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Breakdown of VA Priority Groups for Medical Benefits

September 23, 2021
In this article...
  • Find out what regulations and guidelines the Department of Veterans Affairs uses to classify enrolling veterans into Priority Groups for medical benefits.

When veterans apply for medical benefits through the U.S. Department of Veterans Affairs (VA), they are placed into one of eight priority groups used to allocate funds. Priority for medical services is based on several factors, such as disability rating assigned by the VA, military service history and income related to other benefits, including Medicaid and VA pension.

In nearly all cases, the lower number the priority group an individual is assigned, the higher priority they are to receive benefits. If a veteran qualifies for more than one priority group, they will be placed in the lowest numbered group possible. This breakdown is designed to help veterans determine which priority group they may be eligible for when enrolling for VA medical benefits.

8 VA Priority Groups

Below is a complete breakdown of these eight priority groups along with each group’s eligibility requirements.

Priority Group 1

Veterans are eligible for Priority Group 1 if:

  • They were awarded the Medal of Honor.
  • They have a service-connected disability that is VA-rated to be 50% or more disabling.
  • The VA determines their unemployment status is due to service-connected conditions.

Priority Group 2

Veterans are eligible for Priority Group 2 if:

  • They have a service-connected disability that is VA-rated to be 30% to 40% disabling.

Priority Group 3

Veterans are eligible for Priority Group 3 if:

  • They are a former Prisoner of War (POW).
  • They were awarded the Purple Heart medal.
  • They have a service-connected disability that is VA-rated to be 10% to 20% disabling.
  • They were discharged from service due to a disability that they incurred or was aggravated while on duty.
  • They are awarded special eligibility under the U.S. code that states “benefits for individuals disabled by treatment or vocational rehabilitation” (Title 38, U.S.C., section 1151).

Priority Group 4

Veterans are eligible for Priority Group 4 if:

  • They are receiving household benefits or aid and attendance from the VA.
  • They have been rated as catastrophically disabled by the VA.

Priority Group 5

Veterans are eligible for Priority Group 5 if:

  • They are receiving VA pension benefits
  • They are eligible for Medicaid programs.
  • They are a nonservice-connected or non-compensable service-connected veteran who was VA-rated to be 0% disabling and have an annual income below the income limits for the VA and their geographical location.

Priority Group 6

Veterans are eligible for Priority Group 6 if:

  • They are a compensable 0% service-connected veteran.
  • They participated in Project 112/SHAD.
  • They incurred ionizing radiation exposure either through testing projects or during the occupation of Nagasaki and Hiroshima.
  • They served in the Republic of Vietnam at any time between January 9, 1962, and May 7, 1975.
  • They served in the Persian Gulf War at any time between August 2, 1990, and November 11, 1998.
  • They served at Camp Lejeune military base for a period of at least 30 days at some point between August 1, 1953, and December 31, 1987.
  • They are eligible for enhanced benefits for a period of 5 years after discharge if they are currently enrolled or newly enrolled in benefits and served in a theater of combat operations at any time after November 11, 1998, or they were discharged for duty on or after January 28, 2003.

When the 5-year enhanced benefit period concludes, veterans are reclassified into the priority group based on current eligibility.

Priority Group 7

Veterans are eligible for Priority Group 7 if:

  • They agree to copays and their gross income level is below that adjusted income level for their geographical location.

Priority Group 8

Veterans are eligible for Priority Group 8 if:

  • They agree to copays and have a gross income level higher than the adjusted income limit for the VA and their geographical location.
  • They are eligible for “subpriority a” if they are noncompensable 0% service-connected and have been continuously enrolled since January 16, 2003, or have been reassigned to this subpriority due to changes in their eligibility status.
  • They are eligible for “subpriority b” if they are noncompensable 0% service-connected, their current income exceeds income limits for the VA and their geographical location by 10% or less and they were enrolled on or after June 15, 2009.
  • They are eligible for “subpriority c” if they are nonservice-connected and have been continuously enrolled since June 16, 2003, or were reclassified to this subpriority due to current eligibility status.
  • They are eligible for “subpriority d” if they are nonservice-connected, they have an income that exceeds income limits for the VA and their geographical location and enrolled on or after June 15, 2009.
  • They are eligible for “subpriority e” if they do not meet any eligibility requirements listed above and they are noncompensable 0% service-connected.
  • They are eligible for “subpriority g” if they do not meet any eligibility requirements listed above and they are nonservice-connected.

Veterans interested in enrolling for medical benefits with the United States Department of Veterans Affairs should apply online, by phone (877-222-8387) or in person at their local VA office.