Until now, some veterans with illnesses not linked to their service and who are not rated for a service-connected conditions have been allowed to receive care at VA hospitals and clinics if their combined income and net worth were above VA thresholds, as long as they were willing to make copayments for that care.
But according to a VA announcement Tuesday, the department has dropped the net worth portion of that calculation and instead will consider only a veteran's gross household income and expenses from the prior year when determining eligibility.
The change could lower health care costs for nearly 190,000 low-income and non-service connected veterans in the next five years, according to VA.
VA copayments range from $15 per visit for primary care to $50 per visit for specialty care. Copayments also apply to inpatient care and some hospital services.
With the change, the department stands to lose $55.5 million to $80 million in patient co-payments in the next five years. But officials said the change will help ease the burden of health care costs for low-income veterans.
"Everything that we do and every decision we make has to be focused on the veterans we serve," VA Secretary Robert McDonald said. "Changing the way we determine eligibility to make the process easier for veterans is part of our promise to our veterans."
VA still will use the combined net-worth/income threshold as a variable in determining eligibility for other benefits, such as extended care services, and when considering applications for pensions, officials said.
In coming weeks, veterans now prioritized into the lowest tiers of eligibility for care as a result of their net worth/income calculation — Priority Groups 7 and 8 — will receive notifications that they may now be eligible for enrollment in a higher priority group based on their gross income.
As part of an ongoing effort to streamline the administrative burden on veterans applying for services and benefits, VA last year also dropped the annual requirement for these veterans to provide updated financial information. Instead, the department receives the income figures directly from the Internal Revenue Service and Social Security Administration.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
