Attachment 4 - Enrollment Priority Groups.pdf

Enrollment Priority Groups

Fact Sheet 164-2 June 2010

Priority Group 1

Veterans with VA-rated service-connected disabilities 50% or more disabling Veterans determined by VA to be unemployable due to service-connected conditions

Priority Group 2

Veterans with VA-rated service-connected disabilities 30% or 40% disabling

Priority Group 3

Veterans who are Former Prisoners of War (POWs) Veterans awarded a Purple Heart medal Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty Veterans with VA-rated service-connected disabilities 10% or 20% disabling Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation” Veterans awarded the Medal Of Honor (MOH)

Priority Group 4

Veterans who are receiving aid and attendance or housebound benefits from VA Veterans who have been determined by VA to be catastrophically disabled

Priority Group 5

Non-service-connected veterans and non-compensable service-connected veterans rated 0% disabled by VA with annual income and/or net worth below the VA national income threshold and geographically-adjusted income threshold for their resident location

Veterans receiving VA pension benefits Veterans eligible for Medicaid programs

Priority Group 6

World War I veterans Compensable 0% service-connected veterans Veterans exposed to Ionizing Radiation during atmospheric testing or during the occupation of Hiroshima and

Nagasaki Project 112/SHAD participants Veterans exposed to the defoliant Agent Orange while serving in the Republic of Vietnam between 1962 and

Veterans of the Persian Gulf War that served between August 2, 1990 and November 11, 1998 Veterans who served in a theater of combat operations after November 11, 1998 as follows:

Currently enrolled Veterans and new enrollees who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits for 5 years post discharge Veterans discharged from active duty before January 28, 2003, who apply for enrollment on or after January

28, 2008 are eligible for this enhanced enrollment benefit through January 27, 2011

Note: At the end of this enhanced enrollment priority group placement time period Veterans will be assigned to the highest Priority Group their unique eligibility status at that time qualifies for.

36C24920R0088 - Attachment 4

Priority Group 7

Veterans with gross household income below the geographically-adjusted income threshold (GMT) for their resident location, and agrees to pay co-pays.

Priority Group 8

Veterans with gross household income above the VA national income threshold and the geographically-adjusted income threshold for their resident location and who agrees to pay copays Veterans eligible for enrollment: Non-compensable 0% service-connected and:

Sub-priority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub-priority due to changed eligibility status Sub-priority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income

Thresholds or VA National Geographic Income Thresholds by 10% or less Veterans eligible for enrollment: Non-service-connected and:

Sub-priority c: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub-priority due to changed eligibility status Sub-priority d: Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income

Thresholds or VA National Geographic Income Thresholds by 10% or less Veterans not eligible for enrollment: Veterans not meeting the criteria above:

Sub-priority e: Non-compensable 0% service-connected Sub-priority g: Non-service-connected