Veteran Health Benefits: Understanding Priority Groups

Veterans are eligible for healthcare through the US Department of Veterans Affairs if they have a history of active duty in military, naval, or air service.

While the VA’s veteran health benefits could be better, they can still help cover the cost of service-connected injuries and disabilities. These benefits could boost veterans’ quality of life after they return home.

Veterans applying for medical benefits are placed into one of eight priority groups. This guide will cover the different VA priority groups and their eligibility requirements.

The Eight VA Priority Groups

The assigned priority group of a veteran depends on several factors, including:

• Disability rating assigned by the VA
• Military service history
• Income-related to other benefits, such as Medicaid and VA pension

In most cases, the lower the number of the priority group, the higher the veteran health benefits. A veteran will be placed in the lowest number possible if they qualify for multiple priority groups.

Priority Groups 1 and 2

To qualify for priority group 1, veterans must have a service-connected disability that is VA-rated to be 50% or more disabling. Those who have a total disability rating based on individual unemployability (TDIU) also qualify, as do those who have received the Medal of Honor.

Priority group 2 requires veterans to have a service-connected disability that is VA-rated 30% to 40% disabling.

Priority Groups 3 and 4

Veterans are eligible for priority group 3 if they:

• Are former prisoners of war
• Have received the Purple Heart
• Have a 10% to 20% service-connected disability

Those who receive special eligibility classification under Title 38, U.S.C., section 1151 or who got discharged from service due to a disability that occurred or worsened while on duty may also be eligible for priority group 3.

To qualify for priority group 4, veterans must be receiving housebound benefits or Aid and Attendance benefits. Otherwise, the VA must rate them as catastrophically disabled.

Priority Group 5

Priority group 5 includes veterans who are receiving non-service-connected pension benefits and are eligible for Medicaid programs.

Non-service-connected and non-compensable service-connected veterans are eligible for priority group 5, as are those who are VA-rated at 0% disabling. Those who make an annual income below the income limits for the VA and geographical location may also qualify.

Priority Group 6

Veterans for priority group 6 include those who:

• Served in Vietnam from January 9, 1962, to May 7, 1975
• Served in the Persian Gulf War from August 2, 1990, to November 11, 1998
• Served at Camp Lejeune military base for at least 30 days from August 1, 1953, to December 31, 1987
• Participated in Project 112 or SHAD
• Were exposed to ionizing radiation through testing projects or the occupation of Nagasaki and Hiroshima

This includes veterans who have a 0% compensable rating.

Those in priority group 6 may be eligible for enhanced benefits for 5 years after their discharge. This includes those who have served after November 11, 1998, or were actively discharged after January 28, 2003.

Priority Group 7

Veterans may be eligible for priority group 7 if they have a gross income below the VA’s income limit, which varies by geographical location.

Those who registered and have been continuously enrolled since January 16th, 2003, or have had a change in eligibility status fall under sub-priority A.

Sub-priority B includes veterans who registered on or after June 15, 2009, or have an annual income that is higher than the VA’s geographically adjusted income limits by 10% or less.

Priority Group 8

Priority Group 8 includes veterans that agree to copays and have a gross income above the VA’s geographical income limits.

Those who have been continuously enrolled since June 16, 2003, or have been reclassified to this eligibility status fall under sub-priority c. Sub-priority d includes those who have been enrolled since June 15, 2009. Sub-priority d veterans must exceed the VA’s geographical income limits or be nonservice-connected.

Subpriorities E and G are for veterans who do not meet any of the necessary eligibility requirements for other priority and sub-priority groups.

The main difference between the two is that sub-priority E is for veterans with a 0% non-compensable rating and sub-priority G is for the non-service-connected.

Getting Veteran Health Benefits

The VA’s healthcare could help cover some of the costs veterans pay during and after war.

If you think you may qualify for any of these veteran health benefits, take advantage. File a claim with the VA to see which priority group you may be eligible for. 

If you are interested in what other benefits for veterans are available, learn more on our site today.

This article originally appeared on USMilitary.org and was shared with permission.