Enhanced Eligibility For Health Care Benefits

Veterans who served in a theater of combat operations after November 11, 1998 are eligible for an extended period of eligibility for health care for 5 years post discharge.

Under the "Combat Veteran" authority, the Department of Veterans Affairs (VA) provides health care services and community living care for conditions possibly related to military service and enrollment in Priority Group 6, unless eligible for enrollment in a higher priority group to:

Combat Veterans who were discharged or released from active service on or after January 28, 2003, are eligible to enroll in the VA health care system for 5 years from the date of discharge or release.

Combat Veterans, while not required to disclose their income information, may do so to determine their eligibility for a higher priority status, beneficiary travel benefits, and exemption of copays for care unrelated to their military service.

Who's Eligible?

Veterans, including activated Reservists and members of the National Guard, are eligible if they served on active duty in a theater of combat operations after November 11, 1998, and have been discharged under other than dishonorable conditions.

Documentation Used To Determine Service in a Theater Of Combat Operations

• Military service documentation that reflects service in a combat theater, or
• Receipt of combat service medals, and/or
• Receipt of combat tax exemption, imminent danger or hostile fire pay

Health Benefits Under The "Combat Veteran" Authority

• Medical care and medications provided for conditions potentially related to combat service
• Enrollment in Priority Group 6 unless eligible for enrollment in a higher priority group
• Full access to VA's Medical Benefits Package

What Happens After The Enhanced Eligibility Period?

Veterans who enroll with VA under this authority will continue to be enrolled even after their enhanced eligibility period ends. At the end of their enhanced eligibility period, Veterans enrolled in Priority Group 6 may be shifted to a lower priority group depending on their income level, and required to make applicable copays.

What About Combat Veterans Who Do Not Enroll During Their Enhanced Authority Period?

For those Veterans who do not enroll during their enhanced eligibility period, eligibility for enrollment and subsequent care is based on other factors such as: a compensable service-connected disability, or the Veteran's financial circumstances. For this reason, combat Veterans are strongly encouraged to apply for enrollment within their enhanced eligibility period, even if no medical care is currently needed.

Copays

Veterans who qualify under this special eligibility are not subject to copays for conditions potentially related to their combat service. However, unless otherwise exempted, combat Veterans must either disclose their prior year gross household income OR decline to provide their financial information and agree to make applicable copays for care or services VA determines are clearly unrelated to their military service.

Dental Care

Eligibility for VA dental benefits is based on very specific guidelines and differs significantly from eligibility requirements for medical care. Combat Veterans may be authorized dental treatment as reasonably necessary for the one-time correction of dental conditions if:

• They served on active duty and were discharged or released from active duty under conditions other than dishonorable from a period of service not less than 90 days and
• The certificate of discharge or release does not bear a certification that the Veteran was provided, within the 90-day period before the date of such discharge or release, a complete dental examination
• Appropriate dental service and treatment indicated by the examination to be needed and
• Application for VA dental treatment is made within 180 days of discharge or release under conditions other than dishonorable)

Additional Information

Additional information is available at the nearest VA medical facility. Veterans can also call VA toll-free at 877-222-VETS (8387).

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.

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