VA Priority Groups Explained: What Health Care Do You Qualify for?

The Department of Veterans Affairs uses a system known as Enrollment Priority Groups to determine copayment obligations and access to VA health care services. The priority groups range from 1 to 8, with veterans in Priority Group 1 receiving the highest level of enrollment access and cost-free care.

Placement in a VA priority group depends on a veteran’s service-connected disability rating, income, and special eligibility factors such as combat service, POW status, or receipt of specific medals. If someone qualifies for more than one priority group, the VA automatically places the veteran in the highest priority group for which they are eligible.

How Are Veterans Assigned to Priority Groups?

This video explains who is eligible for VA health care benefits and the criteria used to assign veterans to priority groups. You can also find written explanations below for each priority group.

At Hill & Ponton, we specialize in winning higher ratings for veterans seeking to increase their benefits. Get a free, no-obligation review of your case today to see how we can help you.

The 8 Priority Groups

Priority Group 1	Veterans with ≥50% service-connected disability, TDIU, or Medal of Honor
Priority Group 2	30 to 40% service-connected disability
Priority Group 3	10 to 20% service-connected disability, POWs, Purple Heart recipients, or discharged for service-related disability
Priority Group 4	Receiving Aid & Attendance or housebound benefits, or catastrophic disability
Priority Group 5	Receiving VA pension, eligible for Medicaid, or low income
Priority Group 6	Specific environmental exposures (Vietnam, Gulf War, Camp Lejeune, radiation, SHAD) or 0% compensable disability
Priority Group 7	Income below VA’s geographic means test thresholds; must agree to copay
Priority Group 8	Above income limits; may enroll if income is within 10% of threshold and certain date criteria met

Veterans who disagree with their assigned priority group have the right to appeal or request a reevaluation of eligibility. Hill & Ponton encourages you to learn more about your legal options if you believe your classification is incorrect, and to pursue disability rating increases if the VA has underrated you. Please contact us for assistance in obtaining a higher rating, which can move you from one priority group to another.

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Priority Group 1

To receive placement in the highest priority group, you must meet one of the following:

1. Have a service-connected disability rating of 50 percent or higher, or
2. Have been awarded the Medal of Honor, or
3. Have been rated by the VA as Totally Disabled based on Individual Unemployability (TDIU) due to service-connected conditions

Priority Group 1 Benefits

• No copayment for any VA medical services, including inpatient, outpatient, and prescriptions
• Free VA dental care
• Priority access to specialty and mental health services
• Travel cost reimbursement for VA health care appointments (if eligible)
• Enrollment is guaranteed regardless of income

Priority Group 2

You qualify for the second-highest priority group if you have a VA service-connected disability rating between 30 and 40 percent.

Priority Group 2 Benefits

• No copayment for treatment of service-connected conditions
• No copays for medications related to service-connected care
• Copays required for non-service-connected conditions (inpatient, outpatient, and prescriptions)
• May be eligible for travel reimbursement depending on income

Priority Group 3

You can qualify for Priority Group 3 by meeting any one of the following criteria:

• You are a Purple Heart medal recipient
• You are a former Prisoner of War (POW)
• The VA has rated your service-connected disability at 10 or 20 percent
• You were discharged for a disability that began or worsened while serving on active duty
• You are eligible for benefits under Title 38, U.S.C. § 1151, for individuals disabled by VA treatment or vocational rehabilitation

Priority Group 3 Benefits

• No copays for service-connected care
• Reduced copay rates for non-service-connected treatment
• Free outpatient care for service-related conditions
• Free prosthetic, sensory aids, and certain assistive devices
• Priority access to specialized programs (e.g., rehabilitation, prosthetics, PTSD care)

Priority Group 4

The VA assigns this classification to veterans who are either a) receiving aid and attendance (A&A) or housebound benefits, or b) have been determined by the VA to be catastrophically disabled under the regulations of 38 C.F.R. § 17.36(e). There is no clear list of what the VA considers catastrophic, but it is defined as a permanent severely disabling condition preventing the veteran from leaving home or the bed without personal or mechanical assistance OR one that requires constant supervision to avoid physical harm to self or others.

Priority Group 4 Benefits

• No copayment for inpatient, outpatient, or prescription care
• Priority access to home and community-based services, including home health, skilled nursing, and long-term care programs
• Travel cost reimbursement for qualifying veterans
• Access to comprehensive rehabilitative and assistive services

Priority Group 5

You qualify for Priority Group 5 if any of the following apply:

1. You are receiving VA pension benefits, or
2. You are eligible for Medicaid, or
3. You have nonservice-connected or 0% noncompensable service-connected disabilities and your income and net worth are below the VA’s established national and geographic income thresholds.

Keep in mind that Medicare eligibility alone does not determine placement in this group.

