VA Health Care Eligibility Calculator

VA health care enrollment is organized into eight priority groups under 38 C.F.R. § 17.36, and this calculator walks through the same general order of criteria the VA uses to sort veterans into them — checking disability rating first, then combat service history, then household income, since these criteria are evaluated in a specific sequence rather than all at once. A combined disability rating of 50% or higher places you in Priority Group 1 with no copays at all, while 30-40% lands in Group 2, also copay-free; these highest groups reflect that veterans with more significant service-connected conditions get the strongest coverage and lowest out-of-pocket costs. A lower disability rating between 10-20% drops to Group 3 with reduced copays, and if there's no qualifying disability rating at all, the calculator checks combat veteran status — anyone who served in a combat zone and was discharged within the last 10 years qualifies for Group 6 with copay-free care regardless of income -- a window the PACT Act of 2022 expanded from 5 years to 10, specifically to make it easier for recent combat veterans to get care without financial barriers.

Everyone else is sorted by income against a national threshold that rises with each additional dependent, landing in Group 5 (lowest income, reduced copays), Group 7 (moderate income within a geographic adjustment), or Group 8 (higher income, full copays, with enrollment sometimes limited unless you have at least 2 years of service). Because actual VA priority group determination also weighs additional factors this simplified model doesn't capture — former POW status, Purple Heart recipients, catastrophic disability, and various other special eligibility categories — treat this as a general orientation to the system rather than an official eligibility determination, which only the VA itself can make.