The Department of Veterans Affairs (VA) provides a comprehensive medical benefits package to certain persons who served in the active military, naval or air service and who were discharged or released under conditions other than dishonorably. Some family members of veterans may also receive medical benefits through the VA. However, even though a veteran may be eligible to receive free or reduced cost health care, the provision of services is dependent each year on federal funding of the VA program.

The VA determines eligibility for coverage based on the applicant’s assignment to one of seven priority groups. The VA will determine which priority status an applicant fits into and notify the applicant of his or her eligibility for benefits. Almost 3 million veterans receive some type of health care service from the VA each year. There are also many family members and surviving family members of veterans who also receive VA health care services.

The VA provides coverage for basic and preventive health care which includes inpatient and outpatient care for medical, surgical, and mental health care, including care for substance abuse. Also covered are prescription and over the counter drugs, home health services, hospice and extended care, periodic physical examinations, immunizations, vision care and many other health care services. Co-payments are sometimes required for prescription drugs and other services.

By regulation, the VA will provide health care services for an eligible veteran or family member “only if it is determined by appropriate health care professionals that the care is needed to promote, preserve, or restore the health of the individual and is in accord with generally accepted standards of medical practice.” When the VA denies coverage for a health care service, the claimant has the right to a written notice of the adverse decision that includes the basis for the VA’s denial and an explanation of the claimant’s right to appeal and to have representation.

For further information concerning the legal rights of veterans for health care benefits, please contact the veterans support organizations listed on this Web site or the Health Care Access Project of Legal Services of New Jersey through the LSNJ Hotline (1-888-576-5529).