Enrollment and Enrollment Priority Groups The VA operates an annual enrollment system that helps to manage the provision of health care. Once the VA enrolls a veteran, that veteran remains enrolled in the VA health care system and maintains access to certain VA health benefits. During the enrollment process, the VA will use the veteran’s VA disability rating and other factors to place the veteran in one of eight Enrollment Priority Groups. Priority Group 1 is considered the highest priority group to receive care, and Group 8 is the lowest. The VA uses the Enrollment Priority Groups to ensure that veterans who need healthcare the most will be covered if the VA have enough funding to provide healthcare to all veterans. The number of veterans who can be enrolled in the health care program is determined by the amount of money Congress gives the VA each year. Because funds are limited, the VA set up Priority Groups to make sure that certain groups of Veterans can be enrolled before others. Some veterans may be eligible for more than one Enrollment Priority In that case, the VA will always place the veteran in the highest Priority Group the individual is eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled veterans. The Enrollment Priority Groups determine how much a veteran has to pay (in co- pays) when he or she receives medical treatment and medications. There are many other qualification rules for assignment into the Priority Groups, and this aspect of the VA healthcare system is very complex. The main qualifications are the following: Priority 1: Veterans with service-connected disabilities rated 50 percent or more; and veterans determined by VA to be unemployable due to service-connected conditions. Priority 2: Veterans with service-connected disabilities rated 30 percent or 40 percent. Priority 3: Veterans with service-connected disabilities 10 percent and 20 percent; veterans who are former Prisoners of War (POW) or were awarded a Purple Heart medal; and veterans whose
Enrollment and Enrollment Priority Groups The VA operates an annual enrollment system that helps to manage the provision of health care. Once the VA enrolls a veteran, that veteran remains enrolled in the VA health care system and maintains access to certain VA health benefits. During the enrollment process, the VA will use the veteran’s VA disability rating and other factors to place the veteran in one of eight Enrollment Priority Groups. Priority Group 1 is considered the highest priority group to receive care, and Group 8 is the lowest. The VA uses the Enrollment Priority Groups to ensure that veterans who need healthcare the most will be covered if the VA have enough funding to provide healthcare to all veterans. The number of veterans who can be enrolled in the health care program is determined by the amount of money Congress gives the VA each year. Because funds are limited, the VA set up Priority Groups to make sure that certain groups of Veterans can be enrolled before others. Some veterans may be eligible for more than one Enrollment Priority In that case, the VA will always place the veteran in the highest Priority Group the individual is eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled veterans. The Enrollment Priority Groups determine how much a veteran has to pay (in co- pays) when he or she receives medical treatment and medications. There are many other qualification rules for assignment into the Priority Groups, and this aspect of the VA healthcare system is very complex. The main qualifications are the following: Priority 1: Veterans with service-connected disabilities rated 50 percent or more; and veterans determined by VA to be unemployable due to service-connected conditions. Priority 2: Veterans with service-connected disabilities rated 30 percent or 40 percent. Priority 3: Veterans with service-connected disabilities 10 percent and 20 percent; veterans who are former Prisoners of War (POW) or were awarded a Purple Heart medal; and veterans whose
2017_WIPA_Manual_Module_4_S.docx