Veterans Health Administration Chief Business Office.ppt

Veterans Health Administration Chief Business Office VHA Health Care Benefits Eligibility Overview Establishing Eligibility Applying for VA health care Application for Health Benefits – VA Form 10-10EZ Various ways to apply In person at VA clinic or medical center By submitting a completed application to a VA clinic or medical center Online at /healtheligibility Note: Appreciate DD214 with application but not required A veteran is a person who: Enrollment VA Enrollment System The Veterans’ Health Care Eligibility Reform Act of 1996 (PL 104-262) enacted 10/1/96 Law required implementation of an annual enrollment system to ensure treatment is timely and acceptable Enrollment is managed in accordance with 8 specified priorities, with 1 being the highest priority Medical Benefits Package available to all enrollees – a standard enhanced health benefits plan  Priority Groups 1-5 PG 1 - Service-Connected 50% or more disability rating or Unemployable due to a VA SC condition PG 2 - Service-Connected 30% or 40% PG 3 - SC 10-20%, Purple Heart, former POWs, veterans discharged due to disability incurred in service PG 4 - Veterans receiving Aid Attendance or Housebound VA pension benefits, or determined by VHA to be catastrophically disabled PG 5 - NSC 0% SC noncompensable veterans with income below threshold, or receiving VA pension and/or eligible for Medicaid benefits Priority Group 6 World War I veterans Compensable 0% service-connected veterans Veterans exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki Project 112/SHAD participants Veterans who served in a theater of combat operations after November 11, 1998 as follows: Veterans discharged from active duty on or after January 28, 2003, who were enrolled as of January 28, 2008 and veterans who apply for enrollment after January 28, 2008, for 5 years post discharge Veterans discharged from active duty before January 28, 2003, who apply for enrollment