Enrollment · Care Access · Family Coverage

VA Health Care Navigator

A plain-language field guide to enrolling, understanding your priority group, using Community Care, handling emergency visits, requesting travel pay, and finding family coverage.

AFL educational resource · Reviewed against official VA guidance July 2026
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What do you need today?

Start with the situation closest to yours. You can always use the section bar to move around the full guide.

Do not count yourself out

You may qualify if you served in the active military, naval, or air service and did not receive a dishonorable discharge. Service history, discharge, disability status, toxic exposure, income, and other factors can affect eligibility.

Best first move: Apply even if you are unsure. VA—not a rumor, old denial, or another veteran’s experience—should make the eligibility determination.
Discharge

Other than dishonorable

Most applicants must not have received a dishonorable discharge. Other discharge situations may require a character-of-discharge review.

Service length

Minimum duty rules

Many veterans who enlisted after September 7, 1980, or entered active duty after October 16, 1981, must meet a 24-month or full-call-up requirement. Exceptions exist.

Guard & Reserve

Federal activation matters

Eligibility commonly depends on being called to active duty by a federal order, for more than training only, and completing the ordered period.

Special pathways

Exposure, combat, disability

Service-connected disability, combat service, toxic exposure, certain medals, pension, income, and other statuses may create or strengthen eligibility.

Recent combat veterans: Qualifying veterans discharged from active duty on or after September 11, 2001, after service in a combat theater may receive enhanced enrollment eligibility for up to 10 years after their most recent discharge.

Eligibility is not the whole story

After enrollment, VA assigns you to one of eight priority groups. Your group can affect access and whether you owe copays. If you qualify for more than one group, VA places you in the highest group you qualify for.

Priority group is not a disability rating. It is an enrollment category based on several factors, and it may change if your rating, income, or eligibility changes.
Group Common qualifying examples Plain-language note
150% or higher service-connected rating; VA unemployability; Medal of HonorHighest enrollment priority. Generally no medication copays.
230% or 40% service-connected ratingHigh priority based on compensable service-connected disability.
310% or 20% rating; former POW; Purple Heart; certain service-related discharge or statutory categoriesIncludes several distinct service and disability pathways.
4VA Aid and Attendance or Housebound benefits; catastrophic disabilityBased on significant care needs or qualifying benefits.
5VA pension; Medicaid eligibility; qualifying low household incomeIncome and benefit-based pathway.
6Compensable 0% rating; certain toxic exposure, combat, radiation, Gulf War, Camp Lejeune, and other special authoritiesSpecial eligibility rules can apply to specific cohorts and conditions.
7Income below geographically adjusted limits, with agreement to pay copaysIncome and location affect placement.
8Income above VA and geographically adjusted limits, with specific subpriority requirementsEnrollment depends on the exact subgroup. Some applicants may be ineligible.

Apply once. Keep the record.

There is no open enrollment season for VA health care. You can apply online, by phone, by mail, or in person.

Health Benefits Hotline:
877-222-8387
Monday–Friday, 8:00 a.m.–8:00 p.m. ET
1

Gather your information

Have your Social Security number, separation records, service history, exposure details, insurance information, and household financial information available.

2

Choose how to apply

Apply online, call VA, mail VA Form 10-10EZ, or bring the form to a VA medical center or clinic.

3

Save confirmation

Keep a copy of the form, upload confirmation, date submitted, and any records you sent.

4

Watch for the decision

VA says decisions are usually made in less than one week. If more than a week passes, call instead of submitting a duplicate application.

Bring or gather

Application checklist

  • DD214 or other separation documents
  • Service dates and military history
  • Toxic or hazardous exposure details
  • Insurance cards, including Medicare or coverage through a spouse
  • Household income and eligible deductible expenses, if needed
Mail option

VA Form 10-10EZ

Mail a signed application to:

Health Eligibility Center
PO Box 5207
Janesville, WI 53547-5207

Use VA Form 10-10EZR later to update personal, insurance, or financial information.

What VA health care may include

Enrolled veterans may receive a broad medical benefits package. Your provider determines what is clinically needed, and some services have separate eligibility rules.

VA health care is not conventional health insurance. You can keep Medicare, Medicaid, TRICARE, or private insurance. Other coverage does not prevent you from receiving VA health benefits.
Everyday care

Primary & preventive care

Routine exams, immunizations, health screenings, disease prevention, nutrition, and ongoing primary care.

Behavioral health

Mental health care

Counseling, therapy, medication support, substance-use treatment, and specialized services, including PTSD care.

Medication

Pharmacy services

Prescriptions ordered by a VA provider or an authorized community provider, subject to formulary and copay rules.

Advanced care

Specialty & hospital care

Specialists, diagnostic services, surgery, critical care, inpatient treatment, and other medically necessary services.

Function & recovery

Rehabilitation & prosthetics

Physical and occupational therapy, durable medical equipment, prosthetics, orthotics, and qualifying sensory aids.

Across life stages

Specialized programs

Women’s health, maternity coordination, geriatrics, caregiver support, home health, long-term care, and other programs may be available.

Costs vary. Your priority group, service connection, income, type of care, and other rules may determine whether you owe a copay. Verify costs before non-emergency services whenever possible.

Outside care usually needs VA approval

Community Care allows eligible veterans to receive VA-paid care from approved non-VA providers. For routine care, you generally need VA to determine eligibility and issue a referral or authorization first.

Private insurance is not the same as Community Care. A provider accepting veterans—or accepting VA-related insurance—does not automatically mean VA authorized your appointment.
Access standards

Drive time

Community Care may apply when average drive time exceeds 30 minutes for primary, mental health, or extended outpatient care, or 60 minutes for specialty care.

