How to Apply for VA Health Care Benefits

VA healthcare enrollment operates on a rolling basis. Service members leaving or already separated from the military may apply for VA medical benefits at any time.

Service members and veterans may need to act by certain deadlines, however, to avoid being without insurance or to avoid enrollment exams. The Department of Veterans Affairs makes every effort to process applications in a timely fashion, with a target of taking no more than five days to determine eligibility once applications are complete. In some cases, applicants may be eligible to begin receiving benefits before their applications have been submitted or while they are in processing.

Once a veteran’s application has been approved and he or she is enrolled, the veteran remains enrolled unless or until they choose to unenroll from the program. As part of the VA health care application and enrollment process, all approved applicants are assigned to a Priority Group. Enrollees’ priority groups will directly influence what services they qualify to receive and at what cost.

Ways to Apply for VA Medical Benefits

Veterans and separating service members can apply for VA health care online, in person, by phone or by mail. For applicants’ convenience, the VA encourages that they use its online system whenever possible. Veterans may apply by phone at 1-877-222-VETS (8387).

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Applicants who wish to apply in person or by mail can download and print a copy of the VA health benefits application Form 10-10EZ (Application for Health Benefits) from the Department of Veterans Affairs website. Applicants may submit their completed forms in person at the nearest VA facility. Alternatively, they can mail their applications to:

VA Health Eligibility Center
2957 Clairmont Road, Suite 200
Atlanta, Georgia 30329

If a VA health benefits application is incomplete when it is submitted, the VA will make every effort to obtain the missing information from its databases, the Department of Defense or the applicant. While the VA is researching, incomplete applications are marked as “pending.” Veterans in need of emergency assistance while their applications are pending may contact the VA for assistance.

VA Health Care Application Questions

The VA health benefits application has seven sections. Not all applicants will need to complete all sections. The sections are as follows:

  • Section 1: General Information. Basic identifying information, including name, race, Social Security Number, address and next of kin.
  • Section 2: Military Service Information. Branch of military and dates of service, medals awarded and disability ratings, where applicable.
  • Section 3: Insurance Information. Veterans applying for VA health care who hold other insurance as well must list their policy information on the application.
  • Section 4: Dependent Information. Applicants should list their spouses and children, regardless of whether they live(d) together at the time of application.
  • Section 5: Employment Information. Applicants who are employed at the time of application must supply information on their current employers.
  • Section 6: Prior Year Gross Annual Income. Figures must be provided for applicants and, where applicable, spouses and children.
  • Section 7: Prior Year Deductible Expenses. Medical expenses, burial expenses and educational costs.

Applicants must sign all completed VA health care applications before submitting them.

VA Health Care Application Financial Reporting Conditions

Some veterans who apply for VA medical benefits will qualify for no-cost care due to non-income related factors. These veterans may not need to provide the VA with any personal financial information during the application process.

Other veterans, however, may be required to supply gross household income figures with their VA health care applications. Applicants are generally required to submit approved documentation or evidence supporting their figures, as well, to meet eligibility for VA health care benefits. Federally established VA income limits will be used to determine if applicants qualify for VA medical benefits and what level of copays they will be required to pay.

VA Medical Benefits Applications and Dishonorable Discharges

Veterans who were discharged from the military under terms other than honorable do not typically qualify for VA healthcare enrollment. However, veterans and service members can request a Character of Discharge review to have their discharge statuses upgraded to “honorable for VA purposes.”

Character of Discharge review boards will consider such upgrades when veterans can provide reasonable evidence that their discharges were linked to sexual orientation, mental health conditions, traumatic brain injuries or sexual assault or harassment (MST). Service members whose statuses are appropriately upgraded become eligible to submit a VA medical benefits application and receive benefits.

Character of Discharge reviews may significantly extend the amount of time it takes veterans to sign up for VA healthcare. Applicants in physical or financial need may qualify to receive benefits while their applications are still pending.

Inappropriate VA Healthcare Enrollment

Rarely, veterans who apply for VA health care are enrolled and are later found to be ineligible. When this happens, the VA informs veterans in writing 60 days before they are to be disenrolled. Disenrollment letters clearly state the reason for the change in eligibility decision, the date upon which VA medical benefits will cease and how to submit an appeal, if desired.

Veterans will then have the opportunity to appeal the decision and to provide additional information which may sway the determination. If the initial enrollments are then upheld, veterans may remain enrolled and continue to access care.

If veterans’ VA healthcare enrollment is discontinued, they will have the opportunity to transfer their health care plans to a commercial plan or to make other alternatives to ensure continuity of care. Veterans with questions about this process may call 1-877-222-VETS (8387) or 1-800-829-4833, if they are hearing impaired. Assistance is also available via the VA’s Inquiry Routing & Information System (IRIS) website or the enrollee’s Care Team.

Post Application Steps

Once veterans’ health care applications have been approved, there will be a few remaining steps to complete VA healthcare enrollment.

  • Priority Group assignment. The VA will assign all new enrollees to a Priority Group based on their eligibility. Veterans who qualify for more than one group will be placed in the highest group for which they are eligible.
  • Information Package review. All new enrollees are provided with a customized Handbook explaining their benefits and how to access them.
  • Welcome call and initial appointment with VA staff. New enrollees will receive a welcome call from the VA and an invitation to schedule their first appointments for care.
  • Veteran Health Identification Card (VHIC) issuance. Upon VA healthcare enrollment, new enrollees will be issued an ID card which they can use as proof of identity when receiving services.
  • Personalized Care Team assignment. The VA will assign all new enrollees a Patient Aligned Care Team (PACT), to include a primary care provider, clinical pharmacist, registered nurse care manager, licensed practical nurse or medical assistant and clerk.

Verifying VA Healthcare Enrollment

In most cases, separating service members wondering “am I enrolled in VA health care?” can log on to their service branches’ main portals to check their health care enrollment statuses. Alternatively, they can call the VA hotline or request assistance in person at the nearest VA facility or regional benefits center. Veterans and service members may also be eligible to enroll family members for VA health care benefits.

 

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