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Understanding VA Priority Group 1 Benefits: Exploring Eligibility and Benefits for Veterans

VA Priority Group 1 Benefits determine eligibility for care and estimated cost after VA health care application processing and enrollment.

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Understanding VA Priority Group 1 Benefits Exploring Eligibility and Benefits for Veterans
Source: National Council on Aging

Understanding VA Priority Group 1 Benefits: Following the processing and enrollment of your VA health care application, we will assign you to one of eight priority groups. This grouping will determine if you need to pay for your care and, if so, estimate the cost.

Your VA health care priority group depends on your military service, disability rating, income, Medicaid eligibility, and other benefits.

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Which group is the topmost priority for the VA?

The following entities have priority:

  • Priority Group 1 includes veterans with a service-connected disability that is at least 50% debilitating, Medal of Honor recipients, and those unable to work. Veterans in Priority Group 1 and VA pension beneficiaries are exempt from co-payments for all VA healthcare, including long-term care.
  • Priority Group 2: Veterans with 30% or 40% service-connected disabilities.
  • People in Priority Group 3 have: (1) Former POWs; (2) Purple Heart medal recipients; (3) Discharged Veterans with 10% or 20% debilitating disabilities; or (5) Special eligibility categorization under Title 38, U.S.C § 1151.
  • Veterans in Priority Group 4 are housebound, receiving VA assistance and attendance benefits, or catastrophically handicapped.
  • Priority Group 5 Veterans who have no service-connected disability, a non-compensable disability rated as 0% disabling, an annual income below the adjusted income limits (determined by their resident zip code), Medicaid eligibility, VA pension benefits, or no service-connected disability.
  • Priority Group 6 includes veterans who served at least 30 days in Camp Lejeune, have a 0% disabling compensable service-connected disability, participated in Project 112/SHAD, served 30 days in World War II, the Persian Gulf War, or theater of combat operations after November 11, 1998, and meet specific eligibility requirements.
  • Priority 7 Copayment-paying veterans with gross family incomes below their local GMT are included.
  • Priority Group 8 includes veterans who consent to copayments and have gross household incomes above VA and regionally adjusted income limits.

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