Who Qualifies for VA Medical Benefits?

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If you're caring for a veteran, it's well worth looking into whether he or she qualifies for Veterans Administration (VA) medical benefits. While Medicare is a tremendously effective program, it still leaves up to half of an older adult's healthcare costs unpaid. It doesn't cover some services and supplies, and its deductibles and co-payments are hefty. For eligible veterans, however, veterans medical benefits can be one way to cover these unpaid expenses.

A veteran eligible for care can receive it from any VA doctor or facility, but not all VA healthcare benefits are available to all veterans. The VA maintains a priority system, with the most benefits going to those with the greatest health or financial need.

Why choose VA healthcare over Medicare coverage

With VA healthcare, your friend or relative might receive a number of healthcare-related services that Medicare doesn't cover, including:

  • Physical exams and other preventive care
  • Dental care
  • Long-term in-home care
  • Long-term nursing home residential care

Another reason to choose VA care over Medicare-covered care can be cost. VA co-payments and deductibles are generally lower than Medicare's, including for prescription drugs.

Some veterans qualify for both. Even if he's also enrolled in Medicare, your family member may qualify for the wide range of free or low-cost healthcare benefits provided by the VA. The VA provides healthcare through its own hospitals, clinics, nursing homes, pharmacies, and doctors nationwide.

Who qualifies for VA medical benefits?

Who qualifies for veterans medical benefits can be complex, so the older adult you're caring for may need your help and encouragement throughout the application process.

Veterans medical benefits are determined by a priority system. Anyone who served on active duty in the military may be eligible for at least some VA healthcare benefits. Someone who was in the reserves or National Guard may also qualify if he was called up for active duty.

But the VA health system can't provide full care for all veterans. So the VA has set up a complicated priority system to determine veterans' benefits and out-of-pocket costs. The system divides veterans into eight groups, with the highest-priority groups eligible for the most services at the lowest costs.

The priority groups are based on service-connected disability, other disability, and income. Veterans with severe service-connected disabilities get the broadest coverage; veterans with less severe service-connected disabilities, or other disabilities combined with low income, are given midlevel priority; veterans without disability or low income get the least VA care.

How to apply for veterans medical benefits

Before you can find out what veterans medical benefits an older adult might be eligible for, he has to formally enroll with the VA The VA will then decide what priority group the veteran will be placed in and therefore which healthcare services he can obtain. Enrollment is free.

You can help your veteran apply by obtaining an Application for Health Benefits form (VA Form 10-10EZ), available online. Or you can call the VA toll-free at 877-222-8387 and ask for a form to be mailed. To learn more about eligibility for veterans medical benefits, visit the healthcare pages on the VA website.


3 days ago, said...

I was a Navy Wave from 1964 to 1967....a 3 year tour. I was in the hospital various times. But not for getting hurt...I had kidney problems plus a small surgery. I also have Fibromyalgia, and on Oxy, plus other pills...I should have the patches but, can't afford them. Last time I checked they were about a thousand dollars....and the cream was about a hundred dollars. Any ideas if I would qualify?


4 days ago, said...

My husband served 8 years is he covered? Am I as his spouse covered for va health benefits?


2 months ago, said...

I served 6 years in the Navy aboard submarines. Am I entitled to VA medical benefits?


3 months ago, said...

I was in the reserves while on active duty I was injuryed and received a medical discharge an I entitled to any va benefits.


5 months ago, said...

I served seven(7) years in the Texas National Guard in my younger days. Does this give me any eligibility for VA medical benefits?


9 months ago, said...

I'm hundred percent service-connected disability will my new wife qualify for VA Medical?


about 1 year ago, said...

My 88 year old father served in the Navy. This was not during "war time". He never applied for VA health benefits and is on Medicare . Would he benefit or even qualify for benefits from VA?


about 1 year ago, said...

