Health Care Priority Group Estimator
Answer a few questions to estimate which VA health care Priority Group you may fall into. Your group affects how soon you can enroll and whether you'll have copays.
You may qualify for VA health care — even without a disability rating
When you enroll, the VA sorts you into one of eight priority groups. That group decides your copays and how soon you can enroll — not which care you can use. Answer a few questions below to estimate your group, then see exactly what each group means and what your copays would run.
8 priority groups
Where you land sets the cost
Groups 1–6
Usually $0 copays
Full package
All of your health needs
What enrolling actually gets you
Four things worth knowing before you decide whether VA health care is worth it — because most veterans get more than they expect, and pay less.
The full medical benefits package
Once you’re enrolled you get primary care, specialists, surgery, prescriptions, mental health, and preventive care — for all of your health needs, not just your rated conditions.
Your priority group sets cost, not access
Groups 1 through 8 decide your copays and how soon you can enroll. Every enrolled veteran can use the same VA services — the group only changes what, if anything, you pay.
Service-connected care is always free
Care and medications for a service-connected condition never carry a copay, no matter which priority group you land in. Copays only ever touch care that is not service-connected.
The PACT Act widened the door
Recently discharged combat veterans get a 10-year enrollment window, and veterans with a qualifying toxic exposure now enroll in Group 6 regardless of their income.
Before you decide you don’t qualify
Myths that keep veterans from care they’ve earned
Too many veterans never enroll because of something they heard that simply isn’t true. Here’s what VA guidelines actually say.
“My rating is too low to matter — or I don’t have one at all.”
Reality: Any service-connected rating — even 0% — can qualify you to enroll, and so can lower income, recent combat service, or a qualifying toxic exposure. If you’re rated 10% or higher, you generally pay $0 in copays, even for care that has nothing to do with your service-connected condition.
“The VA will only treat my service-connected condition.”
Reality: Once you’re enrolled, you get the full VA medical benefits package for all of your health needs — primary care, specialists, surgery, prescriptions, preventive care, and mental health — not just your rated conditions. Copays, if any, apply only to non-service-connected care and depend on your priority group.
“I have to be enrolled or rated to get mental health help.”
Reality: You don’t. If you’re in a suicidal crisis, you can get free emergency care at any ER — VA or not — even if you’ve never enrolled (the COMPACT Act). Mental health care for military sexual trauma (MST) is always free, with no rating or enrollment required. And Vet Centers offer free, confidential counseling to combat veterans and their families.
Care that’s always free — no matter your priority group
- Care and prescriptions for any service-connected condition
- Mental health care for military sexual trauma (MST) — no rating or enrollment needed
- Emergency care during a suicidal crisis — at any facility, even before you enroll
- Readjustment counseling at a Vet Center
- Toxic-exposure screenings and registry health exams
- Many preventive services, like immunizations and health screenings
In crisis right now? You don’t need to be enrolled. Call the Veterans Crisis Line — dial 988, then press 1. It’s free and confidential, 24/7.
Estimate your priority group
Tell us about your service, recognitions, any toxic exposure, and — if you don’t have a compensable rating — your household income. We check your VA income limits right here, no need to leave the page.
Tell us about your service
Your current combined VA disability rating, if you have one.
Check every item that applies.
Combat service or a qualifying toxic exposure can place you in Group 6.
For veterans without a compensable service-connected disability, income decides Groups 5, 7, and 8. We check your VA income limits right here — no need to leave the page.
Used to pull the VA income limits for your area.
Gross income for you and your spouse. Unreimbursed medical expenses can lower the income the VA counts.
Your estimated priority group
Priority groups range from 1 (highest) to 8. The VA assigns your final group when you enroll.
Free & no obligation — our accredited team can walk you through enrollment and copay exemptions.
Official VA priority-group referenceThe 8 priority groups, explained
The VA assigns you to the highest group you qualify for. Group 1 is the highest priority; Group 8 the lowest. Here is who each group covers and what copays look like.
| Group | Who it covers | Copays |
|---|---|---|
| Group 1 | A 50% or higher service-connected rating, VA unemployability (TDIU), or Medal of Honor. | No copays for care or medications. |
| Group 2 | A 30% or 40% service-connected rating. | No copays for covered care. |
| Group 3 | A 10% or 20% rating, Purple Heart, former POW, a line-of-duty discharge, or special eligibility under 38 U.S.C. 1151. | No copays for covered care. |
| Group 4 | Catastrophically disabled, or receiving VA Aid & Attendance or Housebound benefits. | No copays for covered care. |
| Group 5 | Receiving a VA pension or eligible for Medicaid; or a 0% non-compensable / non-service-connected status with income at or below the VA limit for your area. | No copays; medications may be free. |
| Group 6 | A compensable 0% rating, recent combat service (10-year window), or a qualifying toxic exposure — Agent Orange, Gulf War, Camp Lejeune, radiation, Project 112/SHAD, or another PACT Act exposure. | Free care for the exposure or combat condition; income-based copays for unrelated care. |
| Group 7 | No compensable service-connected disability, with income above the national limit but at or below the geographic (GMT) limit for where you live. | Reduced copays — up to 80% off inpatient charges. |
| Group 8 | No compensable service-connected disability, with income above both the national and the geographic (GMT) limits for your area. | Full copays for non-service-connected care. |
Copays never apply to care for a service-connected condition, to approved toxic-exposure care, or to MST care — in any group. Rates shown are for care that is not service-connected.
