“Generally, a veteran has to meet three basic criteria to be eligible for VA health care.7 A veteran must (1) meet the statutory definition of a “veteran,” meaning an “individual who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable”8 (see text box for definitions of military discharges); (2) meet the statutory definition of “active duty,” meaning full-time duty in the Armed Forces, other than active duty for training;9 and (3) have served a minimum period of 24 months of continuous active duty.10 Some veterans may meet the eligibility requirements listed above but, due to the discretionary nature of VA health system funding, may not be allowed to enroll in the system.11“
Source: Sidath Viranga Panangala and Jared S. Sussman. Health Care for Veterans: Answers to Frequently Asked Questions. Congressional Research Service. CRS R42747. March 4, 2020.
“Eligibility for VA health care is based primarily on veteran status resulting from military service. Generally, veterans must also meet minimum service requirements; however, exceptions are made for veterans discharged due to service-connected disabilities, members of the Reserve and National Guard (under certain circumstances), and those eligible under special treatment authorities, such as Camp Lejeune veterans.
“In the enrollment process, the VA categorizes veterans into eight priority categories, based on factors such as service-connected disabilities, income, and combat veteran status (among others). The VA may limit enrollment based on the availability of funds—an authority provided by Congress. Some veterans without service-connected disabilities and whose attributable income exceeds established means tests cannot enroll in the VA health care system. Dependents, caregivers, and survivors of certain veterans are eligible to enroll in the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), which reimburses non-VA providers or facilities for their medical care.”
Source: Sidath Viranga Panangala and Jared S. Sussman. Health Care for Veterans: Answers to Frequently Asked Questions. Congressional Research Service. CRS R42747. March 4, 2020.
“With the exception of active-duty servicemembers (who are assigned to the TRICARE Prime option and pay no out-of-pocket costs for TRICARE coverage), MHS beneficiaries may have a choice of TRICARE plan options depending upon their status (e.g., active-duty family member, retiree, reservist, child under age 26 ineligible for family coverage, Medicare-eligible) and geographic location. Each plan option has different beneficiary cost-sharing features. Cost sharing may include an annual enrollment fee, annual deductible, monthly premiums, copayments, and an annual catastrophic cap. Pharmacy copayments are established separately and are the same for all beneficiaries under each option.”
Source: Mendez, Bryce H. P. Defense Primer: Military Health System. Congressional Research Service. CRS IF10530. October 18, 2024.
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Page last updated March 21, 2025 by Doug McVay, Editor.