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VA health care: priority groups and copays by rating
Almost every veteran with a rating can enroll. Your rating decides your priority group, and your priority group decides what you pay.
At a glance
| Who | Served on active duty, not dishonorably discharged. Most who enlisted after Sept 7, 1980 need 24 continuous months or the full call-up period (exceptions for service-connected discharge). |
| Rating needed | None to apply. 10%+ removes most copays. 50%+ removes all copays. |
| Form | VA Form 10-10EZ, online, by phone (877-222-8387), by mail, or in person |
| Official page | va.gov/health-care/eligibility |
Which priority group am I in?
| Group | You are here if | Copays |
|---|---|---|
| 1 | Rated 50% or more, or rated unemployable (TDIU), or Medal of Honor | None: no care copays, no medication copays |
| 2 | Rated 30% or 40% | No care copays. Medication copays for non-service-connected conditions (waived if income is under the limit) |
| 3 | Rated 10% or 20%, former POW, Purple Heart, discharged for a disability, or 38 U.S.C. 1151 eligibility | Same as group 2 |
| 4 | Receiving Aid & Attendance or housebound benefits, or VA found you catastrophically disabled | None by regulation |
| 5 | 0% non-compensable or no rating, with income below VA limits; or receiving VA pension; or Medicaid eligible | Care copays may apply for non-service-connected care; the 0% condition itself is free |
| 6 | 0% compensable rating; PACT Act toxic exposure; combat theater service within 10 years of discharge; Camp Lejeune, Gulf War, WWII, Project 112/SHAD | Free for the covered condition or exposure; copays for unrelated care |
| 7 and 8 | No rating and income above the limits; you agree to pay copays | Full copay schedule |
"0% compensable" is rare (VA pays you at 0%, for example for inactive TB). Most 0% ratings are "non-compensable" and land in group 5, 7, or 8 by income. Source: 38 CFR 17.36.
2026 copay amounts (effective January 1, 2026)
- Outpatient (non-service-connected care, rating under 10%): primary care $15 per visit, specialty care $50, imaging like MRI or CT $50. Labs, x-rays, and preventive tests $0.
- Urgent care: groups 1 to 5, $0 for the first 3 visits per year then $30; groups 7 and 8, $30 per visit.
- Medications (30-day supply): tier 1 $5, tier 2 $8, tier 3 $11. Annual cap $700. Free for any service-connected condition at any rating, and free for everything at 50%+.
- Inpatient (non-service-connected): group 7, $347.20 plus $2 a day for the first 90 days; group 8, $1,736 plus $10 a day.
Copays reset every January 1. Full table: va.gov/health-care/copay-rates.
Traps and tips
- Combat veterans get a 10-year window. If you served in a combat theater after Sept 11, 2001, you can enroll in group 6 for 10 years from discharge even with no rating (PACT Act). Do not wait.
- PACT Act toxic exposure lets many veterans enroll without filing a disability claim first (since March 5, 2024).
- You do not have to report income on the application if you have a compensable rating, but reporting it can only help you.
- Your priority group updates automatically when your rating changes. Check your group on VA.gov after any new decision.
- Enrolling also gets you a VHIC (Veteran Health ID Card), which is the easiest proof for commissary and exchange access.
How to apply
- Fill out the 10-10EZ online (about 30 minutes).
- Or call 877-222-8387, Monday to Friday 8 a.m. to 8 p.m. ET.
- Or mail the paper form to the Health Eligibility Center, PO Box 5207, Janesville, WI 53547-5207, or bring it to any VA medical center.
Sources
- VA health care eligibility (page updated Apr 3, 2026)
- VA priority groups (page updated Apr 3, 2024)
- VA copay rates, effective Jan 1, 2026 (page updated Dec 29, 2025)
- 38 CFR 17.36 enrollment priority
- 38 CFR 17.108 copay exemptions (a July 28, 2026 amendment was published; its content was not reviewed)
- VA Form 10-10EZ (form revised Feb 2025)
- PACT Act and your benefits (page updated June 2, 2026)
All links checked and content verified on Oct 16, 2026. Rules change; confirm on the official page before you act.