Access standards

Wait time

Community Care may apply when the wait exceeds 20 days for primary, mental health, or extended outpatient care, or 28 days for specialty care.

Other pathways

Clinical or service factors

You may also qualify when VA lacks a needed service, Community Care is in your best medical interest, or VA care does not meet applicable quality standards.

1

Ask your VA care team

Explain the care you need and why Community Care may apply.

2

VA reviews eligibility

VA confirms whether you qualify and prepares the referral.

3

Schedule approved care

Use the authorized provider and tell VA within 14 days if you schedule it yourself.

4

Read the authorization

Confirm the approved service, provider, date range, and number of visits before treatment.

A referral protects you from billing problems. Except for covered urgent or emergency care, do not assume VA will pay for an outside appointment that VA did not authorize.

Know which rule you are using

Emergency care is for threats to life or health. Urgent care is for minor illnesses or injuries that need prompt attention but are not life-threatening.

Emergency notice:
Report non-VA emergency treatment to VA within 72 hours of when the care begins.
844-724-7842 · TTY 711
Emergency care

Go first. Report quickly.

  • Call 911 or go to the nearest emergency department when life or health is in danger.
  • Ask the facility to notify VA, but report it yourself if they do not.
  • VA must receive notice within 72 hours for the care to be considered authorized under the notification pathway.
  • Coverage still depends on the facts and eligibility rules; notice alone does not guarantee payment.
Report emergency care online
Urgent care

Use an in-network provider

  • You must be enrolled in VA health care.
  • You must have received care from VA or an in-network provider within the past 24 months.
  • No referral is required, but the urgent care provider must be in VA’s network.
  • Bring government-issued identification and the VA urgent care billing information card.
Use the VA urgent care benefit
Do not pay an urgent care copay at the visit. If you owe one, VA will bill you. An out-of-network urgent care visit may become your financial responsibility.

Your appointment may qualify for travel pay

Eligible veterans and caregivers may receive mileage or other approved travel reimbursement for VA care and VA-authorized community care.

Do not wait: Plan to file a separate claim for each appointment within 30 days. Late claims are usually denied.
You may qualify if

At least one qualifying reason applies

  • Your VA disability rating is 30% or higher
  • You traveled for treatment of a service-connected condition
  • You receive VA pension or meet applicable income/financial hardship rules
  • You traveled for a scheduled C&P exam, approved service-dog care, or VA-approved transplant care
Before filing

Build the paper trail

  • Set up separate direct deposit for VA travel pay
  • Track mileage and keep parking, toll, transportation, lodging, and meal receipts
  • Get proof of attendance for Community Care appointments
  • Request preapproval for transportation, meals, or lodging when required

The benefit rules are different

Routine eye and hearing evaluations may be part of enrolled care, but eyeglasses, contact lenses, hearing aids, and dental treatment can have separate eligibility or clinical requirements.

Ask for the evaluation first. A VA care team can determine whether you need a referral and whether VA can furnish the device or treatment.
Dental

Full VA dental care is limited

Dental eligibility is divided into specific classes based on disability, service history, clinical circumstances, and other factors. Enrolled veterans and CHAMPVA beneficiaries may purchase discounted coverage through VADIP.

Check VA dental eligibility
Vision

Eye exams are broader than glasses

VA health benefits cover routine eye exams and preventive vision testing. VA covers eyeglasses when a veteran meets at least one applicable eligibility requirement.

Review VA vision care
Hearing

Start with VA audiology

Enrolled veterans may receive audiology care. Hearing aids require an authorized clinical evaluation and must meet VA’s eligibility and prescribing requirements.

How to request hearing aids

CHAMPVA is separate from the veteran’s enrollment

CHAMPVA shares the cost of certain covered health services for eligible spouses, dependent children, survivors, and some primary family caregivers.

Core rule: A spouse or dependent generally cannot receive CHAMPVA if eligible for TRICARE. Medicare rules may also apply.
Veteran-related eligibility

A spouse or dependent child may qualify when

  • The veteran is rated permanently and totally disabled from a service-connected disability
  • The veteran died from a service-connected disability
  • The veteran was permanently and totally disabled from a service-connected disability at death
  • Other qualifying survivor or caregiver rules apply
Application preparation

Gather the supporting record

  • Health insurance and Medicare cards, when applicable
  • Proof of marriage or dependent relationship
  • School enrollment proof for qualifying dependent children
  • Any documents requested by the CHAMPVA application instructions
Important distinction: The veteran’s VA health care enrollment does not automatically cover family members. CHAMPVA requires its own eligibility decision and application.

Quick answers before you leave

These are general answers. Your facility or VA eligibility team should confirm how the rules apply to your situation.

Need enrollment help?
877-222-8387
Monday–Friday, 8:00 a.m.–8:00 p.m. ET

No. A disability rating is one path to eligibility and priority, but it is not the only one. Service history, discharge, toxic exposure, combat service, income, pension, and other factors may also matter.

VA does not recommend canceling or declining Medicare or other health coverage simply because you enroll in VA health care. Other coverage can protect you when VA eligibility, location, authorization, or family needs differ.

Usually not. Routine non-VA care normally requires VA eligibility approval, a Community Care referral or authorization, and an approved provider. Urgent and emergency care use different rules.

You can ask your care team to explain the reason and may use VA’s Clinical Appeals process to challenge a medical treatment or Community Care decision. Keep the denial, appointment dates, drive-time information, and relevant medical evidence.

Update VA so your records, priority group, billing, and facility communications remain accurate. You can update information online, by phone, or with VA Form 10-10EZR.

Update VA health information