Special VA Health Care Eligibility for Combat Veterans

Department of Veterans Affairs
December 2002

Department of Veterans Affairs

Effective immediately, the Department of Veterans Affairs (VA) has implemented policies and procedures for providing free health care services and nursing home care to combat veterans for a period of 2 years beginning on the date of separation from active military service.

What's covered?

This benefit covers all illnesses and injuries except those clearly unrelated to military service; for example, a common cold, injuries from accidents that occurred after discharge, and disorders that existed before joining the military. Care may not be provided for any disability found to have resulted from a cause other than the military service in combat operations.

Combat veterans seeking treatment for health conditions claimed to be related to combat operations are evaluated clinically by means of a physical examination and appropriate diagnostic studies. In making this determination, the physician must consider that the following types of conditions are not ordinarily considered to be due to occupational or military service:

1. Congenital or developmental conditions, for example, scoliosis,
2. Conditions which are known to have existed before military service, and
3. Conditions have a specific and well-established cause and that began after military combat service. Coverage extends for a two-year period following separation from active military service.

Dental services are not included.

Who's eligible?

Veterans are eligible if they served on active duty in a theater of combat operations during a period of war after the Gulf War or in combat against a hostile force during a period of "hostilities" after November 11, 1998 and have been discharged under other than dishonorable conditions. National Guard and Reserve members are also eligible for VA health care if they were ordered to active duty by a federal declaration, served the full period for which they were called or ordered to active duty, and have separated from active military service under other than dishonorable conditions. Active duty, National Guard and Reserve members who were activated to a combat mission and then separated from active duty receive a DD Form 214, which should show an award of the Armed Forces Expeditionary Medal. Individuals seeking services under this authority should bring their DD Form 214 when reporting to a VA health care facility.

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.

What's changed?

Unlike other veterans who do not have VA-adjudicated service-connected conditions, veterans who qualify under this special eligibility authority are not subject to VA means testing or copayment requirements. There is no burden placed on these veterans to prove that their health problems are related to their military service or prove that they have low income to qualify for cost-free VA health care.

What happens after the two years?

The co-payment status will depend on whether the veteran's illness or injury is found to be service-connected or whether the veteran is otherwise qualified for VA health care. Each veteran will be enrolled for VA health care in the appropriate priority group. Some veterans - those in the lowest priority group - whose income is above the means test threshold must agree to make required co-payments. If the veteran does not agree to make co-payments, the veteran will be ineligible for VA care.

Where can a veteran get additional information?

Additional information is available at the nearest VA medical facility. The telephone number can be found in the local telephone directory under the "U.S. Government" listings. Veterans can also call toll-free: 1-800-827-1000 or 1-877-222-8387.

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