If I’m a Veteran, Why Can’t I Get VA Health Care?
July 30, 2012
Many veterans are stunned to hear that they do not qualify for VA Health Care simply because they are veterans.
Most veterans who have private health insurance with significant co-pays – especially for expensive treatments like chemotherapy– are looking for alternatives to get their treatments paid for by the VA. But because of rules that changed in 2003, veterans are no longer eligible for VA Health Care because of their veteran status.
The reason for this is rather straightforward: budget cuts.
In 2003, Congress passed a budget that included a freeze on veterans qualifying for benefits, what the VA calls Priority 8. The VA has eight priority groups that it uses to qualify veterans for VA-funded health care.
The highest priority groups are reserved for those veterans with “service connected” disability ratings, or veterans in special groups such as:
- Former POWs;
- Those exposed to Agent Orange;
- Recipients of the Medal of Honor; and
- Recipients of a Purple Heart.
Veterans can qualify for VA Health Care in lower priority groups based on having an income below the VA national income threshold or geographic income thresholds.
The lowest-priority group, Priority Group 8, allowed veterans who did not qualify based on any of the aforementioned criteria but who agreed to pay copays . . . and this is the group that was affected by the 2003 budget cuts.
The result of these cuts was that the VA no longer could accept new veterans into Priority Group 8, and veterans who do not qualify for one of the higher-priority groups are no longer eligible for VA-funded health care.
Veterans already enrolled in Priority 8 were grandfathered in and allowed to continue receiving VA health care in that priority group.
This change often comes as a shock to many veterans who were always told that they could go to the VA for their health care if needed. And many of them who never applied before 2003 are now regretting that they didn’t get in before those changes went into effect.
Unfortunately, the VA guidelines are probably going to get worse before they get better. As recently as last year, the House of Representatives proposed a plan to cut VA Health Care for those in Priority Groups based on income, specifically those who have incomes above the national threshold (currently $36,554 per year for a veteran and one dependent) but who are below the geographic threshold.
If these or any similar changes were to do into effect, it would mean that even fewer of us will qualify for VA Health Care. And the hardest hit will be to those veterans with limited income who may not be able to afford private health insurance.
For veterans with a service-related asbestos illness such as mesothelioma, asbestos lung cancer and asbestosis, we can get them qualified for VA Health Care by getting their disability approved as service related.
This would qualify them for a VA disability payment each month, in addition to VA Health Care in one of the higher priority groups. But even if we expedite the Disability Claim, it does take time to get an approval from the VA . . . time that is all-too-precious when you are dealing with mesothelioma or lung cancer.
By the time we get a veteran qualified for disability compensation, the veteran has typically already started treatment, causing them to start accruing hefty bills due to copays required by their private health insurance plans.
If you are a veteran diagnosed with an asbestos illness, I would encourage you to contact us and allow us to look into whether you may qualify for VA Health Care or VA Disability Compensation. It could be well worth your time.