Attachment D.5 - IB 10-441 Enrollment Priority Group.pdf
PDF 702 KB Posted
- Attached to
- Q201--NEW Dyersburg CBOC Services
- Solicitation number
- 36C24925R0056
About this file
This document is an Internal Brief (IB 10-441) from the U.S. Department of Veterans Affairs detailing the Enrollment Priority Groups for Veterans' medical benefits. The enrollment system categorizes Veterans into eight priority groups based on service-connected disability ratings, service history, income levels, and special circumstances. Priority Group 1 includes Veterans with 50% or more disabling service-connected conditions, those deemed unemployable, and Medal of Honor recipients, while lower-priority groups include Veterans with less severe disabilities, those with specific service experiences (such as Former POWs or Vietnam War veterans), and those with income below certain thresholds. The document provides detailed criteria for each priority group, including special provisions for Veterans who served in combat operations after November 11, 1998, and those with enhanced enrollment benefits for five years post-discharge.
The brief also outlines sub-priority categories for Veterans' enrollment eligibility, distinguishing between those enrolled before specific dates, those with income slightly exceeding VA limits, and those not eligible for full enrollment. Veterans are assigned to priority groups based on factors like service-connected disability ratings, exposure to specific conditions (such as radiation or service in particular conflicts), and income levels. The system ensures that Veterans with more critical needs or more significant service-related challenges receive higher priority in accessing medical benefits, with a commitment to providing comprehensive healthcare services across different treatment programs and locations.
View the file
Other files
Show all 32
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
IB 10-441
Apr 2018
Enrollment Priority Groups Today’s Veterans have a comprehensive medical benefits package, which VA administers through an annual patient enrollment system. The enrollment system is based on priority groups to ensure health care benefits are readily available to all enrolled Veterans.
Complementing the expansion of benefits and improved access is our ongoing commitment to providing the very best in quality health care service to our patients when they are needed during that enrollment period, regardless of the treatment program or the location.
Priority Group Definition
| • | Veterans with VA-rated service-connected disabilities 50% or more disabling |
| • | Veterans determined by VA to be unemployable due to service-connected conditions |
| • | Veterans awarded the Medal Of Honor (MOH) |
2 • Veterans with VA-rated service-connected disabilities 30% or 40% disabling
| • | 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 who are receiving aid and attendance or housebound benefits from VA |
| • | Veterans who have been determined by VA to be catastrophically disabled |
• Nonservice-connected Veterans and noncompensable service-connected Veterans rated 0% disabled by VA with annual income below the VA’s and geographically (based on your resident zip code) adjusted income limits
| • | Veterans receiving VA pension benefits |
| • | Veterans eligible for Medicaid programs |
Page 1 of 2IB 10-441
36C24925R0056 - Dyersburg CBOC
ATTACHMENT D.5. Enrollment Priority Groups
Priority Group Definition
| • | 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 who served in the Republic of Vietnam between January 9, 1962, and May 7, 1975. |
| • | Veterans of the Persian Gulf War who served between August 2, 1990, and November 11, |
1998.
• Veterans who served on active duty at Camp Lejeune for at least 30 days between August 1, 1953, and December 31, 1987.
• Currently enrolled Veterans and new enrollees who served in a theater of combat operations after November 11, 1998 and those who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits for five years post discharge
Note: At the end of this enhanced enrollment priority group placement time period, Veterans will be assigned to the highest PG their eligibility status at that time qualifies for.
• Veterans with gross household income below the geographically-adjusted income limits for their resident location and who agree to pay copays
• Veterans with gross household income above the VA and the geographically- adjusted income limit for their resident location, and who agrees to pay copays
Veterans eligible for enrollment:
Noncompensable 0% service-connected and:
þþ Subpriority 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 þþ Subpriority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA or geographic income limits by 10% or less
Nonservice-connected and:
þþ Subpriority 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 þþ Subpriority d: Enrolled on or after June 15, 2009, whose income exceeds the current VA or geographic income limits by 10% or less
Veterans not eligible for enrollment: Veterans not meeting the criteria above:
þþ Subpriority e: Noncompensable 0% service-connected (eligible for care of their SC condition only) þþ Subpriority g: Nonservice-connected
IB 10-441
Rev. April 2018
File details come from the government source that posted it. Updated .