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More Veterans Eligible for Reduced Cost Health Care Due to Net Worth Elimination

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The Department of Veterans Affairs has announced that it is updating the way it determines eligibility for VA health care benefits, a change that will result in more Veterans having access to the health care benefits.

According to a VA news release dated March 17, 2015, VA has now eliminated the use of net worth as a determining factor for both health care programs and co-payment responsibilities.

Until now, some low income but higher net worth veterans were allowed to receive care at VA hospitals and clinics but only with burden of co-payments that ranged from $15 per visit for primary care to $50 per visit for specialty care. Co-payments also have been applied to in-patient care.

As a result of the change, instead of combining the sum of Veterans’ income with their assets to determine eligibility for medical care and co-payment obligations, VA will now only consider a Veteran’s gross household income and deductible expenses from the previous year. Elimination of the consideration of net worth for VA health care enrollment means that certain lower-income, non-service-connected Veterans will have less out-of- pocket costs. Over a 5-year period, it is estimated that 190,000 Veterans will become eligible for reduced costs of their health care services.

Last year VA eliminated the annual requirement for updated financial information. VA now uses information from the Internal Revenue Service and Social Security Administration to automatically match individual Veterans’ income information which reduces the burden on Veterans to keep their healthcare eligibility up to date.

The net worth change is part of an ongoing effort to streamline the administrative burden on veterans applying for services and benefits.

VA will continue to use the combined net-worth/income threshold in the determination of eligibility for other benefits, such as in considering applications for pensions.

Veterans with low incomes who were prioritized into the lowest tiers of eligibility for care as a result of their net worth/income calculation — Priority Groups 7 and 8 — should receive notifications that they may now be eligible for enrollment in a higher priority group based on their gross income.

Veterans with questions about the change can contact their local Veterans Affairs office.