VA Priority Group 1 Benefits: What’s Included and Who Qualifies?

VA Priority Group 1 Benefits: Upon enrollment in VA health care, you will be assigned to one of eight priority groups that determine whether you have to pay for your care and how much it will cost.

Priority groups for VA health care are determined by factors such as your military service history, disability rating, income level, Medicaid eligibility, and other benefits.

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Which VA priority group has the highest priority?

Priority groups include:

• Priority Group 1 includes veterans with service-connected disabilities rated 50 percent or more disabling or those with a service-connected disability that prevents them from working (unemployable), or Medal of Honor recipients. Those in Priority Group 1 and VA pension recipients can receive all healthcare services through the VA without having to pay a co-pay.
• Veterans with service-connected disabilities that are 30% or 40% disabling are in group 2.
• The third priority group includes former prisoners of war (POWs), Purple Heart medal recipients, veterans discharged for disabilities related to their active-duty service, veterans with disabilities rated 10% or 20% disabling, or veterans with special eligibility classifications under Title 38, U.S.C. § 1151.
• Those who are receiving VA aid and attendance or housebound benefits, or those who have been determined to be catastrophically disabled by the VA, belong to Priority Group 4.
• The priority group consists of veterans without service-connected disabilities, veterans with non-compensable service-connected disabilities that are rated 0% disabling, veterans receiving VA pension benefits, or Medicaid recipients. The annual income level must be below adjusted income limits (based on their resident zip code).
• Those in Priority Group 6 have a compensable service-related disability rated as 0% disabling, participate in Project 112/SHAD, have served at least 30 days at Camp Lejeune or in World War II, the Persian Gulf War, or have served in a theater of combat operations after November 11, 1998, and meet certain requirements.
• Veterans who agree to pay copays and are below the geographically adjusted income limits (GMT) for where they live, are in Priority Group 7.
• Veterans who have a gross household income above VA income limits, and who agree to pay copays, are members of Priority Group 8.

How will VA determine my priority group?

Your priority group will be based on the following:

• The history of your military service, and

• Based on your disability rating, and

• The level of your income, as well as

• If you qualify for Medicaid, and how much it costs

• There may be other benefits you are receiving (like a VA pension)

Veterans with service-connected disabilities have the highest priority. Veterans with higher incomes and no service-connected disabilities receive the lowest priority.

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