Healthcare coverage is a valuable benefit offered to eligible veterans. There are several criteria that must be met in order to qualify for this benefit. The following information will help you evaluate and determine if you are indeed eligible to apply for coverage and what documentation will be required for the application process.
Perhaps the single most important document in determining your eligibility status is your DD 214 form. It will provide you with many necessary pieces of information to determine whether or not you meet the criteria. The first thing to take note of is the character of your discharge status.
The status will be one of the following:
- General under honorable conditions
- Under other than honorable conditions
- Uncharacterized or entry-level separation
- Bad conduct
Those veterans who separated under any condition other than dishonorable may be eligible for benefits. Make note that those separating with an uncharacterized or entry-level separation status are service members who served less than 180 days or had discharge action initiated prior to serving 180 days. This separation status is not characterized as either bad or good, however, unless the service member was injured or incurred an illness as a result of service, they are not eligible for benefits.
“…veterans who separated under any condition other than dishonorable may be eligible for benefits.”
You will need to provide a significant amount of documentation when applying for VA benefits. One of these required documents, perhaps the most important, is your proof of discharge or your DD 214 form. This form will indicate your discharge status which will be a determining factor in the level of benefit you and your dependents can expect.
The following original documents may also be requested when you submit your application. Be sure you have them in a secure and easily accessible location to aid in speeding the application process along.
- Birth certificate
- Social Security card
- Marriage license
- Divorce papers
- Medical care directive
- Letter of last instructions or funeral plans
In the event some of these required documents have been lost, service members or next of kin can request replacement documentation. The National Personnel Records Center, Military Personnel Records: NPRC (MPR) can provide duplicates to these original documents. If a next of kin is requesting documentation they must be one of the following individuals in relation to the veteran: surviving spouse who has not remarried, mother or father, daughter or son, brother or sister. One easy way to submit a request for duplicate documentation is to complete a form online at the E-vetrecs website at www.archives.gov/veterans/evetrecs. It is of some importance to mention that there was a fire that occurred in 1973 at the National Personnel Record Center which lead to the destruction and loss of approximately 16 to 18 million official military personnel records.
Among the lost documents were:
- 80% of records for Army personnel discharge between November 1, 1912 to January 1, 1960.
- 75% of the records for Air Force personnel discharge between September 25, 1947 to January 1, 1964 with names that started alphabetically after Hubbard, James E.
If you are looking for records that fall into one of these categories, they may not be available as no copies were kept in other locations during that time.
If you would prefer to request documents by mail, the duplicate copy request can be submitted to:
National Personnel Records Center
Military Personnel Records
9700 Page Ave.
Saint Louis Missouri 63132–5100
Multiple documents for a single service member can be requested in the same submission. If documents for more than one service member are required, a separate submission must be sent for each veteran. Allow ample time to receive these documents as this is a very slow process due to the large demands on the Records Center.
Once VA has approved your application for healthcare benefits, you will then be placed in a priority group. VA uses priority groups as a way to control the number of veterans using their healthcare system. Just because a veteran is enrolled for benefits does not necessarily mean they will have access to the entire range of services offered. The level of coverage and service available is dependent upon the priority group you are assigned. Presently, due to the conflicts in Afghanistan and Iraq, the VA healthcare system is pushed to the limits and must prioritize veterans when offering healthcare services. Currently, veterans with service-connected disabilities or low income levels are given highest priority.
Enrollment in the VA system makes it easier for veterans to determine the full range of benefits they are entitled to. However, there are a few circumstances in which it is not required for a veterans to enroll to receive healthcare services even though it is strongly recommended.
These special situations are as follows:
- The veteran has been assigned a rating of 50% or more service-connected disability
- The veteran who has been discharged for less than 12 months and is seeking care for a disability the military has determined did occur in the line of duty or was aggravated in the line of duty but yet has not received a rating
- The veteran is solely seeking care for a service connected disability
It is required that those veterans receiving VA healthcare services be seen at a VA hospital or associated facility. One exception is in the case of an emergency where life is imminently threatened creating the need to go to the closest treatment facility available. In these situations VA may reimburse the veteran for services rendered or a portion of their care.