Navigating Veterans Administration Health Care Benefits

As a beloved Veteran becomes older and needs more care, some families are dealing with Veteran’s Administration (VA) healthcare benefits earned by their vet in connection to their military service. Navigating the ins and outs of VA healthcare benefits can be daunting.

The first hurdle is eligibility.

Does your loved one even qualify for health care benefits through the VA? The basic criteria is that the Vet served active duty with an honorable discharge. However, beyond that it does get a little bit trickier.

For Vets enlisted after September 7, 1980, or had active duty after October 16, 1981, they must have served 24 continuous months or the full period they were called to active duty, unless: the individual was discharged for a disability caused or made worse by active duty or the vet was discharged due to hardship or “early out”. For the Reserves or National Guard, the vet must have served active duty by a federal order and completed the full period for the order of active duty. Active duty for training only does not qualify the vet for VA health care.

If a Vet meets one of the following requirements, then they qualify for enhanced eligibility status:

• Received financial compensation from the VA for a service-connected disability; or

• Discharged for a disability resulting from something done in the line of duty; or

• Discharged for disability that worsened in the line of duty; or

• A combat Vet discharged/released on or after September 11, 2001; or

• Received a VA pension; or

• A former prisoner of war (POW); or

• Received a Medal of Honor; or

• You get Medicaid benefits; or

• Served in Southwest Asia during the Gulf War between August 2, 1990, and November 11, 1998; or

• Served at least 30 days at Camp Lejeune between August 1, 1953, and December 31, 1987; or

• Served in any of the following locations during the Vietnam War era:

  • Any US or Royal Thia military base in Thailand from January 9, 1962, through June 30, 1976.

  • Loas from December 1, 1965, through September 30, 1969.

  • Cambodia at Mimot or Krek, Kampong Cham Province from April 16, 1969, through April 30, 1969.

  • Guam or American Samoa or territorial waters of Guam or American Samoa from January 9, 1962, through July 31, 1980.

  • Johnston Atroll or a ship called Johnston Atoll from January 1, 1972, through September 30, 1977; or

  • Republic of Vietnam January 9, 1962, through May 7, 1975.

If your loved one does not qualify under the guidelines set forth above, they may still be eligible. One way is based on their income. You can find more information about the VA health care benefits income guidelines here: https://www.va.gov/health-care/income-limits/introduction. A vet may qualify if they apply for a discharge upgrade. Information about that application is located at: https://www.va.gov/discharge-upgrade-instructions/.

When applying for VA health care benefits, vets are assigned to priority groups (1-8). This system gives priority to vets with the greatest need to be signed up quickly. A vet’s priority group determines how quickly they are signed up and their out-of-pocket expense for VA health care. If you would like more information about the VA’s priority groups, you can visit: https://www.va.gov/health-care/eligibility/priority-groups/.

Navigating VA health care benefits can be very confusing. The VA does offer a toll-free hotline at 877-222-8387 (with limited hours). Additionally, you can request a representative (https://www.ebenefits.va.gov/ebenefits/about/feature?feature=request-vso-representative) or find your state’s Veterans agency (https://department.va.gov/about/state-departments-of-veterans-affairs-office-locations/).

For additional information about VA benefits, such as health care, pension, life insurance and burials, you can visit VA.gov.

Lili also has a page of resources specifically for veterans.

1 https://www.va.gov/health-care/eligibility/

ABOUT WAYLA TODD:

I have a broad background with a Master’s degree from George Washington University in Paralegal Studies and worked in the legal field doing Social Security Disability and Personal injury for 22 years. Currently I live in Berea, Kentucky with my wonderful family and am the Administrative Assistant for the Nursing Department at Berea College.

I know how hard it is to be a Caregiver and to have to manage the different forms and processes for Social Security Disability among other things. Thankfully from my career choice I was able to navigate these things for my Mom when she became ill, but I know many people have trouble and need help to understand the process. As part of my Caregiving journey for my Mom I did a lot of her personal care and also managed her financial affairs.

I know first hand how to navigate the different account issues that come up as you are taking over finances from your Loved One and the many hurdles that come up while you are making all the changes. After she died I was the executor and once again, I learned how to close and move accounts, finding the right paperwork to process and finalize her estate.

Like Lili, I am grateful if I can share the information I gathered during my journey with my Mom and am very pleased if I can help save others the time and headaches of trial and error on the financial and legal aspects of supporting their Loved One’s through illness and final transition.