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Qualifying for health benefits can be complex, but understanding the process can provide better outcomes.
This navigator can help you to:
- Learn more about health benefits provided through the United States Department of Veterans Affairs (VA) and Department of Defense (DoD).
- Understand how to apply and enroll in VA health care.
- Identify how to get help from representatives who have experience and knowledge of the VA’s process for awarding benefits.
Important Tips:
- Be persistent. Criteria for these programs are frequently revised, so eligibility for certain benefits may change. Ask questions and seek out help.
- Gather and organize the veteran’s information. The VA requires physical documentation to determine the benefits a service member is qualified for.
- Stay engaged after submitting initial applications to VA and other programs. No one wants to restart the application process for missing a deadline.
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Table of Contents
Intro to Benefits
What are VA benefits?
The government provides a number of services to help veterans in civilian life. Although not all VA benefits are related to health, service members who experience specific hardships or disabilities as a result of their service may be eligible for specialized health benefits which can sometimes include extra assistance for their caregivers.
- Any veteran who served in active uniformed service and didn’t receive a dishonorable discharge may qualify for benefits from the VA.
- VA benefits, and the level of help they can provide, often change because the VA receives different sums of money from Congress each year.
It's important to note that, in most cases, VA health services are only provided to the Veteran and not their spouse or family.
What health benefits are available?
Depending on household size, income or disability status, veterans and dependents may qualify for any or all of these:
- VA health care benefits.
- Private insurance administered through the Affordable Care Act (ACA).
- Free or low-cost Medicaid or Children’s Health Insurance Program (CHIP).
Other forms of health care coverage (ACA or another private insurance plan, Medicare, Medicaid, or TRICARE), can be used in addition to VA healthcare benefits.
- Having any other health insurance coverage doesn’t affect the VA health care benefits you can get.
- Medicaid provides health care coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults in long-term care and people with disabilities.
New PACT Act Benefits
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In what is being described as one of the largest VA benefit expansions in the history of the U.S., the PACT Act provides additional benefits and health services to more than 5 million Vietnam, Gulf War, post-9/11 eligible veterans. Visit va.gov/PACT to learn more.
Additional Toxic Exposure and Illness Health Coverage, Treatment and Patient Outreach
- Every enrolled veteran will receive an initial toxic exposure screening and a follow-up screening at least every five years. Veterans not currently enrolled but who are eligible will have an opportunity to e receive the screening.
- 20 more illnesses are now eligible for disability benefits as a result of exposure to burn pits and other toxins: meaning veterans will not have to prove that their service caused their condition(s).
This can help the paperwork required and need for a disability exam before being granted access to health care and compensation. The list includes 11 respiratory related conditions and several forms of cancer.
What does this mean for Vietnam era veterans?
- New presumptive conditions for Agent Orange include high blood pressure and monoclonal gammopathy of undetermined significance.
- Veterans who served at an additional five locations are now assumed to have been exposed to Agent Orange if they served during specified dates.
- Veterans who were a part of response efforts in three locations are now assumed to have been exposed to radiation if they served during specific dates.
Impact on Gulf War and Post-9/11 Veterans
- Newly considered presumptive conditions and cancers include brain, glioblastoma, kidney, melanoma, neck and pancreatic cancers, along with any type of cancer that is gastrointestinal, head-related, lymphatic, lymphoma, reproductive and respiratory.
- Other conditions presumed to be service connected include: Asthma diagnosed after service; chronic bronchitis, COPD, rhinitis, sinusitis; constrictive or obliterative bronchiolitis; and emphysema.
- Post-9/11 veterans who served in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen — and any airspace above these locations – are presumed to have been exposed to burn pit toxins.
- Gulf War and post-9/11 era veterans who served in these locations are presumed to have been exposed to burn pits: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the UAE — and any airspace above these countries.
VA Health Care Enrollment Period Expanded
- Post 9/11 and combat veterans may enroll within 10 years of their discharge date instead of five. For other veterans, a one-year open enrollment period is available to join VA healthcare without having to demonstrate a service-connected disability.
- Veterans discharged before October 1, 2013: those who meet the requirements listed below can apply and receive care during a year-long special enrollment period beginning October 1, 2022.
