusted Thresholds.

Enrollment

VA operates an annual enrollment system that helps to manage the provision of health care. VA applies a variety of factors during the application verification process when determining a Veterans’ eligibility for enrollment, but once a Veteran is enrolled, that Veteran remains enrolled in the VA health care system and maintains access to certain VA health benefits.

Once your application is successfully processed, you will be assigned an enrollment Priority Group. Certain Veterans may be eligible for more than one enrollment Priority Group. In that case, VA will always place you in the highest Priority Group that you are eligible. Under the VA Health Benefits Package, the same services are generally available to all enrolled Veterans. Once enrolled, you will receive a personalized Veterans Handbook, which will detail your VA health benefits and provide important information concerning your access to VA health care.

VA Healthcare Applications In A Pending Status

VA’s goal is to process all applications for enrollment in VA healthcare within five (5) business days.  If the healthcare application is complete and contains all necessary information, the application is processed and an enrollment decision is sent to the applicant by mail. Newly-enrolled Veteran will receive a Handbook in the mail welcoming him/her to the VA health care system.  The handbook is personalized and contains detailed information about the specific health benefits the Veteran is eligible to receive as well as information on copay responsibility, if any, and other services available.

Sometimes applications for enrollment in VA health care are not complete and missing information needed to fully process the application to a final enrollment decision, such as military information or income information.  These applications are given a ‘pending’ status while VA attempts to locate necessary information in its electronic databases or receive the needed military information from the Department of Defense (DoD) or from the Veteran.   If unable to obtain the missing information via its databases or from DoD, VA will contact the Veteran via letter to request the missing information.

VA is making every effort to ensure that all applications are processed fully and timely, and will continue its outreach efforts to help reduce the number of application in a pending status.
For immediate assistance or to inquire about the status of their application, Veterans may call toll free 1 877-222-VETS (8387).

Cancel Enrollment

You may request to disenroll from VA Health Care, commonly referred to as cancel/decline, at any time. To request to be disenrolled, you must submit a signed and dated document requesting to be disenrolled from VA health care to a VA Medical Center or you may mail the request to:

VA Health Eligibility Center (HEC) 2957 Clairmont Road Atlanta, GA 30329

If you decide to cancel your VA health care coverage, please note this may impact your health care coverage requirements under the Affordable Care Act if you do not have other qualifying health care.

You may reapply for enrollment at any time by completing a new VA Form 10-10EZ, Application for Health Benefits online at www.vets.gov, by calling 1-877-222-VETS (8387) or by visiting your local VA health care facility. Please note that you will be considered a new applicant and eligibility for enrollment will be based upon eligibility requirements in place at that time.