How to Qualify

[m1ashooter]

This is more of a question of obtaining heathcare treatment verses a disability rating. My wife and I were talking about this last night after watching some coverage of the deaths because of some centers playing games with lists. Sounds like games to make bonus money.

My understand has been the VA would see you if you had a service related injury or a condition caused by a chemical exposure.

It is also my understanding that a vet can us the VA if they meet an income level.

What is the income level you need to be seen at a VA Center? I was on the VA site and it said once you enroll, then the IRS provides the data to see if you can get in the system.

[Dwight55]

Re: How to Qualify

What is the income level you need to be seen at a VA Center? I was on the VA site and it said once you enroll, then the IRS provides the data to see if you can get in the system.

That was my experience in just this last calendar year. They finalized the whole thing by sending me a questionaire that basically asked "Did you and your spouse make these amounts last year?"

I sent the answer back (they were correct for a change) but have not heard from them on that.

I have a heart condition, . . . my son was born with two birth defects, . . . and at times, my face breaks out with what looks like a light case of chlorachne, . . . but they said Agent Orange was not responsible for any of these.

Good luck m1ashooter.

May God bless,
Dwight

[CharlieEcho]

Re: How to Qualify

My experience;

I enrolled over fifteen years ago while waiting for my dad, who was visiting his doctor. At the time I was still working and had good insurance with my employer. There were different levels at that time, still is, based on service connected illness or injury vs non connected and based on income. So I was told. I was told, based on your income level it was prefered but not required to have insurance. Once I retired and began using VA regularly for my yearly physical I filled out another income related form. Nothing changed regarding treatment. I have co-pays on medicines and appointments. I still have private insurance and VA treatments count against family deductibles.

When I retired I asked about required insurance. I was advised that if I didn't have insurance or the insurance would not pay, that the VA picked up the payment. One private insurance company I had, a blood sucking money making *&#@%, never allowed the VA a dime. We have family insurance with Blue Cross / Blue Shield. They have been pretty fair so far with us and the VA. We were allowed to keep this following Obamacare, though it was touch and go for a while. We have two years until Medicare, if it's still around.

I believe there are eight levels of treatment at the VA. You should go to the VA website for better info. At one time the window for participation in VA was closed. My cousin and an acquaintance have both been denied VA participation because they tried to sign up during the closed period. I don't know if either has reapplied or not. Neither had a connected illness or injury.

I believe, Obamacare, has changed some requirements. My only complaint so far with the VA is overtreatment. If I ask for anything they go all out to do as much or more than I think I sometimes need. I'm glad they are there.

[Hawk]

Re: How to Qualify

From what I understand, all veterans are able to get into the system. After that, your income does play a roll. The more you make the lower on the food chain you go. There are 8 steps or levels in their grading system. Each of those levels has their own criteria for qualifying.

Priority Groups Table

The number of Veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up Priority Groups to make sure that certain groups of Veterans are able to be enrolled before others.

Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a Priority Group. The Priority Groups range from 1-8 with 1 being the highest priority for enrollment. Some Veterans may have to agree to pay copay to be placed in certain Priority Groups.

You may be eligible for more than one Enrollment Priority Group. In that case, VA will always place you in the highest Priority Group that you are eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled Veterans.VA determines your eligibility for VA’s comprehensive medical benefits package through our patient enrollment system, which is based on Priority Groups from 1 through 8.

Priority Group 1

Veterans with VA Service-connected disabilities rated 50% or more.
Veterans assigned a total disability rating for compensation based on unemployability.

Priority Group 2

Veterans with VA Service-connected disabilities rated 30% or 40%.

Priority Group 3

Veterans who are former POWs.
Veterans awarded the Purple Heart Medal.
Veterans awarded the Medal of Honor.
Veterans whose discharge was for a disability incurred or aggravated in the line of duty.
Veterans with VA Service-connected disabilities rated 10% or 20%.
Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation.”

Priority Group 4

Veterans receiving increased compensation or pension based on their need for regular Aid and Attendance or by reason of being permanently Housebound.
Veterans determined by VA to be catastrophically disabled.

Priority Group 5

Nonservice-connected Veterans and noncompensable Service-connected Veterans rated 0%, whose annual income and/or net worth are not greater than the VA financial thresholds.
Veterans receiving VA Pension benefits.
Veterans eligible for Medicaid benefits.

Priority Group 6

Compensable 0% Service-connected Veterans.
Veterans exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki.
Project 112/SHAD participants.
Veterans who served in the Republic of Vietnam between January 9, 1962 and May 7, 1975.
Veterans who served in the Southwest Asia theater of operations from August 2, 1990, through November 11, 1998.
Veterans who served in a theater of combat operations after November 11, 1998, as follows:
Veterans discharged from active duty on or after January 28, 2003, for five years post discharge

Priority Group 7

Veterans with incomes below the geographic means test (GMT) income thresholds and who agree to pay the applicable copayment.

Priority Group 8

Veterans with gross household incomes above the VA national income threshold and the geographically-adjusted income threshold for their resident location and who agrees to pay copays

Veterans eligibility for enrollment: Noncompensable 0% service-connected and:

Subpriority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/ or placed in this subpriority due to changed eligibility status.
Subpriority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less

Veterans eligible for enrollment: Nonservice-connected and:

Subpriority c: Enrolled as January 16, 2003, and who remained enrolled since that date and/ or placed in this subpriority due to changed eligibility status
Subpriority d: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less

Veterans not eligible for enrollment: Veterans not meeting the criteria above:

Subpriority e: Noncompensable 0% service-connected
Subpriority g: Nonservice-connected

According to the table above, I am in group 2.

Once enrolled, you would need to take a geographical means test to determine your further eligibility.

More info can be found by looking through the va site http://www.va.gov/

[KPWMS]

Re: How to Qualify

Unless it has changed all you need to do to qualify for VA care is have 180 days active duty and a good discharge. If you have insurance and go to the VA, the VA will bill your insurance compny for your treatment and the VA will not make you pay the deductable your insurance requires if you have one. There is a MEANS test you go through if you are not service connected and you have to pay a co-pay for your meds. The best advice I can give anyone just getting started at the VA is get the Va handbook that has all your benifits and care you are eliagible for. the hand book is called Federal Benefits for Veterans and Dependents. and it is free at all VA centers. AND PLEASE DON"T GET FUSTRATED WITH THE SYSTEM AND GIVE UP