VETERANS' HEALTH CARE ADMINISTRATION (VHA):
The VHA was established to provide medical care to veterans who are determined by the Federal Government to be eligible for enrollment. This is not insurance and does not, under most circumstances, provide payment to private physicians or hospitals. Veterans must first enroll in the facility of their choice.
Since 2003 veterans who submit enrollment paperwork are placed in one of eight priority groups based on either the nature of their service or income and assets. The staff at the Ashland County Veterans Service Office will assist with enrollment and with annual means tests (income) certain veterans are required to complete in order to continue to use the VA Health Care System.
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The means test is based on the prior year’s income and is done annually. However, you can apply for an exemption from paying those co-payments to avoid hardship if projections of your income for the current year will be substantially below the applicable income threshold. Some veterans will be placed in a subcategory of Priority Group 8 and will not be eligible for health care services.
Each veteran who submits an enrollment form will be placed in one of eight priority groups. All veterans can enroll in the VA Health Care System.
Eligibility for services is determined by the following conditions:
- Former Prisoner of War (POW) – Is a person who, while serving in the active military, naval, or air service, was forcibly detained or interned in the line of duty.
In receipt of the Purple Heart Medal, In receipt of the Medal of Honor, Have a VA-awarded service-connected disability of 10% or more.
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In receipt of a VA Pension:
- Were discharged or separated for medical reasons, early out, or hardship.
- Were discharged from the military because of a disability (not preexisting)
- Are found by VA to be Catastrophically Disabled.
- Previous years’ household income is below VA’s National Income or Geographical-Adjusted Thresholds. Hardship applications are available if current year’s income is significantly lower than previous year’s income.
- Served in the Republic of Vietnam from January 9, 1962 to May 7, 1975 or the Persian Gulf from August 2, 1990 to November 11, 1998.
- Special Care for PTSD Treatment may be available to Veterans who do not qualify for VA Health Care Benefits but still need help with care for certain needs like PTSD or Military Sexual Trauma.
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MST Military Sexual Trauma Link
Other Mental Health Problems Link
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VA Dental
Dental is not a part of VHA benefits for all Veterans. Only a select few can be eligible for VA Dental
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Eligibility:
Service-Connected dental disability or condition that you are receiving monthly compensation payments for
- Former Prisoner of War
- Service-Connected non compensable dental condition that is the result of a combat wound or service trauma
- One or More Service-Connected disability rated 100% disabling *Please note: If you’re being paid at the 100% disabling rate based on a temporary rating (for a reason such as a long stay in the hospital or rehab care), that doesn’t qualify you for this benefit.
- Receiving Total Disability Due to being unemployable (TDIU)
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VA Dental Care provider has concluded that your dental condition is linked to a service-connected condition health condition is making that condition worse. Active in 38 U.S.C. Chapter 31 Veteran Readiness and Employment Program
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The dental care must be needed to:
Make it possible for you to be in the employment program
OR
Make it possible for you to reach the goals of your Veteran Readiness and Employment program, or
Prevent you from having to stop your employment program
OR
Help you get back to your employment program faster if you’ve had to stop (and are in “interrupted” or “leave” status)
OR
Help you get back to your employment program faster if you’ve had to stop (and are in “discontinued” status) because of an illness, injury, or dental condition
OR
Make it possible for you to get and adjust to a job during the period of employment assistance
OR
Make it possible for you to be fully independent in your daily living
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- Scheduled for inpatient care for a health condition and need dental care for an issue that the dental condition is making your condition harder to treat. You may qualify for Dental care to treat the dental issue that a VA dental care provider finds is making the health condition you’re being treated for harder to treat
- Signed up to get care through the Homeless Veterans Dental Program (VHA Directive 2007-039)
-You may qualify for a one-time course of dental care that a VA dental care provider concludes you need to achieve at least one of the goals listed below.
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The dental care must be needed to:
Relieve your pain
OR
Help you get a job
OR
Treat your moderate, severe, or complicated and severe gingival and periodontal conditions (gum infections that can lead to pain, swelling, and bone and tooth loss if not treated)
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Currently inpatient care in a hospital, nursing home, or other supervised domiciliary care
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You may qualify for: Dental services that a VA dental care provider—working with your primary care provider—concludes you need to manage a health condition a doctor is currently treating you for
- Served Active Duty for 90 days or more during the Persian Gulf War (One-time dental Care)
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All of these must be true for you:
You didn’t receive a dishonorable discharge
AND
You apply for dental care within 180 days of discharge or release
AND
Your DD214 certificate of discharge doesn’t show that you had a complete dental exam and all needed dental treatment before you were discharged
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*Please note: If you got a dental award letter from VBA dated before 1955 stating that your dental conditions aren’t compensable, then you are no longer eligible for Class II outpatient dental treatment. This is because of Public Law 83, which was enacted June 16, 1955, and which amended Veterans’ eligibility for outpatient dental services.
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