VA Eliminates Net Worth as Health Care Eligibility Factor
The Department of Veterans Affairs has announced that it is updating
the way it determines eligibility for VA health care benefits, a change that will result
in more Veterans having access to the health care benefits.
According to a VA news release
dated March 17, 2015, VA has now eliminated the use of
net worth as a determining factor for both health care programs and co-payment
responsibilities.
Until now, some low income but higher net worth veterans were allowed to receive care at VA hospitals and clinics but only with burden of co-payments that ranged from $15 per visit for primary care to
$50 per visit for specialty care. Co-payments also have been applied to in-patient care.
As a result of the change, instead of combining the sum of Veterans’ income with their
assets to determine eligibility for medical care and co-payment obligations, VA
will now only consider a Veteran’s gross household income and deductible
expenses from the previous year. Elimination of the consideration of net worth
for VA health care enrollment means that certain lower-income, non-service-connected
Veterans will have less out-of- pocket costs. Over a 5-year period, it is
estimated that 190,000 Veterans will become eligible for reduced costs of their
health care services.
Last year VA eliminated the annual requirement for updated
financial information. VA now uses information from the Internal Revenue
Service and Social Security Administration to automatically match individual
Veterans’ income information which reduces the burden on Veterans to keep their
healthcare eligibility up to date.
The net worth change is part of an ongoing effort to streamline the
administrative burden on veterans applying for services and benefits.
VA will continue to use the combined net-worth/income
threshold in the determination of eligibility for other benefits, such as in
considering applications for pensions.
Veterans with low incomes who were prioritized into the
lowest tiers of eligibility for care as a result of their net worth/income
calculation — Priority Groups 7 and 8 — should receive notifications that they
may now be eligible for enrollment in a higher priority group based on their
gross income.
Veterans with questions about the change can contact their local Veterans Affairs office.