Health-Care Enrollment To receive health care, veterans generally must be enrolled with VA. A veteran may apply for enrollment at any time. Veterans do not have to be enrolled if they: (1) have a service-connected disability of 50 percent or more; (2) want care for a disability, which the military determined was incurred or aggravated in the line of duty, but which VA has not yet rated, during the 12-month period following discharge; or (3) want care for a service-connected disability. To permit better planning of health resources, however, these three categories of veterans also are urged to enroll. Veterans will be enrolled to the extent Congressional appropriations allow. If appropriations are limited, enrollment will occur based on the following priorities:
1. Veterans with service-connected conditions who are rated 50 percent or more disabled.
2. Veterans with service-connected conditions who are rated 30 or 40 percent disabled.
3. Veterans who are former POWs or were awarded a Purple Heart, veterans with disabilities rated 10 and 20 percent, and veterans awarded special eligibility for disabilities incurred in treatment.
4. Veterans who are receiving aid and attendance or housebound benefits and veterans who have been determined by VA to be catastrophically disabled.
5. Nonservice-connected veterans and service-connected veterans rated zero percent, noncompensable disabled, who are determined to be unable to defray the expenses of needed care.
6. All other eligible veterans who are not required to make copayments for their treatment. This includes veterans of the Mexican border period or of World War I; veterans solely seeking care for a disorder associated with exposure to a toxic substance or radiation, for a disorder associated with service in the Southwest Asia theater of operations during the Gulf War, or for any illness associated with service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998, as provided and limited in 38 U.S.C. 1710(e); and veterans with 0 percent service-connected disabilities who are nevertheless compensated, including veterans receiving compensation for inactive tuberculosis.
7. Nonservice-connected veterans and noncompensable zero percent service-connected veterans who agree to pay copayments.
These groups are enrollment priorities only. The services and treatment available to enrolled veterans is not based on enrollment priority groups. Enrollment will be reviewed each year and veterans will be notified in writing of any change in their enrollment status.
The Veterans’ Millennium Health Care and Benefits Act of 1999 authorized VA to expand long-term care services and to reimburse emergency treatment expenses for certain enrolled veterans. It also authorized VA to place Purple Heart recipients into Priority Group Three unless they are otherwise eligible for a higher Priority Group. This legislation may result in additional changes to health-care benefits during the year. Call your nearest health-care facility or the Health Benefits Service Center, 1-877-222-8387, to obtain the latest information.
Financial Assessment
Veterans who want to enroll in priority group 5 based on their inability to defray the cost of their care must provide VA with information on their annual income and net worth to determine whether they are below the "means test" threshold; or agree to copayment requirements. The threshold is adjusted annually and announced in January. In making the assessment, the veteran’s household income is considered. The "means test" eligibility assessment includes Social Security, U.S. Civil Service retirement, U.S. Railroad Retirement, military retirement, unemployment insurance, any other retirement income, total wages from all employers, interest and dividends, workers’ compensation, black lung benefits and any other gross income for the calendar year prior to application for care. Also considered are assets such as the market value of stocks, bonds, notes, individual retirement accounts, bank deposits, savings accounts and cash. The patient may fill out VA Form 10-10EZ at the time application for enrollment is made.
VA may compare income information provided by the veteran with information obtained from the Social Security Administration and the Internal Revenue Service.
Copayments
After a veteran completes a financial assessment that determines the veteran’s income is above the "means test" threshold, the veteran must agree to pay copayments to be eligible for VA care. If a veteran does not agree to make the copayments the veteran will be ineligible for VA care. VA holds these patients whose income is determined to be above the "means test" threshold responsible for the Medicare deductible for the first 90 days of care during any 365-day period. For each additional 90 days of hospital care, the patient is charged one-half the Medicare deductible. For each additional 90 days of nursing-home care, the patient is again charged the full Medicare deductible. In addition to these charges, the patient is charged $10 a day for hospital care and $5 a day for VA nursing-home care. For outpatient care, the copayment is 20 percent of the cost of an average outpatient visit.
Other Information
Information on this important benefit and the below listed subjects can be found in the VA Internet Home Page at www.va.gov or call Veterans Services @ (252) 728-8440 to discuss them.
 | Billing Insurance Companies |
| Nursing-Home Care |
| Domicillary Care |
| Outpatient Pharmacy Services |
| Outpatient Dental Treatment |
| Gulf War, Agent Orange and Ionizing Radiation |
| Beneficiary Travel |
| Alocohol- and Drug-Dependence Treatment |
| Home Improvements and Structural Alterations |
| Prosthetic and Sensory Aid Services |
| Services and Aids for Blind Veterans |
| Readjustment Counseling |
| Medical Care for Dependents and Survivors |
Women Veterans
Women veterans are eligible for the same VA benefits as male veterans. Additional services and benefits for women veterans are gender-specific, and include breast and pelvic examinations and other general reproductive health-care services. Preventive health care provided includes counseling, contraceptive services, menopause management, Pap smears and mammography. Referrals are made for services that VA is unable to provide. VA health-care professionals provide counseling and treatment to help veterans overcome psychological trauma resulting from sexual trauma during active military service. Appropriate care and services are provided for any injury, illness or psychological condition resulting from such trauma. To ensure privacy for women veterans, VA medical centers have made structural changes. Women Veterans’ Coordinators are available at all VA facilities to assist women veterans seeking treatment and benefits.
Additional Notes: The Carteret County Health Department may be reached by e-mail at: cchd@internet.net
For more information, contact:
Carteret County Veterans Services Officer
613 Cedar Street
Beaufort, NC 28516
Tel: 1-252-728-8440
FAX: 1-252-728-8582
e-mail: ccvso@coastalnet.com
