In 1996 Congress passed the Veterans’ Health Care Eligibility Reform Act, which was designed to simplify the process of determining benefit eligibility.
Priority Group 1:
A 50% or greater service related disability.
Priority Group 2:
A 30% to 40% service related disability.
Priority Group 3:
- Former POWs.
- A disability that incurred or was aggravated in the line of duty.
- Special eligibility under Title 38, U.S.C., Section 1151 (benefits for individuals disabled by treatment or vocational rehabilitation).
Priority Group 4:
- Veterans receiving aid and attendance or housebound benefits.
- Veterans Administration has determined Veteran is Catastrophically Disabled (Individuals who have a severely disabling injury, disorder, or disease which permanently compromises their ability to carry out the activities of daily living to such a degree that they require personal or mechanical assistance to leave home or bed or require constant supervision to avoid physical harm to self or others.)
Priority Group 5:
Veterans with 0% disability whose annual income and net worth are below a specified amount.
Priority Group 6:
Veterans not required to make C0-payments for their care, including:
- WWI and Mexican Border War veterans.
- Veterans with disabilities resulting from exposure to toxic substances, radiation or for disorders associated with service in the Gulf War; or for any illness associated with service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998.
- Compensable (A veteran who has been rated by VA as being service-connected and who receives monetary benefit.) 0% service-connected veterans
Priority Group 7:
Nonservice-connected veterans and Compensable (A veteran who has been rated by VA as being service-connected and who receives monetary benefit.) 0% service-connected veterans whose needed care cannot be provided by enrolling in any of the groups above and who agree to pay specified co-payment.