March, 2012 - The American Legion Department of North Dakota

North Dakota Legion News March 2012 Page 3
Service Officer’s Column
VA Health Care and Who’s Eligible
Several years ago Congress passed
what is commonly known as the Means Test.
The Means Test essentially categorized
veterans into groups. Depending on what
“priority group” you fall into will dictate
whether you are entitled to health care from
the VA. Once you apply for enrollment,
your eligibility will be verified. Based on
your specific eligibility status, you will be
assigned a Priority Group. Your priority
group may depend on your family income
and assets. Depending on what priority
group you’re in, you may have to make copays
to the VA for medication, outpatient
and inpatient visits, etc. If you have private
health insurance coverage the VA may also
bill your insurance carrier. The following
clarifies who falls into what category.
Priority Group 1
• Veterans with VA Service-connected
disabilities rated 50% or more.
• Veterans assigned a total disability
rating for compensation based on
unemployability.
Priority Group 2
• Veterans with VA Service-connected
disabilities rated 30% or 40%.
Priority Group 3
• Veterans who are former POWs.
• Veterans awarded the Purple Heart
Medal.
• Veterans awarded the Medal of
Honor.
• Veterans whose discharge was for a
disability incurred or aggravated in
the line of duty.
• Veterans with VA Service-connected
disabilities rated 10% or 20%.
• Veterans awarded special eligibility
classification under Title 38, U.S.C.,
§ 1151, “benefits for individuals
disabled by treatment or vocational
rehabilitation.”
Priority Group 4
• Veterans receiving increased
compensation or pension based
on their need for regular Aid and
Attendance or by reason of being
permanently Housebound.
• Veterans determined by VA to be
catastrophically disabled.
Priority Group 5
• Nonservice-connected Veterans
and noncompensable Serviceconnected
Veterans rated 0%, whose
annual income and/or net worth are
not greater than the VA financial
thresholds.
• Veterans receiving VA Pension
benefits.
• Veterans eligible for Medicaid
benefits.
Jim Deremo
Department Service Officer
Priority Group 6
• Compensable 0% Service-connected
Veterans.
• Veterans exposed to ionizing radiation
during atmospheric testing or during
the occupation of Hiroshima and
Nagasaki.
• Project 112/SHAD participants.
• Veterans who served in the Republic
of Vietnam between January 9, 1962
and May 7, 1975.
• Veterans who served in the Southwest
Asia theater of operations from
August 2, 1990, through November
11, 1998.
• Veterans who served in a theater of
combat operations after November
11, 1998, as follows:
• Veterans discharged from active duty
on or after January 28, 2003, for five
years post discharge
Priority Group 7
• Veterans with incomes below the
geographic means test (GMT) income
thresholds and who agree to pay the
applicable copayment.
Priority Group 8
• Veterans with gross household
incomes above the VA national income
threshold and the geographicallyadjusted
income threshold for their
resident location and who agrees to
pay copays
Veterans eligibility for enrollment:
Noncompensable 0% service-connected
and:
• Subpriority a: Enrolled as of
January 16, 2003, and who have
remained enrolled since that date
and/ or placed in this subpriority
due to changed eligibility status.
• Subpriority b: Enrolled on or after
June 15, 2009 whose income
exceeds the current VA National
Income Thresholds or VA National
Geographic Income Thresholds by
10% or less
Veterans eligible for enrollment:
Nonservice-connected and
• Subpriority c: Enrolled as January
16, 2003, and who remained
enrolled since that date and/ or
placed in this subpriority due to
changed eligibility status
• Subpriority d: Enrolled on or after
June 15, 2009 whose income
exceeds the current VA National
Income Thresholds or VA National
Geographic Income Thresholds by
10% or less
Veterans not eligibility for enrollment:
Veterans not meeting the criteria above:
• Subpriority e: Noncompensable 0%
service-connected
Subpriority f: Nonservice-connected
Once enrolled, the VA will provide
a full spectrum of medically necessary
services, based on the judgment of your VA
primary care provider and in accordance
with generally accepted standards of
clinical practice. Examples of these health
benefits include Preventative, Inpatient
and Specialty Care Services, Ancillary
Services, and Mental Health Care. VA
strives to ensure that you have access to
all of your needed services wherever you
receive your VA health care. This may be
on-site during inpatient hospitalization, at
one of our primary or specialty care clinics,
at a Community Based Outpatient Clinic
(CBOC), in a Community Living Center
(formerly known as a VA nursing home),
or in a residential care facility. However,
all services may not be available at every
location. Sometimes, you may need to travel
to another VA facility or a community care
facility to receive the necessary treatment.
If that is the case, your VA provider will
work with you to find the place best suited
for you to obtain the required services.
To learn more about your VA health care
benefits please go to http://www.va.gov/
healthbenefits/ and follow the links there.
Lester W. Peterson Post #191
of Gwinner is proud to endorse
Robert (Bob) Krause
to seek the position of
Alternate National Executive Committeeman
Bob Krause
Bob is a 40 year (PUFL) member of the American Legion and has served
as Post #191 Commander, 10th District Vice Commander, 10 th District
Commander, East Region Vice Commander, Department Commander
Elect and is currently serving as Department Commander.
Bob served as a Medic in the US Army from 1970 to 1972.
Bob is an active Legion member involved with Color Guard activities
as well as fundraising, Veterans Day dinners, Memorial Day activities and
many other duties with Post #191.
Bob has been a member of several community organizations that
include, Church Council and the North Sargent School Board where he
served as Board President. Bob is retired from Bobcat where he worked
in various capacities for 32 years.
Bob and his wife Gail recently moved to Fargo from Gwinner. They
have 4 grown children and four grandchildren.