The number of veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up Priority Groups to make sure that certain groups of veterans are able to be enrolled before others.
Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a Priority Group. The Priority Groups range from 1-8 with 1 being the highest priority. Based on eligibility and income, some veterans may have to pay copay for treatment, and some may not be eligible for enrollment.
You may be eligible for more than one Priority Group. In that case, VA will always place you in the highest Priority Group that you are eligible for.
Depending on your Priority Group, the VA may reimburse you for your travel costs from your home to a medical facility.
Priority Group 1
- Veterans with service-connected disabilities rated 50% or higher
- Veterans determined by VA to be unemployable due to service-connected conditions
Priority Group 2
- Veterans with service-connected disabilities rated 30% – 40%
Priority Group 3
- Veterans who are former Prisoners of War (POWs)
- Veterans awarded a Purple Heart
- Veterans whose were discharged for a disability
- Veterans with service-connected disabilities rated 10% – 20%
- Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”
- Veterans awarded the Medal Of Honor
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 by VA with annual income below the VA’s and geographically (based on your resident zip code) adjusted income limits.
- Veterans receiving VA pension benefits
- Veterans eligible for Medicaid programs
Priority Group 6
- Veterans with service-connected disabilities rated 0%
- Veterans exposed to Ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki
- Project 112/SHAD participants
- Veterans who served in Vietnam between Jan. 9,1962 and May 7,1975
- Veterans of the Persian Gulf War who served between Aug. 2, 1990 and Nov. 11, 1998
- Veterans who served on active duty at Camp Lejeune for not fewer than 30 days beginning Aug. 1, 1953 and ending Dec. 31, 1987
- Combat veterans who were discharged on or after Jan. 28, 2003, are eligible for enhanced benefits for 5 years after discharge.
Priority Group 7
- Veterans with gross household income below certain limits and who agree to pay copays
Priority Group 8
- Veterans with gross household income above certain limits and who agree to pay copays
VA Travel Reimbursement
Reimbursement for mileage or public transportation may be paid to the following:
- Veterans with service-connected disabilities rated at 30% or more;
- Veterans traveling for treatment of a service-connected condition;
- Veterans receiving a VA pension;
- Veterans traveling for scheduled compensation or pension examinations;
- Veterans whose income does not exceed the maximum VA pension rate;
Mileage reimbursement is made at the current rate of 41.5 cents per mile. The deductibles are $3 for a one-way trip, $6 for a round trip, with a maximum of $18 per calendar month. However, these deductibles can be waived if they cause a financial hardship to the veteran.
The deductible is also waived for veterans traveling for scheduled compensation or pension examinations.