When applying for VA benefits, you will have to fill out the application form, submit all required paperwork, and have your application reviewed in order to be assigned to an enrollment priority group.
The Application: VA Form 10-10EZ
The first step in applying for benefits through the VA is to fill out VA Form 10-10EZ, “Application for Health Benefits.”
You have three options for filing your 10-10EZ:
- Visit 1010ez.med.va.gov/ to complete the form and submit it electronically
- Visit va.gov/vaforms/medical/pdf/1010EZ-fillable.pdf for a printable copy of the form and instructions for filling it out, which you can then submit in person at your local VA facility.
- Mail a completed, signed 10-10EZ to:
Health Eligibility Center
2957 Clairmont Road, Suite 200
Atlanta, GA 30329-1647
If you find that you are unable to fill out any of the sections of the form because you don’t understand what information is required or you do not know how to get that information, do not guess. Discrepancies and mistakes in filling out the 10-10EZ can result in delayed or denied benefits.
For assistance in filling out the 10-10EZ, you have a few options:
- Stop by a VA facility for in-person assistance
- Call 1-800-222-VETS (8387) between 8 am and 8 pm EST, Monday through Friday
- Contact a military/veterans organization (e.g., benefits associations for individual service branches, The American Legion, or Disabled American Veterans)
In addition to a completed VA Form 10-10EZ and a copy of your Form DD 214, the following documentation will assist the VA in determining your enrollment priority group.
- Leave and Earnings Statements, or “LES”s, indicating hostile fire pay/imminent danger pay
- Combat activation orders
- Proof of hostile fire/imminent danger tax-exempt status
- Any campaign medals earned for combat service
- Any service medical records in your possession related to claimed injuries or disabilities
Assignment to an Enrollment Priority Group
Veterans applying to the VA for medical benefits will be assigned an enrollment priority group based on the veteran’s income, disability rating, and enhanced eligibility status, among other factors. Any veteran assigned to Priority Group 6 or higher is entitled to free healthcare and long-term care.
Enrollment Priority 1
- Veterans with service-connected disabilities rated 50% or more disabling
- Veterans determined by VA to be unemployable due to service-connected conditions
Enrollment Priority 2
- Veterans with service-connected disabilities rated 30% or 40 % disabling
Enrollment Priority 3
- Veterans who are former POWs
- Veterans awarded the Purple Heart
- Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty
- Veterans with service-connected disabilities rated 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”
Enrollment Priority 4
- Veterans who are receiving aid and attendance or housebound benefits
- Veterans who have been determined by VA to be catastrophically disabled.
A veteran is considered catastrophically disabled when suffering from “a severely disabling injury, disorder or disease that permanently compromises their ability to carry out the activities of daily living. The disability must be of such a degree that the veteran requires personal or mechanical assistance to leave home or bed, or require constant supervision to avoid physical harm to themselves or others.”
Enrollment Priority 5
- Non–service-connected veterans and non-compensable service-connected veterans rated 0% disabled whose annual income and net worth are below the established VA means test thresholds
- Veterans receiving VA pension benefits
- Veterans eligible for Medicaid benefits
Enrollment Priority 6
- World War I veterans
- Mexican Border War veterans
- Compensate 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 five years post discharge. Veterans discharged from active duty before January 28, 2003, who apply for enrollment after January 28, 2008, until January 27, 2011
Enrollment 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 co-pays
Enrollment Priority 8
- Veterans who agree to pay specified copayments with income and/or net worth above the VA means test threshold and the HUD geographic index
Noncompensable 0% service-connected and:
- Sub-priority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub-priority due to changed eligibility status.
- Sub-priority b: Enrolled on or after June 15, 2009, whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less
- Sub-priority c: Enrolled as of January 16, 2003, and who remained enrolled since that date and/or placed in this sub-priority due to changed eligibility status
- Sub-priority d: Enrolled on or after June 15, 2009, whose income exceeds the current VA National Income Thresholds or VA National Geographic Income Thresholds by 10% or less
Any veterans with noncompensable 0% service-connected conditions or non-service-connected conditions will not be eligible to enroll.