Veterans must have been active-duty during a theater of combat operations that include:
- A period of war or an operation after the Persian Gulf War, or
- Combat service against a hostile force after November 11, 1998.
And both of these must be true:
- A veteran must have been discharged or released between September 11, 2001, and October 1, 2013, and
- Has not enrolled in VA health care before.
VA encourages eligible veterans to apply during the 1-year period to receive any urgent care they might need now or in the future. Enrollment is free and VA health care may be free, too.
What is Available to Military Families?
- Family members of veterans who died due to one of these conditions may also be eligible for survivors benefits, including dependency and indemnity compensation.
- A one-time accrued benefits payment
- Health care through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
- A burial allowance for help with funeral or burial costs for qualifying spouses, partners or children. Visit aarp.org/vetsburialbenefits to learn more.
How to file a claim online
- Claims can be filed online, by mail, in person or with the help of a trained professional from a Veteran Service Organization.
- Claims for conditions that were denied in the past but are now considered presumptive should be filed through a supplemental claim.
- Full details and eligibility information related to the PACT Act can be found at va.gov/PACT, by calling 800-MyVA411 (698-2411) or by visiting a Veterans Benefits Administration (VBA) regional office.
VA Specialty Programs
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Accessing Veterans Specialty Care Programs and Services
First of all, what is a specialty care program or service?
The VA recognizes that in order to address a number of unique situations, many veterans and their families need specialized programs and services, such as:
- Women Veterans Health Care Program
- Specialty Emotional and Mental Health Services
- Specialty Dental, Oral, Hearing and Vision Services
- Family Caregiver Assistance Program
These programs and services require specific qualifications based on circumstances that are laid out by legislation or regulations established by the VA.
Information on qualifying for and using these specialty care programs and services is provided below.
Women Veterans Health Care Program
Women veterans are a diverse group — professionals, mothers, retirees — of varying ages; racial, ethnic and gender identities; and sexual orientation. The VA recently established a Center for Women Veterans that provides healthcare teams that can help in all stages of a woman’s life and health status, including:
- Comprehensive Primary Care
- Military exposures and whole health
- General health and cancer screenings, such as breast, cervical and colon, and other unique services for women
- Gynecologic and fertility treatments
- Sensory aids and prosthetics, including gender-specific items like those used after a mastectomy
- Other specialties, including radiology, neurology, cardiology, orthopedics, rheumatology, oncology and endocrinology
For women who have transitioned from active-duty or reserve/guard service, an online course is available to help them understand the VA’s health care benefits and services available.
Call, text or chat online with the Women Veterans Call Center (WVCC) at 1-855-829-6636 to get help and to obtain specific assistance from trained women representatives about available health resources and services.
Specialty Emotional and Mental Health Services
VA Health covers physical as well as emotional and mental health care. This includes a range of services, such as checkups, home health care, and mental health care services for post-traumatic stress disorder (PTSD), psychological effects of military sexual trauma (MST), depression, grief, anxiety and many other ailments.
The VA is concerned about addressing the risk of suicide among those who have served in the military and has a hotline and other services available — including for veterans not enrolled in VA health care.
If you are a veteran in mental health crisis and are thinking about hurting yourself (or if you know a veteran in this situation), you can get help right away:
- Call 1-800-273-8255, select 1, or
- Text 838255
Veterans also can call 1-877-927-8387 to talk with a fellow combat veteran about their experiences or concerns, 24 hours a day, seven days a week, 365 days a year.
Identify how to generally qualify for VA Mental Health Care:
If you have a VA primary care provider, talk with this professional about your concerns. Your provider can help you figure out if you have PTSD or other issues and can offer treatment and support.
If you don’t have a VA primary care provider or have never been seen in a VA hospital or clinic, contact the VA in one of these ways:
- Call the general information hotline at 1-800-827-1000, Monday through Friday, 8 a.m. to 9 p.m. ET
- Contact a local VA medical center.
Specialty Dental, Oral, Hearing and Vision Services
The VA offers comprehensive dental, oral, hearing and vision care benefits for qualifying veterans.
