Posted on Apr 17, 2017

What happens after the 5 years of free VA healthcare are used up?

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My 5 years of free VA healthcare end June 20, 2017. What should I do or know so I don't get caught off guard later? I am service connected with a 30% rating and appealing for higher.

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Posted >1 y ago

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Responses: 3

SFC Andrew Miller

Posted >1 y ago

The 5 year rule entitles you to Priority Group 6 care, while being rated at 30% entitles you to Priority Group 2 care. The only real differences are the copays. You will have copays for any outpatient medication, but if you are using the mail order pharmacy with formulary or generic drugs you still won't have a copay for them. Here is a link to the current co-pay plan.

https://www.va.gov/healthbenefits/resources/publications/IB10-431_copay_requirements_at_a_glance.pdf

Also keep in mind that you are eligible for travel for any service connected disability related treatment or appointments.

IB10-431_copay_requirements_at_a_glance.pdf

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MCPO Roger Collins

>1 y

Thanks, fills in the gap.

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1SG (Join to see)

>1 y

^This^

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CPL Crystal Pettway, MBA

Posted >1 y ago

I'm pretty sure that if you have the 30% rating, you should be entitle to free medical care from the VA. Do you have a disability benefits booklet from the VA? It should give you an idea of how to proceed. If you don't have one, you get one online from va.gov

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MCPO Roger Collins

>1 y

Agree. The 5 year thing is new to me.

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SGT (Join to see)

>1 y

MCPO Roger Collins - I've heard it before. Don't remember who it applies to, though.

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SSgt Ryan Sylvester

>1 y

It's over 50%, actually (unless they changed it again since I transferred my care last year). Free across-the-board care at Priority Group 1. The Registration office at your nearest facility should have a detailed breakdown of entitlements to care based on eligibility. But your SCDs are always fully covered.

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SFC Andrew Miller

>1 y

MCPO Roger Collins The 5 year rule applies to those deployed to a combat zone after 2003. You are entitled to Priority Group 6 care for 5 years following your return at any VA facility.

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