DO VETERANS RECEIVE FREE VA HEALTH CARE? UNDERSTANDING YOUR COVERAGE OPTIONS

There is a lot of confusion about what the VA health care benefit is, and what coverage is available for Veterans. Some Veterans may believe that since they don’t have a disability rating, they do not qualify for health care through the VA. But the truth is all Veterans are eligible to apply for VA health care.

While all Veterans are eligible for VA health care, there are determining factors that will impact if you qualify. And, additional factors will determine what care is covered, and whether a copay is required for certain services.. In this article we will break down how to enroll in health care, disability, what is covered, priority groups, and copays.

Enrolling in VA Health Care: What Steps Should I Take?

The first step to enrolling in for health care with the VA is to head over to their website and look at if you qualify. The general requirement for most Veterans is serving 24 months on active duty; however, there are exceptions based on when you served.

After checking your eligibility, you’ll need your social security number, and insurance card information for all health insurance companies that cover you. This includes Medicare, private insurance, or insurance from your employer.

You can also provide the following information: your military service history, a copy of your DD214, income information, and deductible expenses.

All Veterans should apply to enroll in health care with the VA even if they do not believe they qualify. Let the VA tell you no, instead of disqualifying yourself before enrolling.

To apply, Veterans need to complete the EZ10-10. You can apply online, by phone, or in person at a VA hospital.

Once you are approved for health care with the VA, you will be required to go in person to the closest VA hospital to enroll in health care services for that district.

Veterans who enroll in VA health care within the first five years (ten years for combat Veterans) after they discharge from military service are not subject to income caps. After the time period ends, there are income caps that can make it difficult for Veterans to be eligible for health care through the VA.

If you receive a disability rating of 0% or higher, you can enroll in health care with the VA any time after service and will not be subject to income caps.

Basic Health Care Coverage Options

All Veterans enrolled in VA health care receive a general health physical once a year along with any required lab work.

Additional coverage includes:

• Readjustment counseling and related mental health services
• Counseling and care for issues related to military sexual trauma
• Exams to determine your risk of health problems linked to your military service
• Care related to a VA-rated service-connected disability
• Care for cancer of head or neck caused by nose or throat radium treatments received while in the military
• Individual or group programs to help you quit smoking or lose weight
• Care that’s part of a VA research project (like the Million Veteran Program)
• Laboratory (lab) tests
• Electrocardiograms (EKGs or ECGs) to check for heart disease or other heart problems
• VA health initiatives that are open to the public (like health fairs)

You won’t need to pay a copay for any of the services listed above, no matter what your disability rating is or what priority group you’re in. Additional care is based on priority groups which will be discussed below.

Combat Vets Are Eligible for Free Healthcare

Combat Veterans receive free health care for any illness possibly related to their service in theater for ten years after military service.

Being a combat Veteran will put you in a minimum of priority group 6 for ten years after you leave the service. After ten years, your priority group will be reassessed and may change.

The PACT ACT has expanded the list of presumptive conditions related to serving in Iraq or Afghanistan making it easier for Veterans to receive a disability rating for many illnesses related to combat in theater.

VA Disability Can Impact What Health Care You Receive

VA disability and VA health care are two separate entities. You do not have to be enrolled in one to take advantage of the other.

You can receive VA disability and not receive or enroll in health care at a VA facility. You can also receive care at a VA health clinic or hospital and not have a disability rating.

Having said this, VA disability can affect what health care you receive from the VA. The VA provides care for any medical condition you receive a rating of 0% or higher for.

Your disability rating also affects your priority group, which determines what care is covered and how much your copay is for various services.

Understanding VA Health Care Priority Groups

There are eight priority groups with the VA. Priority groups help determine what coverage you receive and what copays Veterans have.

We broke out what is required for each priority group in depth here, but here’s a quick summary.

Priority group 1 has the most benefits while priority group 8 has the least amount of benefits.

The VA Copay Rates for 2025

Each year copay rates are assessed and updated. These are the most current rates for each priority group.

Urgent Care Copay Rates

There is no limit for how many times you can use urgent care.

However, to be eligible for urgent care benefits, both of the following statements must be true:

• You must be enrolled in the VA health care system, and
• You must have received care from the VA within the past 24 month

Outpatient Care Copay Rates

Outpatient care does not require an overnight stay.

If you have a disability rating of 10% or higher you won’t need to pay for inpatient care.

If you don’t have a disability rating of 10% or higher, and you are receiving care for conditions not related to your military service, you may be required to pay a copay.

Inpatient Care Copay Rates

Inpatient care is care that lasts one or more days.

If you have a disability rating of 10% or higher, you won’t need to pay for inpatient care.

If you are in priority group 6, and the inpatient care is not for a service-connected disability, you may need to pay an impatient care copay based priority group 7 or 8 income limits.

Income limits are based on where you live and your dependents. You can check out income limits for where you live here.

Medication Copay Rates

If you’re in priority group 1, you do not have to pay a fee for medication.

If you’re in priority groups 2 through 8, you may pay a copay for these types of medications:

• Medications your health care provider prescribes to treat non-service-connected conditions, and
• Over-the-counter medications (like aspirin, cough syrup, or vitamins) that you get from a VA pharmacy. You may want to consider buying your over-the-counter medications on your own.

Note: The costs for any medications you receive while staying in a VA or other approved hospital or health facility are covered by your inpatient care copay.

The amount you’ll pay for these medications will depend on the “tier” of the medication and the amount of medication you’re getting, which we determine by days of supply.

Once you’ve been charged $700 in medication copays within a calendar year (January 1 to December 31), you won’t have to pay any more that year—even if you still get more medications. This is called a copay cap.

Geriatric and Extended Care Copay Rates

You won’t need to pay a copay for geriatric care (also called elder care) or extended care (also called long-term care) for the first 21 days of care in a 12-month period.

Starting on the 22nd day of care, your copays will be based on these 2 factors:

• The level of care you’re receiving, and
• The financial information you provide on your Application for Extended Care Services (VA Form 10-10EC).

Besides health care through the VA, many states provide additional health benefits for Veterans. Make sure that you check out your state's Veteran service website to learn more about the benefits available.

FAQs About VA Health Care Eligibility

When I leave active-duty service, how do I know if I’m eligible for TRICARE, VA health care, or both?

If you are retiring, you are eligible for TRICARE. You may also be eligible for certain VA health care benefits.

If you are separating from service due to a service-connected injury or illness, you may be eligible for VA health care benefits or TRICARE.

If you are an OEF/OIF/OND combat Veteran who has returned from service, you can receive free medical care for any condition related to your service in Iraq or Afghanistan for 10 years after discharge.

I think I may have a service-connected disability. Can I get disability compensation?

If you have an illness or an injury that was caused, or made worse, by active-duty service, you may be eligible for disability compensation. You can check your eligibility here.

I have other health insurance. Does that affect whether I can get VA health care benefits?

No, whether you do or don’t have other types of health insurance coverage will not impact the VA health care benefits you can get.

Suggested reads:

• The Trump Administration is Devising a New Bill for Private Healthcare for Veterans
• VA Hiring Freeze Lifted for Over 100 Positions, Including Veterans Crisis Line Jobs
• Your Military ID Will Now Count as a REAL ID: What You Need to Know