Health Care Eligibility
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Veterans health benefits eligibility is extended to veterans who have been honorably discharged from the U.S. Armed Forces, as well as service personnel who are currently serving on active duty. Veteran eligibility for health care enrollment is available to those who meet the minimum requirements for veterans health care benefits and have served for the required minimum tour. While most applications are processed within the same week in which they were received, not everyone will be granted access to veterans health care. To find out more about veterans health benefits eligibility, select from the following topics:
- Basic eligibility and minimum service requirements
- Enhanced eligibility programs
- Enrollment for VA health care
- Veterans health care application in a pending status
Basic Eligibility and Minimum Service Requirements
Veterans health care eligibility is offered to former service personnel who served, were honorably discharged and have been classified as a veteran by the Veterans Affairs department. Many veterans believe that they will not qualify to meet veterans health benefits eligibility if they did not incur a service-related disability designation. However, this belief is unfounded. Veteran eligibility for health care enrollment is determined based on many factors, but health care eligibility is extended even to veterans who did not serve in a war zone. Veteran eligibility for health care enrollment is based on factors such as service dates, where the service member was deployed and other qualifying factors.
Enhanced Eligibility Programs
Certain veterans are qualified to enroll to receive veterans health care benefits based on an enhanced eligibility status. Veterans who were at one time a POW, veterans who received the Purple Heart or Medal of Honor and veterans who receive a VA Pension will be considered under this enhanced program. Additionally, veterans health care eligibility is offered to those who were discharged early due to a disability or hardship, those who served on active duty in a theater of combat operations and those who served in any war zone for a full tour.
Enrollment for VA Health Care
To enroll to receive veterans health care benefits, form 10-10EZ will be required. In order to complete this form, the applicant will need to gather information about his or her service, such as DD Form 214 (Report of Separation), dates of service, branch of the service, service records (if the applicant was a POW or a Purple Heart recipient) or military records that indicate participation in a war zone and hostile combat situations. Unlike civilian health care programs, veterans do not need to renew each year. Veterans health care eligibility remains in effect from one year to the next, after a veteran has submitted all documentation, information and forms successfully. Once the minimum requirements for veterans health care benefits have been met, the veteran will receive a Veteran Health Identification card, which allows the holder access to participating VA medical facilities. The VA card will also serve as proof of service in lieu of a military ID card. Petitioners can enroll to receive veterans health care benefits online, through mail or in person at any VA facility.
Veterans Health Care Application in a Pending Status
The VA determines veterans health benefits eligibility within a week of receiving the application. If the applicant meets the minimum requirements for veterans health care benefits, then the VA sends a determination and acceptance letter to the applicant, along with a handbook listing the various services available to the new enrollee. In some instances, however, veterans health care eligibility takes longer to process. A delay that results from a pending status will be reported to the applicant, and the reasons for the delay may be detailed in the letter. The pending status is not a rejection, but instead indicates that some of the information has been found to be inconsistent or incomplete. In order to enroll to receive veterans health care benefits, the veteran must fill out the VA form completely and have the required documentation accompanying it. The VA will attempt to retrieve needed documents from the military databases or the Department of Defense offices. However, the applicant will not be allowed to enroll to receive veterans health care benefits if the missing information is not able to be obtained. In this instance, the VA will contact the applicant by mail to request the information or documents.
Despite a veterans health care eligibility approval, some veterans opt to disenroll from the health care plans offered by the VA. Cancellation can be undertaken at any time, but the veteran must write a signed and dated letter. If at any time the veteran wishes to reenroll, he or she may do so without penalty.