The VA's priority group system determines your healthcare access, copays, and enrollment status under 38 USC 1705 and 38 CFR 17.36. This 2026 guide explains every priority group from 1 to 8, the income thresholds that drive group assignment, Combat Veteran 5-year enrollment rights, the PACT Act expansions, Camp Lejeune eligibility, and exactly how to enroll using VA Form 10-10EZ.
VA healthcare is not universally available to every veteran on equal terms. Instead, Congress and the VA have established an enrollment and priority system that allocates healthcare resources based on need, service-connected disability, income, and the nature of military service. When demand for VA healthcare exceeds capacity, veterans in lower priority groups may face enrollment restrictions or reduced access — while veterans in higher priority groups always have guaranteed access.
The priority group system ranges from 1 (highest priority, guaranteed enrollment, no copays) to 8 (lowest priority, income-based enrollment, highest copays). Your priority group is determined at enrollment and reviewed annually. Changes in your disability rating, income, or circumstances may move you to a different priority group — in either direction. Understanding which group you're in, and why, is the first step to ensuring you're getting the full healthcare access you've earned.
Priority group assignments affect: (1) whether you can enroll in VA healthcare at all, (2) what copays you pay for services and prescriptions, (3) whether you receive dental care, (4) your access to extended care and nursing home services, and (5) your eligibility for certain specialized programs. Veterans in Priority Groups 1 through 3 receive free VA care for service-connected conditions. Veterans in Priority Groups 4 through 8 pay graduated copays based on income and service-connection status.
Establishes the 8-group priority system. VA must maintain enrollment categories ensuring available resources are distributed equitably based on service-connected disability and other factors.
Detailed regulations implementing the priority groups, enrollment criteria, income thresholds, geographic means tests, and enrollment process requirements.
Governs the VA enrollment system, including when VA may restrict enrollment in lower priority groups and how capacity determinations are made annually.
Establishes copay amounts and rules for outpatient medical care, prescription medications, extended care services, and inpatient stays by priority group.
38 USC 1705 is the enabling statute for the entire VA priority group system. It directs the Secretary of Veterans Affairs to establish and maintain a system for enrolling veterans for hospital care and medical services, and to maintain priorities within that system to ensure that veterans with the greatest medical need — and the greatest sacrifice — receive preferential access. The statute explicitly identifies service-connected disability rating as the primary criterion for priority placement, with income-based factors governing the lower priority groups.
38 CFR 17.36 translates this statutory mandate into specific enrollment categories with defined criteria for each priority group. The regulation also governs the income means tests, the Geographic Means Test (GMT), and the processes by which VA determines enrollment capacity for lower priority groups. Understanding the specific regulatory criteria helps veterans verify that they've been assigned to the correct priority group — errors in priority group assignment do occur, and veterans have the right to contest a wrong assignment.
38 CFR 17.37 governs enrollment capacity and gives the VA authority to restrict Priority Group 8 enrollment when resources are limited. It also establishes that VA must provide notice to veterans who are denied enrollment due to capacity constraints and must offer them an opportunity to re-apply when capacity expands. 38 CFR 17.49 covers copays, establishing the specific dollar amounts for each type of service across priority groups.
Priority Group 1 is reserved for veterans with the most severe service-connected disabilities. This is the most comprehensive VA healthcare enrollment category, offering free care for all conditions — both service-connected and non-service-connected.
Priority Group 1 veterans receive VA healthcare with no copays for any services — whether service-connected or not. This includes:
The financial value of Priority Group 1 VA healthcare is substantial — comprehensive health coverage with no premiums, no copays, and access to the full VA network of medical centers, community-based outpatient clinics (CBOCs), and community care partners. If you're currently rated below 50% but believe your conditions warrant a higher rating, see our disability ratings guide and consider requesting a reexamination or filing for an increase.
Priority Group 2 consists of veterans with service-connected disabilities rated at 30% or 40%. Like Priority Group 1, these veterans have demonstrated significant service-connected disability and receive preferential access to VA healthcare. Priority Group 2 veterans pay no copays for service-connected care. For non-service-connected conditions, copays may apply for outpatient visits, though at reduced rates compared to lower priority groups.
