VA Healthcare Priority Groups

VA HEALTHCARE PRIORITY GROUPS (PG)

(38 CFR § 59.50):

PG1

• You have a service-connected disability that the VA rated as 50% or more disabling, or

• You have a service-connected disability that we’ve concluded makes you unable to work (also called unemployable), or

• You received the Medal of Honor (MOH)

PG2

• You have a service-connected disability that the VA rated as 30% or 40% disabling.

PG3

• You’re a former prisoner of war (POW), or

• You received the Purple Heart medal, or

• You were discharged for a disability that was caused by or got worse because of your active-duty service, or

• You have a service-connected disability that the VA has rated as 10% or 20% disabling, or

• You were awarded special eligibility classification under Title 38, U.S.C § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”

PG4

• You’re receiving VA aid and attendance or housebound benefits, or

• You have received a VA determination of being catastrophically disabled

PG5

• You don’t have a service-connected disability, or you have a non-compensable service-connected disability that we’ve rated as 0% disabling, and you have an annual income level that’s below our adjusted income limits (based on your resident zip code), or

• You’re receiving VA pension benefits, or

• You’re eligible for Medicaid programs

PG6

• You have a compensable service-connected disability that the VA rated as 0% disabling, or

• You were exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki, or

• You participated in Project 112/SHAD, or

• You served in the Republic of Vietnam between January 9, 1962, and May 7, 1975, or

• You served in the Persian Gulf War between August 2, 1990, and November 11, 1998, or

• You served on active duty at Camp Lejeune for at least 30 days between August 1, 1953, and December 31, 1987

The VA may also assign you to priority group 6 if you meet all of these requirements:

• You’re currently or newly enrolled in VA health care, and

• You served in a theater of combat operations after November 11, 1998, and

• You were discharged less than 10 years ago

• You were exposed to toxins or hazards by working with chemicals, pesticides, lead, asbestos, certain paints, nuclear weapons, X-rays, or other toxins. This exposure could have happened while training or serving on active duty, even if you were never deployed. UPDATED MARCH 2024.

Note: As a returning combat Veteran, you’re eligible for these enhanced benefits for 10 years after discharge. At the end of this enhanced enrollment period, the VA will assign you to the highest priority group you qualify for at that time.

PG7

• Your gross household income is below the geographically adjusted income limits (GMT) for where you live, and

• You agree to pay copays

PG8

• Your gross household income is above VA income limits and geographically adjusted income limits for where you live, and

• You agree to pay copays

You may be eligible for VA health care benefits if we place you in one of these subpriority groups:

Subpriority group a: All of these must be true:

• You have a non-compensable service-connected condition that the VA rated as 0% disabling, and

• You enrolled in the VA health care program before January 16, 2003, and

You have remained enrolled since that date and/or were placed in this subpriority group because your eligibility status changed

Subpriority group b: All of these must be true:

• You have a non-compensable service-connected condition that the VA rated as 0% disabling, and

• You enrolled in the VA health care program on or after June 15, 2009, and

• You have income that exceeds current VA or geographical limits by 10% or less

Subpriority group c: All of these must be true:

• You don’t have a service-connected condition, and

• You enrolled in the VA health care program as of January 16, 2003, and

• You have remained enrolled since that date and/or were placed in this subpriority group because your eligibility status changed

Subpriority group d: All of these must be true:

• You don’t have a service-connected condition, and

• You enrolled in the VA health care program on or after June 15, 2009, and

• You have income that exceeds current VA or geographical limits by 10% or less

You’re not eligible for VA health care benefits if we place you in one of these subpriority groups:

Subpriority group e: All of these must be true:

• You have a non-compensable service-connected condition that we’ve rated as 0% disabling, and

• You don’t meet the criteria for subpriority group a or b above

Note: You’re eligible for care for your service-connected condition only.

Subpriority group g: All of these must be true:

• You don’t have a service-connected condition, and

• You don’t meet the criteria for subpriority group c or d