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Veterans Affairs (VA) Benefits - Medical Treatment Categories

Effective October 9, 1996 two categories for providing VA medical treatment were established by Congress. All veterans seeking medical care are classified into one of these categories when they apply. Actual enrollment is additionally controlled by placement into a treatment priority group.

Category 1 - Category A

VA shall furnish all necessary hospital and outpatient treatment to the following veterans:

·     Veterans in need of treatment of a service-connected disability.

·     Veterans with a compensable service-connected disability.

·     Veterans whose release from active duty service was for a compensable disability that was incurred or aggravated in the line of duty.

·     Veterans in receipt of benefits under 38 U.S.C. Section 1151 which provides for medical care in the settlement.

·     Veterans who are former Prisoners of War.

·     Veterans of the Mexican border period or of World War I.

·     Veterans who were exposed to Agent Orange, ionizing radiation, or environmental hazards in the Persian Gulf (care is limited to conditions which are possibly related to exposure).

·     Veterans who have an annual income and net worth below the established "means test" threshold.

NOTE: When a veteran's income alone is less than the threshold levels but net worth (assets) is greater than $50,000, the veteran is tentatively placed into "Category 2 - Category C" until a financial assessment or determination can be made by the VA Regional Office.

Category 2 - Category C

Veterans in this category must agree to pay VA a copayment in order to receive medical care. VA may furnish all necessary hospital and outpatient treatment to the following veterans:

·     Veterans whose income and net worth are above established "Means Test" thresholds.

·     Veterans who are not receiving VA compensation for a 0% service connected condition and require treatment of a nonservice-related condition, and whose income and net worth exceed the established "Means Test" threshold.

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