When you apply for VA health care, you need to figure out which one out of the eight priority groups you belong to. This system helps the VA determine who needs health care benefits urgently so they can get signed up quickly. It also makes sure that the veterans who need it the most are given the best care under the VA program.
So what determines your eligibility under the priority system? You will be assigned a group according to your military service and history, disability rating, income level, whether you qualify for Medicaid and other benefits that you may already be receiving under the VA pension program.
Here’s a Checklist that you can use to know your Priority Group and help facilitate your application for VA health care benefits. Check which statements apply. If you qualify for more than one priority group, the highest one will be assigned to you.
Priority Group 1
⬜ Have a service connected disability that is rated as 50% or more disabling
⬜ Have a service connected disability that renders me unemployable
⬜ Have received the Medal of Honor
Priority Group 2
⬜ Have a service connected disability that is rated as 30% to 40% disabling
⬜ Have a service connected disability that renders me unemployable
⬜ Have received the Medal of Honor
Priority Group 3
⬜ Was a prisoner or war (POW)
⬜ Was discharged for a disability that was caused by—or got worse because of—your active-duty service
⬜ Received a Purple Heart Medal
⬜ Have a service connected disability that is rated as 10% to 20% disabling
⬜ Was awarded special eligibility classification under Title 38 – “benefits for individuals disabled by treatment or vocational rehabilitation”
Priority Group 4
⬜ Receiving VA aid and attendance or housebound benefits
⬜ Have received VA determination of being catastrophically disabled
Priority Group 5
⬜ Don’t have a service-connected disability, nor a non-compensable service-connected disability
⬜ Receiving VA pension benefits
⬜ Eligible for Medicaid programs
⬜ Have an annual income level that’s below the adjusted income limits (based on my resident zip code)
⬜ Don’t have a service-connected disability, nor a non-compensable service-connected disability
Priority Group 6
⬜ Don’t have a service connected disability, nor a non-compensable service connected disability
⬜ Exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki
⬜ Participated in Project 112/SHAD
⬜ Served in the Republic of Vietnam between January 9, 1962, and May 7, 1975
⬜ Served in the Persian Gulf War between August 2, 1990, and November 11, 1998
⬜ Served on active duty at Camp Lejeune for at least 30 days between August 1, 1953, and December 31, 1987
⬜ Currently or newly enrolled in VA health care, and
⬜ Served in a theater of combat operations after November 11, 1998, or were discharged from active duty on or after January 28, 2003
⬜ I was discharged less than 5 years ago
Priority Group 7
⬜ Gross household income is below certain Geographically Adjusted Income (GMT) limits. View GMT Limits
⬜ Agree to pay certain copays. View current copay rates
Priority Group 8
⬜ Gross household income is above certain Geographically Adjusted Income (GMT) limits. View GMT Limits
⬜ Agree to pay certain copays. View current copay rates
What’s Next?
Whether it’s your first time to file a claim, pursuing an appeal or just want to learn more about your rights and entitlements under the VA pension program, we will support you every step of the way.
