What is Co-Managed Care for Veterans?

VA Health Care Priority Groups

During enrollment, veterans are assigned to priority groups VA uses to balance demand with resources. Changes in available resources may reduce the number of priority groups VA can enroll. If this occurs, VA will publicize the changes and notify affected enrollees. Below are descriptions of the VA priority groups:

Group 1: Veterans with service-connected disabilities rated 50 per¬cent or more and/or veterans determined by VA to be unemployable due to service-connected conditions.

Group 2: Veterans with service-connected disabilities rated 30 or 40 percent.

Group 3: Veterans with service-connected disabilities rated 10 and 20 percent, veterans who are former Prisoners of War (POW) or were awarded a Purple Heart, veterans awarded special eligibility for disabilities incurred in treatment or participation in a VA Vocational Rehabilitation program, and veterans whose discharge was for a dis¬ability incurred or aggravated in the line of duty. 

Group 4: Veterans receiving aid and attendance or housebound benefits and/or veterans determined by VA to be catastrophically dis¬abled. 

Group 5: Veterans receiving VA pension benefits or eligible for Medicaid programs, and non service-connected veterans and non compensable, zero percent service-connected veterans whose gross an¬nual household income and net worth are below the established VA means test thresholds. 

Group 6: Veterans of World War I; veterans seeking care solely for certain conditions associated with exposure to radiation; for any illness associated with combat service in a war after the Gulf War or during a period of hostility after Nov. 11, 1998; for any illness associated with participation in tests conducted by the Department of Defense (DoD) as part of Project 112/Project SHAD; and veterans with zero percent service-connected disabilities who are receiving disability compensation benefits.

Group 7: Non service-connected veterans and non-compensable, zero percent service-connected veterans with gross annual household income and/or net worth above VA’s national income threshold, but whose household income is below the geographically-based income threshold for their resident location.

Group 8: All other non service-connected veterans and zero per¬cent, non-compensable service-connected veterans who agree to pay co-pays. Effective Jan. 17, 2003, VA no longer enrolls new veterans in priority group 8. However, new regulations have been proposed that would allow certain Priority Group 8 Veterans to be enrolled in the VA health care system if their household income does not exceed the current VA income thresholds (means test threshold and/or geographical means test threshold) by more than 10%. The VA anticipates that the new regulations will take effect in June 2009. 

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