Veterans in Priority Group 2 should evaluate whether a rating increase to 50% or higher — which would move them to Priority Group 1 — is warranted based on their current symptoms and functional limitations. Filing for a rating increase is one of the most impactful steps a Priority Group 2 veteran can take. Our VA claims process guide explains how to file for increases effectively.
Priority Group 3 is broader than the higher groups, encompassing several distinct categories of veterans:
Priority Group 3 veterans receive free VA care for their service-connected conditions. For non-service-connected outpatient care, reduced copays apply. Prescription copays for Priority Group 3 veterans with service-connected conditions are waived; prescriptions for non-service-connected conditions may carry a nominal copay. For Purple Heart and POW veterans specifically, the priority group placement recognizes the combat and captivity service in a tangible way — ensuring these veterans' healthcare needs are met regardless of their income or disability rating percentage.
Priority Group 4 covers two distinct categories:
Veterans who are receiving Aid and Attendance (A&A) or Housebound benefits — forms of Special Monthly Compensation under 38 USC 1114 — are placed in Priority Group 4. These veterans require a higher level of care due to their inability to protect themselves from hazards, or their need for regular aid from another person. A&A beneficiaries often need home health care, assisted living support, or nursing home care, and Priority Group 4 placement ensures they have preferential access to VA long-term care services.
The VA defines a catastrophic disability as a permanent, severely disabling injury or disease that compromises the ability to carry out activities of daily living to such a degree that the veteran requires personal or mechanical assistance to leave home or bed. Examples include veterans with permanent loss of limb function, severe TBI with permanent cognitive impairment, or spinal cord injuries resulting in paralysis. Catastrophically disabled veterans in Priority Group 4 receive free VA healthcare regardless of income — the nature of their disability, not their financial situation, drives their enrollment. See our related guide on nexus letters for complex disability conditions.
Priority Group 5 is the first income-based priority group. It covers veterans who:
Priority Group 5 veterans receive free VA care for their service-connected conditions (if any) and reduced-cost care for non-service-connected conditions. The VA's national income threshold for 2026 is based on the Department of Housing and Urban Development's (HUD) area median gross income figures and varies by family size. Veterans at this income level likely qualify for Medicaid or other low-income healthcare programs as well, and VA enrollment can complement those programs.
For Priority Group 5 veterans, VA healthcare represents meaningful financial relief — a safety net for those whose income limits their access to private insurance. However, it also comes with waiting time challenges at some facilities during high-demand periods. Community care options under the MISSION Act of 2018 provide an alternative pathway to care when VA wait times exceed established targets.
Priority Group 6 is a critical enrollment category for many veterans, particularly those who served in post-9/11 combat operations. It covers veterans who do not have a service-connected disability rating but who served in specific circumstances:
Priority Group 6 veterans receive free VA care for conditions that may be related to their combat service or toxic exposure. This is a critically important provision — it means a combat veteran who hasn't yet filed a disability claim can still access VA healthcare for conditions that might be service-related while their claim is being processed. The 5-year combat veteran enrollment window begins at discharge, so veterans approaching that deadline should enroll immediately even if they don't currently need care.
Priority Groups 7 and 8 are the income-based enrollment categories for veterans without service-connected disabilities whose income exceeds the VA's national income threshold.
Priority Group 7 covers veterans whose gross household income exceeds the VA national income threshold but is below the Geographic Means Test (GMT) threshold for their area, and whose income falls within specific subgroups (7a and 7c). These veterans pay copays for VA care — but at a rate lower than Priority Group 8. Priority Group 7 veterans pay 80% of the standard VA copay for most outpatient services and 20% of the inpatient per diem charge.
Priority Group 8 covers veterans whose income and net worth exceed both the national income threshold and the GMT. Priority Group 8 has historically been subject to enrollment restrictions when VA resources are limited. Currently, VA has opened enrollment for most Priority Group 8 subgroups. Priority Group 8 veterans pay standard VA copays — currently $15 per primary care visit and $50 per specialty care visit for outpatient services, plus inpatient copays of $15 per day for the first 90 days and $7.50 per day thereafter. Priority Group 8 veterans who have toxic exposure or burn pit exposure should check whether the PACT Act has made them eligible for Priority Group 6 instead.
