VA health care priority groups, explained by rating
Veterans rated 50% or higher may be assigned to Priority Group 1, generally with no copays, verify with VA health eligibility.
One program, three rating tiers
VA health care assigns enrollees to priority groups. Three of those groups are keyed directly to the combined disability rating under 38 CFR §17.36: Priority Group 1 at 50% or higher, Priority Group 2 at 30% to 40%, and Priority Group 3 at 10% to 20%. Veterans in Priority Group 1 generally pay no copays.
The tiers are rating paths, not the complete rule. Priority Group 1 also includes veterans VA has determined unable to work because of service-connected conditions, and Medal of Honor recipients. Priority Group 3 also includes former prisoners of war, Purple Heart recipients, and several other categories that have nothing to do with a rating percentage.
Who decides, and how to verify
The VA Health Eligibility Center decides enrollment and priority-group assignment. Your assignment is made when you enroll in VA health care; verify it through your VA.gov account or with VA health eligibility directly. This page explains the landscape; it does not determine anything about your enrollment.
See it next to everything else your rating may open
The Benefits Explorer lists this program beside the rest of the federal set, and your state’s verified programs, keyed to your combined rating. Educational only. Every program is decided by the agency named on it.