What VA benefits are available to a veteran often depend on his or her VA-assigned disability rating. Many health benefits are available to different categories of veterans, but there are additional advantages for those who are rated permanently and totally disabled for service-connected conditions. The benefits listed on this page are available to veterans of various conditions, besides those who are considered “P&T.”
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Priority Grouping in VA Health Care System
Veterans with a 50% or higher service-connected disability rating or are rated individually unemployable are given top priority or Priority 1. This means you get priority in scheduling appointments before veterans in lower priority groups. It also means there is no copay or cost share for you when you access the VA health care system. Unlike certain other vets, you do not need to enroll in the VA health care system to be able to use it, even though it is still recommended.
Dental services in the United States are very expensive. Permanent and totally disabled veterans, and those who are rated unemployable – qualify for free dental care at the VA. Free services include preventive, restorative and surgical care. Other categories of veterans also qualify.
If your disability requires you to use a prosthetic device such as a cane, braces, orthopedic shoes, etc. you will receive them for free from the VA. Eyeglasses and hearing aids are also available to certain qualifying vets, including those who receive disability pay for service-connected conditions. (If you are P&T – permanent and total – you should be receiving VA disability compensation at the 100% rate and are therefore eligible for this benefit.)
Among the veterans who qualify for free outpatient pharmacy services are vets who have a 50% disability rating or greater. You can get your prescription drug refills, insulin supplies, etc. at no cost through the VA pharmacy mailing service. Refills can be requested by mail or phone. There is no copay for totally disabled veterans.
Because it takes time to have drugs mailed to your home, you should order only non-urgent refills this way. If you run out, you will need to go personally to your VAMC (VA medical center) or buy at a local pharmacy and seek reimbursement later.
Among other qualifying vets, those with a disability rating of 30% or higher can receive travel reimbursement for going to a VA medical center. This means the VA will pay you a fixed amount based on distance traveled whenever you make a trip to a VA facility. Pay rate is at $41.5 per mile. There is a deductible of $3 for one-way, $6 for round trip, at up to $18 per month.
In case of emergency and there is no VA medical facility near enough, you can receive emergency treatment at a private hospital or clinic. VA will either pay the bill or reimburse you if you paid for it upfront.
Health Coverage for Family
Veterans with permanent and total disability rating or who are found unemployable, and are not TRICARE-eligible, may sponsor family for CHAMPVA benefits. CHAMPVA is a cost-sharing health coverage program that your spouse and eligible children can enroll in. There is no premium but you do have copay up to a yearly catastrophic limit (right now at $3,000). In general, CHAMPVA will cover medically necessary services and supplies and includes a free pharmacy mailing service for non-urgent prescription refills.
If you are a qualifying CHAMPVA sponsor married to another veteran who also qualifies for the same, you can gain CHAMPVA coverage through each other. You can choose between private health care under CHAMPVA or the VA health care system.