VA Health Care: Enrolling, Priority Groups and Community Care

What it is

VA health care is a full medical plan for eligible veterans. It covers primary care, specialists, mental health, prescriptions, hospital stays, and more. It counts as qualifying health coverage under the Affordable Care Act. Many veterans use it alongside TRICARE, Medicare or work insurance.

Who qualifies

In general, you need to have served on active duty and have a discharge that is not dishonorable. You must also meet minimum service rules, which usually means 24 continuous months or your full call-up period. There are exceptions for people discharged for disability or hardship.

The PACT Act widened the door. Since March 5, 2024, veterans who served in Vietnam, the Gulf War, Iraq, Afghanistan or other post-9/11 combat zones, or who were exposed to toxins, can enroll without first filing a disability claim. Recently separated combat veterans also get a special enrollment period after discharge.

Priority groups

VA puts each enrolled veteran into one of eight priority groups. Your group can affect copays and how fast you get in.

• Group 1: 50% rating or higher, or unemployable due to service-connected conditions
• Group 2: 30% or 40% rating
• Group 3: 10% or 20% rating, former POWs, Purple Heart recipients
• Groups 4 to 6: catastrophic disability, low income, Medicaid, a 0% rating, or toxic exposure
• Groups 7 and 8: based on income, with copays

Care for service-connected conditions is free for everyone. Income limits for groups 5, 7 and 8 change by ZIP code.

Community care

Sometimes VA pays for you to see a local, non-VA doctor. You may qualify if VA does not offer the service you need, if you live in a state without a full-service VA hospital, or if you and your VA doctor agree it is best for you. You may also qualify if VA cannot meet its access standards:

• Primary care and mental health: a 30-minute average drive or a 20-day wait
• Specialty care: a 60-minute average drive or a 28-day wait

In most cases, you need VA approval first. Emergency and urgent care have their own rules. Congress has debated bills that would write these standards into law and widen access, so check VA.gov for the latest rules before you book.

How it works when you are relocating

You do not have to re-enroll when you move. You do need to change your preferred VA facility.

1. Update your address on VA.gov. It flows to your health records and pharmacy.
2. Call the enrollment office at the VA medical center near your new home and ask to be assigned a new primary care team.
3. Refill prescriptions before you move. VA mails most medicines, so give yourself time.
4. Ask your old team to send referrals and care plans to the new facility.
5. If you have a gap, ask about community care or urgent care rules.

How to apply

Apply on VA.gov with form 10-10EZ, by phone, by mail, or in person. Have your DD-214, insurance cards, and last year's income on hand. Service members can apply before discharge.

Common mistakes

• Assuming you earn too much to qualify. Many veterans qualify with no rating at all.
• Forgetting to change your preferred facility after a move.
• Getting non-emergency community care without approval, then getting a bill.

Related benefits

Ask about dental care (limited eligibility), the caregiver program, mental health services through Vet Centers, and CHAMPVA for some family members. If you are in crisis, call 988 and press 1 for the Veterans Crisis Line.