Guide to healthcare services available to veterans, families

United States Veterans from our armed forces are eligible for a broad range of programs and services provided by the U.S. Department of Veterans Affairs (VA).  Their dependents and survivors may also be eligible for coverage under the legislative Title 38 of the United States Code.
To receive care, veterans must be enrolled in the VA health system.  Eligibility for the health system depends on a number of factors, including the nature of your discharge from military service, your length of service, whether you have service-connected disabilities, your income level and available VA resources, among others.
To be eligible, you must not have been dishonorably discharged from the military.  Your length of service may also be important. 
Former enlisted persons who started active duty before Sept. 8, 1980, and former officers who first entered active duty before Oct. 17, 1981, do not have a length-of-service requirement.  Otherwise you must have 24 months of continuous active duty military service, though there are several exceptions for reservists, national guard members, service-connected disabilities, and hardship discharges, among others.
Certain veterans do not need to be enrolled in the VA health system to receive benefits if you are 50 percent or more disabled from a service-connected disability, you are seeking care for a VA rated service-connected disability, or it has been less than one year since you were discharged for a disability that the military determined was caused or aggravated by your service, but the VA has not yet rated the disability.
The VA has limited resources, so if you are eligible for services, you will be assigned to a priority group.  The priority groups range from 1-8 with 1 being the highest priority for enrollment.  Previously, veterans assigned to priority 8 were not eligible for enrollment or care for non-service connected conditions.  New regulations went into effect on June 15, 2009 that enables the VA to relax income restrictions on enrollment for health benefits. 
The standard benefits package includes preventative care services, outpatient diagnostic and treatment services (including mental health and substance abuse treatment), inpatient diagnostic and treatment services, prescriptions, and long-term care (including nursing home care for some veterans).
The VA offers a number of long-term care options through its health plan.
All enrolled veterans are eligible for the following services:
• Geriatric evaluation provides either an inpatient or outpatient evaluation of a veteran’s ability to care for him or herself.
• Adult day health care therapeutic day care program that provides medical and rehabilitation services to veterans
• Respite care provides either inpatient or outpatient supportive care for veterans to allow caregivers to get a break
• Home care nursing, physical therapy, and other services provided in the veteran’s home
• Hospice/palliative care provides services for terminally ill veterans and their families
Some services are limited to certain veterans: nursing home care and domiciliary care are not automatically available to all veterans enrolled in the VA health plan.
The following veterans automatically qualify for unlimited nursing home care:
• Veterans who are seeking nursing home care for a service-related condition
• Veterans with a service-connected disability rating of 70 percent or more
• Veterans who have a service-connected disability of 60 percent and are unemployable
A service-connected disability is a disability that the VA has officially ruled was incurred or aggravated while on active duty in the military and in the line of duty.  The VA must rule that your illness/condition is directly related to your active military service, and it assigns each disability a rating.  The ratings are established by VA regional offices around the country.
There are also state-run veteran’s nursing homes.  The VA provides funds to states to help them build the homes and pays a portion of the costs for veterans eligible for VA health care.  The states, however, set eligibility criteria for admission.
A Domiciliary is a VA facility that provides care on an ambulatory self-care basis for veterans disabled by age or disease who are not in need of acute hospitalization and who do not need the skilled nursing services provided in a nursing home.  Domiciliary care is available to low-income veterans with a disability.

Disability Benefits
The VA offers two disability programs.  Disability compensation is available only for veterans with service-connected disabilities, while the disability pension benefit is available to anyone who served during wartime and has a disability.  The disability does not have to be related to military service.
Disability Compensation
If you have an injury or disease that happened while on active duty or if active duty made an existing injury or disease worse, you may be eligible for disability compensation.  The amount of compensation you get depends on how disabled you are and whether you have children or other dependents.  Additional funds may be available if you have severe disabilities, such as loss of limbs, or a seriously disabled spouse.
Disability Pension Benefit
The VA pays a pension to disabled veterans who are not able to work.  The pension is also available for surviving spouses and children.  This pension is available whether or not your disability is service-connected, but to be eligible you must meet some criteria
In addition, your income must be below the yearly limit set by law; called the Maximum Annual Pension Rate (MAPR).  You can read more detail about the MAPR in the web site listed at the end of the article. 
Your pension depends on your income.  The VA pays the difference between your income and the MAPR.  The pension is usually paid in 12 equal payments.
Your income does not include welfare benefits or Supplemental Security Income.  It also does not include unreimbursed medical expenses actually paid by the veteran or a member of his or her family. 
This can include Medicare, Medigap, and long-term care insurance premiums; over-the-counter medications taken at a doctor’s recommendation; long-term care costs, such as nursing home fees; the cost of an in-home attendant that provides some medical or nursing services; and the cost of an assisted living facility.  These expenses must be unreimbursed.  This means that insurance must not pay the expenses.  The expenses should also be recurring.
A veteran who needs the help of an attendant may qualify for additional help on top of the disability pension benefit.  The veteran needs to show that he or she needs the help of an attendant on a regular basis.  A veteran who lives in an assisted living facility is presumed to need aid and attendance.
I have tried to give an overview of the many services that our veterans receive through the U.S. Department of Veterans Affairs.  No citizen in our country is more deserving of our support and assistance.  They are the ones that have sacrificed and put their lives on the line to defend and preserve our most basic freedoms that we sometimes take for granted.
More information can be obtained through the VA web site at http://www.va.gov.