Priority Group 5 Benefits

• No copays for inpatient or outpatient care
• Free preventive and primary care services
• Free medications for service-connected or low-income veterans
• May have small copays for non-service-connected prescriptions depending on income
• Priority enrollment for community care programs when local VA services are unavailable

Priority Group 6

You may be assigned to Priority Group 6 if you meet any of these criteria:

• You have a compensable 0% service-connected disability
• You participated in Project 112/SHAD
• You participated in a toxic exposure risk activity (TERA) while on active duty, active duty for training, or inactive duty training
• You served in the Persian Gulf War between August 2, 1990, and November 11, 1998
• You served on active duty at Camp Lejeune for at least 30 days between August 1, 1953, and December 31, 1987
• You were assigned to a duty station (including the airspace above it) in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the UAE on or after August 2, 1990, or in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan, or another VA-determined country on or after September 11, 2001
• You were deployed in support of Operation Enduring Freedom, Operation Freedom’s Sentinel, Operation Iraqi Freedom, Operation New Dawn, Operation Inherent Resolve, or the Resolute Support Mission
• You were exposed to ionizing radiation during atmospheric testing; during the occupation of Hiroshima or Nagasaki; during Enewetak Atoll cleanup (Jan. 1, 1977 – Dec. 31, 1980); during onsite response at Palomares, Spain (Jan. 17, 1966 – Mar. 31, 1967); or during onsite response at Thule Air Force Base, Greenland (Jan. 21, 1968 – Sept. 25, 1968)
• You were exposed to Agent Orange and served in the Republic of Vietnam (Jan. 9, 1962 – May 7, 1975); or in Thailand at a U.S. or Royal Thai base (Jan. 9, 1962 – June 30, 1976); Laos (Dec. 1, 1965 – Sept. 30, 1969); Cambodia at Mimot or Krek, Kampong Cham Province (Apr. 16 – Apr. 30, 1969); Guam, American Samoa, or their territorial waters (Jan. 9, 1962 – July 31, 1980); or Johnston Atoll or a ship that called there (Jan. 1, 1972 – Sept. 30, 1977)

Or, if ALL three of these are true:

1. You served in a theater of combat operations after November 11, 1998, and
2. You were discharged from active duty on or after October 1, 2013, and
3. You meet the minimum active-duty service requirement

Priority Group 6 Benefits

• Free care for any service-connected condition or condition related to qualifying exposure
• Free 10-year enhanced care from the date of discharge. No copays for environmental exposure-related conditions
• Reduced or no copays for other medical care depending on income
• Priority access to specialty clinics for exposure monitoring (e.g., burn pits, Agent Orange, Camp Lejeune)

For instance, veterans eligible for health care under the 2012 Camp Lejeune health care law may receive medical services for the 16 covered health conditions free of charge, according to the VA.

Priority Group 7

You qualify for placement in Priority Group 7 if your gross household income is less than the VA’s geographically adjusted income limit according to your current ZIP code. You must agree to make copayments when you receive health care services from the VA.

Priority Group 7 Benefits

• Low-cost VA health care with copays based on income
• Reduced prescription copayments compared to private insurance rates
• May be eligible for free preventive care (immunizations, cancer screenings)
• Access to the same care network as higher-priority veterans
• Veterans remain enrolled even if future income rises slightly above threshold (if within 10%)

Priority Group 8

The last priority group is for veterans who have a disability unrelated to military service and whose gross household income is above the geographically adjusted income limit set by the VA for their region. Priority Group 8 includes subpriority groups a to g (only groups a to d are eligible for VA health care benefits).

• Subpriority group a: Enrolled veterans registered as of January 16, 2003 who have remained continuously enrolled or had a change in eligibility status that required the current VA staff to place them in this group
• Subpriority group b: This applies to enrolled veterans who registered as of June 15, 2009 and whose annual income is 10 percent or less above the geographically adjusted income limits
• Subpriority group c: Veterans enrolled on or before January 16, 2003, who remained continuously enrolled or were reclassified in this group due to eligibility changes
• Subpriority group d: Veterans enrolled on or after June 15, 2009, with income 10% or less above VA income limits
• Subpriority groups e and g: Veterans who are not eligible for enrollment unless previously enrolled before the 2003 enrollment freeze. They generally do not receive VA health care services. The only exception is veterans who have a non-compensable 0 percent service-related disability, but their medical benefits only cover the service-related condition.

Priority Group 8 VA Health Care Benefits

• Access to VA health care with standard copay for inpatient, outpatient, and prescriptions
• No-cost preventive care (immunizations, screenings)
• Can use VA as secondary insurance for cost savings
• May qualify for fee-based community care if local services are unavailable

FAQs About VA Health Care and Priority Groups

Can I qualify for health care even if I don’t have an honorable discharge? In some cases, yes. VA performs a Character of Discharge review to determine eligibility for health care and benefits and veterans with an Other than Honorable Discharge can also apply for a discharge upgrade if their conduct and separation circumstances were influenced by factors like PTSD, traumatic brain injury, or military sexual trauma.

What benefits are available to all priority groups? All enrolled veterans, regardless of their priority group, have access to core VA services (but copays may apply). Services include preventive care like flu shots and screenings, primary and specialty medical care, mental health treatment, women’s health services, and prescription medications. Veterans also have access to emergency and urgent care and may qualify for community care outside VA.

Do priority groups affect community care eligibility? Not directly. Eligibility for community care outside VA is determined by factors such as drive time to the nearest VA facility, appointment wait times and clinical need, not by your priority group. Any enrolled veteran may be referred to approved non-VA providers if the VA cannot provide timely or appropriate care locally.

Can my priority group change over time? Yes. Your priority group may change if your disability rating, income, or benefit status changes, or if you qualify for a new eligibility category (for instance, if you become eligible for Medicaid or VA pension or if you gain new exposure-related benefits under laws like the PACT Act).

What if I disagree with my assigned priority group? If you believe you’ve been placed in the wrong group, you can request a review or appeal. This usually involves submitting updated income or disability information to the VA Health Eligibility Center or your local VA facility. VA will re-evaluate your case and may reassign you to a higher priority group if you meet new criteria.