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The Financial Assessment by VA for the Health Care Benefits

The gross household income of the spouse or dependents of the veterans who are non-service related or non-compensable will be assessed by the VA so that they can determine the authenticity of the veterans’:

  • Status of Copay
  • Qualification for free VA health care services
  • Enrollment in the priority group assignment.

It is beneficial for you to provide the information about your gross household income that is lesser than or equal to the amount that the threshold calculator shows which helps in deciding on the VA health care benefit applicable for you.

The VA calculates and determines your health care benefits based on the information about the income that you provide on the Financial Worksheet at the time of enrolling yourself at www.1010ez.med.va.gov/sec/vha/101

In case of any hardships, the net worth and income of the current year are considered. Your gross income in your household including your spouse and dependents’ income is verified by the VA based on the financial information given by you and matching them with the info on the financial records that the SSA and IRS maintain. When the VA determines that the gross income of your household is more than that provided by the threshold amount in the process of matching the data, then you can avail another chance to review the data given in the SSA and IRS and provide them additional data relevant to the resulting difference in the amount. All the relevant details will be notified to the veterans by mail during this process.

In the event of determining that the gross income of your household is greater than the threshold amount then the following are the outcomes:

  • You need to agree for copay.
  • The priority group assignment is modified
  • You will be billed for the health care services that you were provided for the period when your income assessment was made.

In the event of declining to provide VA the details about your financial income then the VA will:

  • Modify your group priority and you will be placed in Priority Group 8
  • Demand a fee for copay from you before availing the health care services or treatment.

Those veterans who are changed to the priority group 8 and who have applied for enrolling in the health care benefits after 17th January 2003 will not be qualified for the health care of the conditions related to non-service and other reasons.

Health care benefits and treatments are given to the eligible veterans for free of cost depending on the following conditions:

  • When the veteran receives a Purple Heart medal
  • When the veteran is a former war prisoner.
  • If he has a low household income
  • And when the veteran has disabilities that are connected to the military service and compensable.

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