Does My Income Affect My VA Health Insurance if I Am 65 & Retired?

The U.S. Department of Veterans Affairs offers certain health care services to qualifying veterans and their families. Though VA health care isn't the same as an insurance policy, it will cover many of the medical expenses a veteran and his family members incur. If you qualify for VA healthcare, your income may affect the level of coverage you receive.

Basic Requirements

To qualify for VA health care services, you must have been an active member of the military. If you were in the National Guard or Reserves, you may qualify for coverage if you were called to active duty and served the full amount of time assigned to you. You won't qualify for health care benefits if you received a dishonorable discharge from services. However, all other types of separation are acceptable.

Priority Groups

The VA places all individuals who qualify for VA health care services into priority groups numbered 1 through 8 based on certain characteristics. Those in the lowest numbered groups receive enrollment priority. Veterans with service-connected disabilities and non-service connected disabilities typically fall into one of the first six groups. Veterans whose annual income and assets fall beneath the VA's national thresholds fall into Priority Group 5. Groups 7 and 8 are composed of those veterans who have incomes higher than the national threshold but can pass the VA's geographic means test, which is a test that assesses the applicant's income based on trends in the area.

Cost of Care

Veterans placed in Priority Groups 1-6 don't pay any fees for the health care services they receive. However, those veterans who fall into groups 7 and 8 must submith a co-pay amount for health care services. Outpatient co-pays are the same for both groups, but members of Priority Group 8 will pay a higher rate for inpatient services than members of Priority Group 7.

Implications

If you don't fall into one of the first six priority groups because of special characteristics, such as a Medal of Honor or a disability, your income will determine whether you qualify for VA health care, as well as how much you pay for services. Veterans who don't pass the geographic means test won't qualify for any VA health care services. Veterans who pass the GMT but don't qualify for placement in Priority Group 5 will pay for a portion of their services, and veterans who pass the GMT but earn more than the threshold for Priority Group 7 will pay even more for their services than veterans whose incomes fall beneath this limit.