The following table summarizes VA healthcare copay structures across priority groups for 2026. Note that copays for service-connected conditions are always zero regardless of priority group:
| Priority Group | Outpatient Primary Care | Outpatient Specialty | Inpatient (per day) | Prescriptions (30-day) |
|---|---|---|---|---|
| Priority Group 1 (50%+ SC or TDIU) | $0 | $0 | $0 | $0 |
| Priority Group 2 (30–40% SC) | $0 (SC care) | $0 (SC care) | $0 (SC care) | $0 (SC meds) |
| Priority Group 3 (10–20% SC, PH, POW) | $0 (SC care) | $0 (SC care) | $0 (SC care) | $0 (SC meds) |
| Priority Group 4 (A&A, catastrophic) | $0 (SC care) | $0 (SC care) | $0 (SC care) | $0 (SC meds) |
| Priority Group 5 (low income, 0% NSC) | $0 | $0 | Reduced | $0 (Tier 1) |
| Priority Group 6 (combat/exposed) | $0 (related care) | $0 (related care) | Reduced | $0–$11 |
| Priority Group 7 (above NIT, below GMT) | ~$12 | ~$40 | ~$12/day | $5–$11 |
| Priority Group 8 (above GMT) | $15 | $50 | $15/day (1–90 days) | $11 |
SC = Service-Connected. NSC = Non-Service-Connected. NIT = National Income Threshold. GMT = Geographic Means Test. Copay amounts subject to annual adjustment. Prescription tiers vary by drug type.
One of the most important and most underused VA healthcare access provisions is the Combat Veteran enhanced enrollment period established under 38 USC 1710(e)(3). This provision gives veterans who served in a theater of combat operations after November 11, 1998, a 5-year enrollment window from their discharge date during which they can access VA healthcare regardless of income.
Combat veteran status under 38 USC 1710(e) is established by service in a combat theater — not necessarily direct participation in combat. Veterans who served in:
...qualify for combat veteran healthcare enrollment even if their income would otherwise place them in Priority Group 8. During the 5-year window, these veterans are enrolled in Priority Group 6 (or higher if they meet other criteria) and can receive care for any condition potentially related to their combat service at no cost.
After the 5-year enhanced enrollment period expires, combat veterans without a service-connected disability rating are subject to the standard income-based enrollment rules. Veterans approaching the end of their 5-year window should:
The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 is the most significant expansion of VA healthcare access in decades. For priority group purposes, the PACT Act made the following key changes:
Veterans with documented toxic exposure — including burn pit exposure in Southwest Asia, radiation exposure, Agent Orange exposure outside Vietnam, and other toxic substances — may now qualify for Priority Group 6 healthcare enrollment even without a service-connected disability rating. This is a direct parallel to the combat veteran 5-year window, extended to veterans who may not have served in "combat" as traditionally defined but who were exposed to hazardous substances during service.
The PACT Act established dozens of new presumptive service-connected conditions for veterans exposed to burn pits, Agent Orange, and radiation. Veterans who are granted service-connected ratings for these conditions will move to the appropriate higher priority group based on their disability percentage. Veterans currently in Priority Groups 6 through 8 who have unaddressed conditions potentially covered by PACT Act presumptives should file disability claims immediately. A successful claim will both increase monthly compensation and upgrade the veteran's priority group for healthcare purposes.
The PACT Act extended the combat veteran enhanced enrollment period and removed certain time limits that previously caused some veterans to lose Priority Group 6 eligibility. Veterans who previously lost access due to the 5-year window expiring should consult a VA benefits specialist to determine whether PACT Act provisions restore their eligibility.
🩺 Is Your Priority Group Wrong? Get a Second Opinion.
VA priority group assignments affect your healthcare costs for years. If you believe your service-connected rating should be higher — moving you from Priority Group 2 to Priority Group 1 and eliminating copays — a physician-authored Independent Medical Opinion (IMO) from REE Medical can strengthen your rating increase claim.
Get an IMO from REE Medical →claim.vet may receive a referral fee. Veterans never pay more.
One of the most unique VA healthcare access provisions covers not just veterans but their family members. Under 38 USC 1787 (enacted as part of the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012), certain family members who resided at Marine Corps Base Camp Lejeune, North Carolina, are eligible for VA healthcare for specific conditions associated with contaminated water at that installation.