I'm very disappointed in the V.A.. My father, a Korean war veteran (you know the forgotten war) who is 84 was denied V.A. benefits due to his retirement income was more than what the V.A. allowed. It's pretty sad to try to better ones self life after serving his country. I see the disappointment in his teary eyes. What would be amazing is, if my father could go back in time to 1951 when this country was needing help in Korea, and knowing what he knows today , would he serve his country now? John F. Kennedy once said .....ask not what your country can do for you, ask what can you do for your country. There's some truth in that.


almost 2 years ago, said...

Why does my husband not qualify for any V.A. benefits? He was honorably discharged due to an emergency at home, his years of service were not in active war time yet if so he would have remained & would qualify. I think no matter the circumstances any person that serves should qualify for something & or be on a time served /evaluation system. All veterans no matter their time of service should get some type insurance etc.


almost 2 years ago, said...

I've been married since 1999. I have a question. My husband goes to the VA but does not like to ask questions of course. I'm have some problems & we are financially strapped. Someone has told me that even though we were not married when he was in the service, I could still be covered as his spouse under the VA and go there is this true?


almost 2 years ago, said...

I am a combat Vietnam vet. Who just got married . can my wife use the va


over 2 years ago, said...

yes, VA has their own homes; well, they're state run, so goes through the VA in each state, not the Federal VA medical clinics, though if you're getting VA medical care might make it easier, but not necessary; think either way the more issue is going to be his diagnoses; many regular healthcare facilities/homes will not take people - veterans otherwise - with those; they have to a place designed especially for them - at least that's what my dil's grandfather's family's been going through with him; he's had to go to at least 2 out of state places; granted, they're close to the borders so not that far and actually not, considering where they live, any farther than the closest state VA home would be


over 2 years ago, said...

I am working part time and do not have Heath care. How do I apply for it. And can I get any financial help? And does my wife qualify for any benefits?


over 2 years ago, said...

My 87-year-old father who was in the Navy as a young man now needs to apply for VA benefits for the first time in order to help with the cost of an assisted living facility is it too late for him to apply for benefits.


over 2 years ago, said...

Doesn't really answer the question. My son served 17 years and has PTS and is receiving disalibilty. Why isn't he covered through VA?


over 2 years ago, said...

I served active duty in the navy , from 1970 to 1072 at naval air station rota spain, I guess i,am a Vietnam era vet.i would never take away from anyone who was in country, they are the real deal. My question is, if we're all vets, why can't we get on a military base just because we did not retire from the service? We all did our service for our country, why not..


almost 3 years ago, said...

I am VIETNAM veteran, have VA medical primary, HUMAN GOLD HMO secondary, been in good health 3 weeks ago had 1st emergency-requested VA hospital LAS VEGAS-denied discovered I had multiple blood clots lungs and legs. VA refuses to pay because I have medicare! VA book says do not cancel in case of budget cuts-real reason is they will not pay if you have medicare-what a scam! I have a primary DR. at nearby clinic was getting blood pressure pills. within past 12 months! try that by saying need to see a VA dr within 2yrs!!!


almost 3 years ago, said...

I served four years active duty in the air force, with three of these years outside the U.S. But, because of my teacher's pension, I am not entitled to veteran's medical benefits. My friend was in for two years, with six months active duty in Niagra Falls. His pension is much larger than mine and he gets V.A. medical benefits. It is just not right!


almost 3 years ago, said...

My friends husband had Alzheimer's and had to pay for the VA nursing home. Is it because it was not service related?


about 3 years ago, said...

I am taking early retirement from my teaching position due to health reasons. I am going to lose my health care insurance which is provided by the school district, which I pay for. When I leave the school district I will lose my health insurance. Will I be able to see a doctor at the local VA clinic if I need to? I have going to the VA clinic for years for blood work and medication, by appointment. My teacher's retirement money is minimal and I can't afford personal health insurance.


about 3 years ago, said...

If I have 100 percent va medical, do I still need to apply for Medicare at age 65.