VA Central Plains Health Network Eligibility/Enrollment Fact Sheet

In October, 1996, Congress passed Public Law 104-262, the Veteran's Health Care Eligibility Reform Act of 1996.  This legislation led the way for the creation of a Uniform Benefits Package - a standard health benefit plan available to all veterans.  The package not only opens up services to veterans, but also simplifies the process by which veterans can receive the services.

Veterans must first be enrolled to receive care.

  • Veterans may enroll for services at the nearest VA health care facility.
  • To enroll, veterans complete application form 10-10EZ.
  • Veterans may obtain this form from any VA health care facility, VA clinic, or county veteran service officer.

Veterans will be placed in priority groupings.

  • After a veteran has completed the 10-10EZ form, the Health Eligibility Center in Atlanta, Georgia, will send him/her a letter confirming enrollment.
  • Veterans are placed in one of seven priority groupings based upon service connection or income status.
  • The health care benefits veterans are eligible for will depend upon the priority group which they are assigned.

Once enrolled veterans will remain enrolled for one year.  Yearly, veterans will be asked to update the enrollment information.  Renewal is automatic, unless they chose not to enroll, or unless VA resources limit the number of veterans to whom the VA can provide.

Veterans should keep their existing healthcare coverage.

  • VA enrollment can be used as a complement to any existing health care coverage.

Benefit Package

Enrollment means veterans are eligible for a comprehensive healthcare benefits package of inpatient and outpatient services.  Among these services are the following:

  • Preventive services, including immunizations, screening tests and health education and training classes.
  • Primary medical cares, including outpatient surgery.
  • Diagnosis and treatment.
  • Surgery.
  • Mental Health and Substance Abuse Treatment.
  • Home healthcare.
  • Respite and Hospice Care.
  • Emergency care in VA facilities.
  • Drugs and Pharmaceuticals (as prescribed by VA providers on a VA prescription)
  • Pregnancy Services
  • Hearing aids and eyeglasses require a service-connected disability rating of 10 percent or more and are not usually provided for normal hearing or vision loss.
  • Dental services are provided, however eligibility for dental services is more restrictive than healthcare, and is determined on a case to case basis.

Exclusions

Some medical services not normally covered by the Uniform Benefits Package include cosmetic surgery, sterilization, abortion, membership in health spas for rehabilitation, special private duty nursing and gender alteration.

Drug and medical devices not approved by the Food and Drug Administration are not covered, except under special circumstances.

The law has not changed the requirement for limited nursing home care, domiciliary care, limited dental care, adult health day care, homeless programs, sexual trauma counseling and non-VA hospitalization.  Enrolled veterans may be eligible for these programs, but they are not part of the Uniform Benefits Package.

VA Priority Groups