VA Health Care Enrollment and Priority Groups Guide

VA health care enrollment is the single step that unlocks everything else the VA can do for an older veteran, from primary care to nursing home coverage. Once a veteran enrolls, the VA assigns a priority group from 1 to 8, and that group shapes how quickly care comes and what, if anything, it costs. The system isn't hard to navigate once you understand it. Most families just never get the explanation.

This guide walks through who can enroll, what the eight VA health care priority groups mean, what you'll pay in each one, how to apply, and why enrollment matters so much for long-term care down the road.

In This Guide

• Key Takeaways
• Who Can Enroll in VA Health Care
• The Eight Priority Groups
• What You'll Pay (Copays by Group)
• How to Apply
• Why Enrollment Matters for Long-Term Care
• Frequently Asked Questions
• Learn More

Who Can Enroll in VA Health Care

To enroll in VA health care, a veteran must have served in the active military, naval, or air service and not received a dishonorable discharge.1

For most veterans, there's also a minimum length-of-service requirement. Veterans who enlisted after September 7, 1980, or who entered active duty after October 16, 1981, generally must have served 24 continuous months or the full period for which they were called to active duty.1 There are exceptions to this rule, including discharges for a disability caused or worsened by service and hardship discharges.

Reserve and National Guard members can qualify too, but the path is narrower. They generally must have been called to federal active duty and completed that full period of service.1 Training time alone usually doesn't count.

If you're unsure whether a discharge or service record meets these requirements, it's worth applying anyway. The VA reviews each case, and an accredited representative can help you understand where a particular record falls.

The Eight Priority Groups

When a veteran enrolls, the VA places them in one of eight priority groups. The group reflects military service history, service-connected disability rating, income level, Medicaid eligibility, and other benefits received.1 Group 1 is the highest priority; Group 8 is the lowest. The group affects how soon a veteran is enrolled and what they pay.

The table below describes who falls into each group. Income-based groups (7 and 8) use a geographically-adjusted income threshold, often called GMT, that the VA updates annually and varies by location, so the description here stays in terms of being below or above the limit rather than a fixed dollar figure.

Priority Group 8 is further divided into subpriority classifications that affect enrollment.1 If a veteran's income, disability rating, or other circumstances change, the VA can move them to a different priority group, so it's worth keeping the VA informed when something shifts.

What You'll Pay (Copays by Group)

Copays in VA health care depend on the priority group and on the kind of care. The general rule is that higher priority groups receive care with the lowest or no copays.1

The clearest cases are at the top:

• Priority Group 1 veterans pay no copays.1
• Veterans rated 50% or higher, or who are unemployable because of a service-connected disability, generally pay no copays for their care.1

There's also a rule that cuts across every group. Care related to a VA-rated service-connected disability is copay-exempt for any veteran, no matter which priority group they're in.1 So even a veteran in a copay group pays nothing for treatment tied to a condition the VA has already rated as service-connected.

For veterans in the income-based groups who do owe copays, the amounts depend on the type of service and update over time. The VA publishes current copay rates on its website, and that's the right place to confirm a specific figure before relying on it.

How to Apply

Applying for VA health care uses a single form, the Application for Health Benefits, VA Form 10-10EZ.1 There are several ways to submit it:

• Online at va.gov/health-care/how-to-apply.1
• By phone at 877-222-8387.1
• By mail, sending VA Form 10-10EZ to the Health Eligibility Center.1
• In person at a VA medical center or clinic.1

You can also get free help applying. An accredited attorney, claims agent, or Veterans Service Organization (VSO) representative can complete the application with you and make sure the supporting records are in order.1 For an older veteran or a family member doing the legwork, that help is often worth seeking out.

It helps to have the veteran's discharge papers (the DD-214), basic income information, and any current health insurance details on hand before you start. The VA uses these to confirm eligibility and to assign the priority group.

Why Enrollment Matters for Long-Term Care

Enrollment isn't just about doctor visits. Enrollment in VA health care is what determines access to VA long-term care and other VA medical programs.1 A veteran who never enrolls generally can't tap into the VA's long-term care system, no matter how much care they later need.

That system is substantial. Once enrolled, eligible veterans can access VA long-term care programs including Home Based Primary Care, where a VA physician-supervised team visits the veteran at home; Adult Day Health Care; Community Living Centers, which are VA nursing homes; the Community Nursing Home program; respite care; and Veteran-Directed Care, which gives a veteran a flexible budget to hire their own caregivers.2 Eligibility for each of these still depends on the veteran's priority group, service-connected conditions, and clinical need, but enrollment is the door you have to walk through first.

Enrollment also opens the way to community care. Under the VA MISSION Act (2018), eligible enrolled veterans can receive care from non-VA community providers when the VA can't offer a timely appointment, when the drive to a VA facility is too long, or when the needed care isn't available at their VA facility.3 In May 2025, the VA streamlined that pathway under the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (the Dole Act, enacted 2025), removing an extra review step so eligible veterans get faster access.3 For an older veteran living far from a VA medical center, that can be the difference between timely care and a long wait.

The takeaway is simple. If there's any chance a veteran will need VA care, whether next month or years from now, enrolling now is the move that keeps every later option open.

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