How does the VA determine whether a veteran is eligible for free VA Health Care?

By Larry Dandridge

My next five articles on veterans’ benefits will cover VA health care, vet centers, priority groups, VA copay rates, Medal of Honor recipients, registry health exams, service-connected disabled veterans, veterans’ income levels, other special eligibility factors for veterans, and how these affect VA healthcare.

According to the VA webpage titled “Your Health Care Costs” (https://bit.ly/4c62Opm), the VA is committed to providing free health care for conditions related to military service and for veterans with catastrophic disabilities and disability ratings of at least 50%. The VA is also committed to caring for veterans who cannot afford to pay for care. The VA’s “Your Health Care Costs” webpage covers:

Can a veteran get free VA health care?

A veteran can get free VA health care for any illness or injury that the VA determines is connected to their military service (called a “service-connected disability”).

The VA also provides these other services for free:

  • Readjustment counseling. Learn about free readjustment counseling on the VA’s Vet Centers website at https://www.vetcenter.va.gov. Vet Centers are community-based counseling centers that provide a wide range of social and psychological services, including professional counseling to eligible veterans, service members, including National Guard and Reserve components, and their families. Counseling is offered to make a successful transition from military to civilian life or after a traumatic event experienced in the military, including military sexual trauma (MST). Individual, group, marriage, and family counseling are offered in addition to referral and connection to other VA or community benefits and services. Vet Center counselors and outreach staff, many of whom are veterans themselves, are experienced and prepared to discuss the tragedies of war, loss, grief, and transition after trauma.
  • Other mental health services. Find out how to get mental health care at https://bit.ly/4t0zO9U. Find out how to access VA mental health services for posttraumatic stress disorder (PTSD), psychological effects of military sexual trauma (MST), depression, grief, anxiety, and other needs. Veterans can use some services even if they are not enrolled in VA health care.
  • Care for issues related to military sexual trauma (MST). Learn more about services for military sexual trauma at https://bit.ly/48xArPP. MST refers to sexual assault or threatening sexual harassment experienced during military service. MST can happen to anyone. The VA can help the veteran learn more about how MST affects people. The VA can provide treatment that helps the veteran cope with how the experience of MST is impacting their life. Or if the veteran prefers, the VA can provide treatment that involves discussing their experiences in more depth.
  • A registry health exam to determine if the veteran is at risk of health problems linked to their military service. Explore health issues related to service history at https://bit.ly/47Qcinw. Certain health concerns may be more likely to affect veterans who served in a specific time and place. Find out which health concerns a veteran should be aware of depending on when and where they served. 1) Operation Enduring Freedom in Afghanistan, Oct. 7, 2001 – present, learn about health issues related to the OEF at https://bit.ly/4mi9NAg; 2) Iraq War — Operation Iraqi Freedom and Operation New Dawn, March 19, 2003 – Dec. 15, 2011, learn about health issues related to the OEF at OIF & OND at https://bit.ly/4dyMqAi; 3) Gulf War — Operation Desert Shield and Desert Storm, Aug. 2, 1990 – present, learn about health issues related to the ODS and DS at https://bit.ly/4slu8Gj; 4) Cold War Era 1945-1991, learn about health issues related to the Cold War Era, at https://bit.ly/4bXgDb1; 5) Vietnam War Nov. 1, 1965 -April 30, 1965, learn about health issues related to the Vietnam War, at https://bit.ly/4e2SSzy; and 6) World War II, Sept. 1, 1939-Sept. 2, 1945, learn about health issues related to World War II at https://bit.ly/4skVVGP.
  • Other Services that the VA provides at no cost. Some Veterans do not pay copays. Effective Jan. 1, 2026, some veterans do not have to pay copays (they are exempt) based on their disability rating, income level, or specialty eligibility factors. Veterans can review 2026 copay rates for VA and VA-approved healthcare at the VA “Current VA Health Care Copay Rates” webpage found at https://bit.ly/4ctZoOu.

Veterans may also be eligible for additional free VA health care based on factors such as their disability rating, service history, or income. Or veterans may be eligible for care but must pay a fixed amount (called a “copay”) for some types of care, tests, and medications to treat conditions not related to their service.

How does the VA decide if a veteran pays copays for non-service-connected care? (Which of the 8 Priority Groups Assigned)

Whether or not a veteran needs to pay copays — and how much the veteran pays — depends on which of the VA’s 8 priority groups the VA assigns the veteran to when they enroll in VA health care.

The VA assigns the highest priority to veterans with service-connected disabilities. The VA assigns the lowest priority to veterans who earn a higher income and who do not have any service-connected disabilities that make them eligible for VA disability compensation.

Example: If a veteran 1) has a VA service-connected disability rating of 50%; 2) if the VA determined that the veteran can’t work because of their disability; or 3) if the veteran received a Medal of Honor, the VA assigns them to priority group 1; the veteran won’t pay copays for any type of care, tests, or medications.

Learn more about priority groups at https://bit.ly/4bVlcCB. Learn more about VA healthcare costs at https://bit.ly/4mgqtrH, review copay rates at https://bit.ly/4cgip5P, and ask your VA Patient Team Aligned Care Team (PACT) Social Worker about VA health care, vet centers, priority groups, copay rates, registry health exams, service-connection, income levels, special eligibility factors, and how these affect VA healthcare.

The bottom line

It is wise to use a VA-accredited Veterans Service Officer to help you file for state and federal benefits and services. Your benefits are more valuable to you and your family than you realize. Do not procrastinate — enroll in VA healthcare and claim your benefits now!

Continued next week.

Larry Dandridge is a Vietnam War wounded warrior, a combat and 100% service-connected disabled veteran, an ex-Enlisted Infantryman, an ex-Warrant Officer Pilot, and a retired Lt. Colonel. He is a former Veterans Service Officer, a Patient Adviser at the RHJ VA and Durham VA Medical Centers, a Fisher House Charleston Goodwill Ambassador, and the Veteran Benefits Advisor for the AUSA Coastal Carolina Chapter, MOPH Chapter, MOAA Triangle Chapter, and VFW Post 7383. Larry is also the author of the award-winning Blades of Thunder (Book One) and a contributing freelance writer with the Island News. Contact him at LDandridge@earthlink.net or 843-276-7164.

Editor’s note

This article is the first in a series of five.