VA healthcare under 38 USC 1787 covers 15 specific conditions associated with Camp Lejeune's contaminated water supply (which included trichloroethylene, tetrachloroethylene, benzene, and vinyl chloride):
Family members eligible under 38 USC 1787 may be reimbursed for certain medical expenses related to these conditions rather than receiving care directly at VA facilities, depending on whether the conditions were treated at a VA facility or elsewhere. Family members who believe they qualify should apply to VA with documentation of their Camp Lejeune residency and the covered condition.
The Geographic Means Test (GMT) is a location-adjusted income threshold used by VA to determine priority group placement for veterans without service-connected disabilities. The GMT recognizes that cost of living varies significantly across the United States — $60,000 in rural Mississippi has very different purchasing power than $60,000 in San Francisco — and adjusts the income threshold accordingly.
The GMT is set at 115% of the VA national income threshold and is further adjusted based on the median income data for each veteran's zip code as provided by the Census Bureau. The VA publishes updated GMT tables annually. Veterans whose gross household income falls below the GMT (but above the national income threshold) are placed in Priority Group 7 rather than Priority Group 8, resulting in lower copays.
For 2026, the VA national income threshold for a single veteran with no dependents is approximately $17,566 annually. For a veteran with one dependent, the threshold is approximately $21,167. Veterans below these thresholds qualify for Priority Group 5 with no copays. Veterans between the national income threshold and the GMT qualify for Priority Group 7. Veterans above the GMT qualify for Priority Group 8. These figures are updated annually and may change; verify current thresholds at the VA's website or with your VA enrollment coordinator.
Net worth (assets minus liabilities) is also considered as part of the means test. VA uses a net worth threshold to prevent veterans with substantial assets from qualifying for low-income priority groups. The current net worth limit is approximately $155,356 (updated annually for inflation). Veterans with net worth above this threshold may be moved to a higher-numbered priority group regardless of income.
Enrolling in VA healthcare requires completing VA Form 10-10EZ (Application for Health Benefits). Here's the complete enrollment process:
📋 Want to Move to a Higher Priority Group? Start Your Claim.
Every service-connected disability rating moves you to a better priority group and reduces (or eliminates) your VA healthcare copays. If you have service-connected conditions but no rating — or a rating you believe is too low — starting a disability claim now can improve both your monthly compensation and your healthcare access. Our free eligibility check takes 2 minutes.
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Yes. Priority group assignments are reviewed annually and can also change mid-year if your circumstances change. Events that may change your priority group: a new or increased service-connected disability rating (moves you to a higher group), a decrease in disability rating (may move you to a lower group), changes in income above or below the means test thresholds, and new legislation such as the PACT Act that changes eligibility criteria. Notify your VA enrollment coordinator of significant changes in your disability status or income.
VA healthcare and Medicare are separate programs that do not coordinate benefits the way private insurance networks do. VA pays for care you receive at VA facilities; Medicare pays for care you receive in the Medicare network. Veterans who have both can use whichever program is more convenient for a given service, but VA generally will not reimburse for Medicare-covered care received outside the VA system, and Medicare does not cover VA care. Some veterans use VA healthcare for service-connected conditions and Medicare for everything else — a strategy that optimizes both programs.
The VA MISSION Act of 2018 expanded veterans' access to community care — meaning care at non-VA facilities paid for by VA — when VA care isn't available within specific distance or wait time standards. The MISSION Act applies across all priority groups and does not change priority group assignment. However, it provides a meaningful alternative for veterans in areas with limited VA facilities or long wait times. Community care eligibility depends on the veteran's priority group and the specific standards for their situation. Consult your VA primary care team to request community care authorization when VA wait times exceed standards.
VA dental care eligibility is more restrictive than general healthcare eligibility and does not follow the same priority group structure. Most veterans — regardless of priority group — are not automatically entitled to VA dental care. However, veterans who are 100% service-connected (schedular or TDIU with P&T designation) are entitled to comprehensive VA dental care. Veterans with service-connected dental conditions are entitled to dental care for those specific conditions. Former POWs and those in certain specialized programs may also receive dental care. Priority Groups 1 through 4 do not automatically confer full dental eligibility — the specific dental eligibility criteria are separate and more limited than the healthcare priority group system.