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Medical Benefits

 

York VA Outpatient Clinic
2251 Eastern Blvd, York PA 17402
Phone Number 717-840-2730

Lebanon VA Medical Center
1700 South lincoln Avenue
Lebanon, PA 17042
Phone Number 1 800 409-8771 or 717-272-6621

Veterans Medical Benefits

VA provides a Medical Benefits Package, a standard enhanced health benefits plan available to all enrolled veterans. This plan emphasizes preventive primary care that offers a full range of outpatient and inpatient services within VA health care system.

VA maintains an annual enrollment system to manage the provision of quality hospital and outpatient medical care and treatment to all enrolled veterans. A priority system ensures that veterans with service-connected disabilities and those below the low-income threshold are able to be enrolled in VA’s health care system.

Eligibility Requirements

All Veterans are Potentially Eligible

  • Reservists and National Guard members who were called to active duty by a Federal Executive Order may qualify for VA health care benefits.Returning service members, including Reservists and National Guard members who served on active duty in a theater of combat operations have special eligibility for hospital care, medical services, and nursing home care for five years following discharge from active duty.
  • Care eligibility is not just for those who served in combat.
  • Other groups may be eligible for some health benefits.
  • Veteran’s health care is not just for service-connected injuries or medical conditions.
  • Veteran’s health care facilities are not just for men only. VA offers full-service health care to women veterans.

Health Care Eligibility for 5 years — Enroll for health care at any VA Medical Center or clinic for 5 years following your military separation date. When you enroll, you may start receiving your health care at the VA right away, or not - the choice is yours! Once you enroll, the VA will be available to help serve your health care needs for years to come - but you must enroll within 5 years from separation!

Dental Benefits — We provide dental examinations and benefits to veterans with service related dental conditions. You may be eligible for one-time dental care but you must apply for a dental exam within the first 180 days of your separation date. Visit the Office of Dentistry for more information.

OEF/OIF Programs — every VA Medical Center has a team ready to welcome OEF/OIF service members and help coordinate their care. Visit How Do I Get Help? for more information.

Federal Recovery Coordination Program — assists severely wounded, ill or injured recovering service members, veterans, and their families in accessing the care, services, and benefits provided through the various programs in the Departments of Defense and Veterans Affairs, other federal agencies, states, as well as the private sector. Visit How Do I Get Help? for more information.

Primary Health Care for Veterans — We provide general and specialized health care to meet veterans' needs.

Enrollment Priority Groups Overview

Additional Benefits — We provide additional, non-health related benefits which may include: financial benefits, home loans, vocational rehabilitation, education, and more. Visit the Veterans Benefits Administration for more information.

The number of veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up priority groups to make sure that certain groups of veterans are able to be enrolled before others.

Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a priority group. The priority groups range from 1-8 with 1 being the highest priority for enrollment. Some veterans may have to agree to pay copay to be placed in certain priority groups.

You may be eligible for more than one Enrollment Priority Group. In that case, VA will always place you in the highest priority group that you are eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled veterans.

The priority groups are complicated and some reference financial thresholds. For more information about the thresholds go to the copay and charges page. We have provided a couple of different ways to view priority groups. Click below on the format that seems most helpful to you.

All Enrollment Priority Groups

PriorityDescription
Priority 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 2:
  • Veterans with VA-rated service-connected disabilities 30% or 40% disabling
Priority 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., Section 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”
Priority 4:
  • Veterans who are receiving Veterans who are receiving aid and attendance or household benefits from VA
  • Veterans who have been determined by VA to be catastrophically disabled
Priority 5:
  • Nonservice-connected veterans and noncompensable service-connected veterans rated as 0% disabled by VA and whose annual income and net worth are below the VA Pension Benefits, VA national income threshold
  • Veterans receiving VA pension benefits
  • Veterans eligible for Medicaid programs
Priority 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 who served in a theater of combat operations after November 11, 1998 as follows:
    • Veterans discharged from active duty on or after January 28, 2003, who were enrolled as of January 28, 2008 and veterans who apply for enrollment after January 28, 2008, for 5 years post discharge
    • Veterans discharged from active duty before January 28, 2003, who apply for enrollment after January 28, 2008, until January 27, 2011
Priority 7:
  • Veterans with income and/or net worth above the VA national income threshold and income below the geographic income threshold who agree to pay copays
Priority 8:
  • Veterans with income and/or net worth above the VA national income threshold and the geographic income threshold who agree to pay copays
    • Subpriority a: Noncompensable 0% service-connected veterans enrolled as of January 16, 2003, and who have remained enrolled since that date
    • Subpriority c: Nonservice-connected veterans enrolled as of January 16, 2003, and who have remained enrolled since that date
    • Subpriority e**: Noncompensable 0% service-connected veterans applying for enrollment after January 16, 2003
    • Subpriority g**: Nonservice-connected veterans applying for enrollment after January 16, 2003

Medical Benefits Package (Standard Benefits)

VA’s medical benefits package provides the following health care services to all enrolled veterans.

Preventive Care Services

  • Immunizations
  • Physical Examinations
  • Health Care Assessments
  • Screening Tests
  • Health Education Programs

Ambulatory (Outpatient) Diagnostic and Treatment Services

  • Emergency outpatient care in VA facilities
  • Medical
  • Surgical (including reconstructive/plastic surgery as a result of disease or trauma)
  • Chiropractic Care
  • Mental Health
  • Bereavement Counseling
  • Substance Abuse

Hospital (Inpatient) Diagnostic and Treatment

  • Emergency inpatient care in VA facilities
  • Medical
  • Surgical (including reconstructive/plastic surgery as a result of disease or trauma)
  • Mental Health
  • Substance Abuse

Medications and Supplies

  • Prescription medications
  • Over-the counter medications
  • Medical and surgical supplies

Generally, they must be prescribed by a VA provider and be available under VA's National Formulary System

Medical Benefits for Women

Women veterans may receive the full spectrum medical benefits package. They also receive the full continuum of comprehensive medical services including health promotion and disease prevention, primary care, women’s gender-specific health care e.g., hormone replacement therapy, breast and gynecological care, maternity and limited infertility (excluding In-vitro fertilization), acute medical/surgical, emergency and substance abuse treatment, mental health, domiciliary, rehabilitation and long term care.

Primary Care Services include:

  • Family Planning and Birth Control
  • GYN & Maternity Care
  • Infertility Evaluation & Treatment
  • Midlife and Menopause Issues
  • Cancer Screenings
  • Wellness and Healthy Living
  • Mammograms

Mental Health Services include:

  • Management of Depression
  • Anxiety, Stress
  • Counseling and Medication
  • Family and Parenting Issues
  • Adjustment from Deployment Dependence
  • Treatment for Alcohol and Drug
  • Military Sexual Trauma Counseling

More information on the VA Programs for Women Veterans is available at http://www.va.gov/womenvet/.

Special Considerations

  • Each medical facility has a Women Veterans Program Manager.
  • Women’s Trauma Recovery Program (Palo Alto) inpatient post traumatic stress disorder (PTSD) and military sexual trauma (MST) treatment
  • VA researchers also conduct studies on women’s health

Women’s Benefit Coordinators are available for disability benefits. You may call for information on disability benefits from your local Regional Office at 1-800-827-1000 or find them online at http://www.va.gov/directory/guide/division_flsh.asp?dnum=3.