Combat Veteran Eligibility

 Benefit Description: The Department of Veterans Affairs (VA) provides cost-free health care services and nursing home care for conditions possibly related to military service to veterans with combat service after November 11, 1998 for a 2-year period beginning on the date of their separation from active military service. Who’s eligible: Veterans, including activated Reservists and members of the National Guard, are eligible if they served on active duty in a theater of combat operations during a period of war after the Gulf War or; were in combat against a hostile force during a period of “hostilities” after November 11, 1998 and, have been discharged under other than dishonorable conditions. What’s meant by “hostilities”: “Hostilities” is defined as conflict in which Armed Forces members are subjected to the danger comparable to that faced in a period of war. Acceptable documentation includes: 

•service documentation that reflects service in a combat theater, or  

•receipt of combat service medals and/or,  

•receipt of imminent danger or hostile fire pay or tax benefits.  

What are combat veterans eligible for: 

•Cost-free care, including medications, for conditions potentially related to their combat service for up to 2 years following their discharge or release from active duty.  

•Enrollment into Enrollment Priority Group 6 if not otherwise qualified for a higher enrollment priority group assignment.  

•Full access to VA’s Medical Benefits Package.  

What happens after the 2-year authority expires: Veterans who enroll with VA under this authority will retain enrollment eligibility even after their 2-year post discharge period ends under current enrollment policies. At the end of that 2-year period VA will reassess the veteran’s information (including all applicable eligibility factors) and make a new enrollment decision. If the veteran was in Priority Group 6 and no other eligibility factors apply then he/she will continue enrollment in either Priority Group 7 or Priority Group 8 depending on their income level and will be required to make applicable copayments. What about combat veterans who do not enroll during this post 2-year period: For those veterans who do not enroll during this 2-year post-discharge period, eligibility for enrollment and subsequent care is based on other factors such as: a compensable service-connected disability, VA pension status, catastrophic disability determination, or the veteran’s financial circumstances. For this reason, combat veterans are strongly encouraged to apply for enrollment within 2 years of release from active duty to take advantage of the special combat veteran eligibility even if no medical care is currently needed.  

Copays: Veterans who qualify under this special eligibility are not subject to copays for conditions potentially related to their combat service. However, unless otherwise exempted, combat veterans must either disclose their prior year gross household income OR decline to provide their financial information and agree to make applicable copays for care or services VA determines are clearly unrelated to their military service. Note: While income disclosure by a recently discharged combat veteran is not a requirement, this disclosure may provide additional benefits such as eligibility for travel reimbursement, cost-free medication and/or medical care for services unrelated to combat. Dental Care: Eligibility for VA dental benefits is based on very specific guidelines and differs significantly from eligibility requirements for medical care. Combat veterans may be authorized dental treatment as reasonably necessary for the one-time correction of dental conditions if:  

•They served on active duty and were discharged or released from active duty under conditions other than dishonorable from a period of service not less than 90 days and  

•The certificate of discharge or release does not bear a certification that the veteran was provided, within the 90-day period immediately before the date of such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental service and treatment indicated by the examination to be needed and  

•Application for VA dental treatment is made within 90 days of discharge or release  

Additional information: Additional information is available at the nearest VA medical facility. VA facilities listing and telephone numbers can be found on the internet at www.va.gov/directory, or in the local telephone directory under the “U.S. Government” listings. Veterans can also call theHealth
Benefit
Service
Center toll free at 1-877-222-VETS (8387) or visit the VA health eligibility website at www.va.gov/healtheligibility.  

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