Hearing and vision challenges can be linked to many service-connected disabilities, as military members are disproportionately exposed to environments negatively affecting sensory capabilities.
What’s more, a large number of veterans receive VA dental or oral care due to issues ranging from cancers to oral and facial surgery resulting from trauma or serious illness.
While there are exceptions, the most effective way to qualify for any of these specialty care services is to apply for VA Health Care as shown in other sections of this Navigator.
If not eligible for specialized services, veterans enrolled in VA Health can purchase specialty insurance through the VA, such as dental insurance at a reduced cost. Veterans who have recently served (for example, OEF/OIF/OND) may be entitled to a one-time course of free dental care.
For more information about eligibility for the VA’s specialty dental and medical benefits, call 1-877-222-VETS (8387) or click here.
Family Caregivers Assistance Program
This VA program provides educational services, monetary assistance and other benefits to qualifying veteran family caregivers. Eligibility is determined if the caregiver(s) and the veteran being cared for meet certain requirements.
The family caregiver must be at least 18 years old and either be:
- A spouse, son, daughter, parent, stepfamily member or extended family member of the veteran, or
- Someone who lives full-time with the veteran or is willing to do so if designated as a family caregiver.
The veteran also must meet certain qualifications:
- Have a VA disability rating of 70% or higher that was made worse during specific periods of active duty (as described by the VA) and
- Require at least six months of continuous in-person personal-care services.
To apply, both the veteran and the caregiver(s) need to sign and date an application and answer questions about their circumstances.
Applications can be submitted online, by mail or in person at a VA Medical Center (Caregiver Support Coordinator).
Additional information on qualifications and program details are available by clicking here, or by calling the VA at 1-855-260-3274.
VA and Other Insurance Plans
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VA Health Services Works With Other Health Insurance Plans
If not already enrolled, make sure to enroll in Medicare during the eligibility window — three months prior to turning 65 years of age, through the three months after turning 65 (a total of seven months). Here’s how:
- Social Security online
- Call Social Security at 1-800-772-1213*, Monday through Friday, from 7 a.m. to 7 p.m., or
- In person at any local Social Security office.
If a veteran already has other forms of health coverage (like a private insurance plan, Medicare, Medicaid or TRICARE), they can use VA health benefits along with these plans — so applying to the VA is still a good idea.
Learn more about how VA works with other health insurance by calling the VA toll-free hotline at 1-877-222-8387*, Monday through Friday, 8 a.m. to 8 p.m. ET and ask for assistance.
Additionally, 1-800-MyVA411* is a national, toll-free number that serves as a “front door” to VA. You can still reach VA at any other direct or contact center numbers, but 1-800-MyVA411 offers the simplicity of a single number to call when you don’t know whom to call.
Also, use the recommendations for applying for VA Health Benefits.
Steps to Obtaining VA Health Benefits
Three Steps to Getting VA Health Benefits
- Identify if a service member is eligible for VA health services.
- Ensure you have your important documents.
- Reach out to others if you need help.
How to Determine Which VA Benefits Are Available
Veterans qualify for benefits in three ways:
- Service-connected injury: A disability from an injury or illness incurred during or because of military service.
- Special circumstance: Recipients of a Purple Heart or Medal of Honor, and prisoners of war.
- Low income: Those with an income below a certain dollar amount determined by the VA.
Disability-Related Benefits
How to Qualify for Disability-Related Benefits
Disabilities come in two forms:
- Physical conditions like a chronic illness or injury.
- Mental health conditions like PTSD, that developed before, during or after service.
If you have a disability, you may also qualify for disability compensation: monthly tax-free payments based off your condition.
To qualify, both of the following must be true:
- Served at least 180 days of active duty, active duty for training, or inactive duty training.
- Received a disability rating from the VA for your service-connected condition.
AND at least ONE of the following must be true:
- In-service disability: A sickness or injury that occurred while serving and linked to current condition.
- Preservice disability: An illness or injury before joining the military that was made worse from serving.
- Post-service disability: A disability related to active duty that didn’t appear until after service ended.
If you are already receiving disability pay, it should be easier to also obtain health benefits