Copay estimator
What would your copays cost?
Based on your estimated Priority Group 8, enter how much care you expect in a year. We’ll add up your likely annual copays for care that is not service-connected. Remember: service-connected care, approved toxic-exposure care, and MST care are always free.
Your expected care in a year
Monthly prescriptions
Count each medication you take every month as 1 fill. Refills are capped at $700 a year.
Estimated annual copays
per year, for non-service-connected care
2026 VA copay rate chart
Effective January 1, 2026. Copays apply only to non-service-connected care.
Outpatient & urgent care
- Primary care visit
- $15
- Specialty care visit
- $50
- Urgent care visit
- $30 (first 3/yr free, Groups 1–6)
Hospital (inpatient)
- Priority Group 7 (reduced)
- $347 + $2/day
- Priority Group 8 (full)
- $1,736 + $10/day
Flat charge for the first 90 days in a 365-day period, plus the daily rate.
Prescriptions (per fill)
| Tier | 1–30 days | 31–60 | 61–90 |
|---|---|---|---|
Tier 1 Preferred generic | $5 | $10 | $15 |
Tier 2 Non-preferred generic / some OTC | $8 | $16 | $24 |
Tier 3 Brand name | $11 | $22 | $33 |
Annual medication copay cap: $700. Priority Group 1 pays $0 for medications, and veterans rated 40% or less with income below VA limits may get free medications too.
VA health care, answered
Do I qualify if my rating is only 10%?
Yes. A 10% or 20% service-connected rating places you in Priority Group 3, and rated veterans generally pay $0 for covered VA care — even care that has nothing to do with the rated condition. You do not need a high rating, or any rating at all, to enroll: low income, recent combat service, or a qualifying toxic exposure can also make you eligible.
Will the VA only treat my service-connected condition?
No. Once you’re enrolled you receive the full VA medical benefits package for all of your health needs — primary care, specialists, surgery, prescriptions, preventive care, and mental health. Copays, if any, apply only to care that is not service-connected and depend on your priority group.
What will my copays actually cost?
It depends on your group. Groups 1–6 generally have no outpatient or inpatient copays for covered care. Groups 7 and 8 pay reduced or full copays for non-service-connected care. For 2026, a primary care visit is $15, specialty care is $50, and most medications run $5–$11 per 30-day fill, with a $700 annual medication cap. Use the copay estimator above to add up your own likely total.
I was exposed to burn pits or Agent Orange — does the PACT Act help me enroll?
Yes. Under the PACT Act, veterans with a qualifying toxic exposure now enroll in Priority Group 6 regardless of income, and care tied to that exposure is free. Recently discharged combat veterans also get a 10-year enhanced enrollment window. Toxic-exposure screenings are free to every enrolled veteran.
How do the income limits work?
For veterans without a compensable service-connected rating, income decides Groups 5, 7, and 8. The VA compares your household income against a national limit and a higher geographic (GMT) limit for your ZIP code. Below the national limit is Group 5; between the two is Group 7 (reduced copays); above both is Group 8 (full copays). The estimator above checks these limits for your area automatically.
Can I get mental health care right away?
Yes. If you’re in a suicidal crisis you can get free emergency care at any ER — VA or not — even if you’ve never enrolled, under the COMPACT Act. Mental health care for military sexual trauma (MST) is always free with no rating or enrollment required, and Vet Centers offer free, confidential counseling to combat veterans and their families.
How do I apply?
You apply with VA Form 10-10EZ — Application for Health Benefits, the VA health benefits application. You can file it online at VA.gov, by phone at 1-877-222-8387, by mail, or in person at any VA medical center. If you’d rather not do it alone, an accredited team member can walk you through eligibility, your priority group, and any copay exemptions.
Your rating decides your priority group
The single biggest lever on your VA health care costs is your disability rating — a higher rating moves you into a higher priority group and can wipe out copays entirely. Filing and increasing service-connected and toxic-exposure claims is exactly what our accredited agents do. Get a free review, or let us walk you through enrollment on VA Form 10-10EZ.
Enroll anytime — there is no deadline to apply for VA health care.
About this benefit
When you enroll in VA health care, the VA assigns you to one of 8 Priority Groups. Your group is based on your service-connected disabilities, special recognitions (Medal of Honor, Purple Heart, former POW), combat service, toxic exposures, and household income. The VA always places you in thehighest group you qualify for.
This estimator draws the real dividing lines between groups — a compensable 0% rating and toxic-exposure eligibility (Group 6), line-of-duty and 38 U.S.C. 1151 special eligibility (Group 3), and the income split that separates Groups 5, 7, and 8. Because VA income limits depend on your ZIP code and household size, the tool asks where your income falls rather than guessing a dollar figure.
Priority Group 1 is the highest. Lower-numbered groups generally enroll faster and pay fewer copays. This tool gives a general estimate — the VA determines your actual group when you apply.
How to use it
- 1Select your current service-connected disability rating (and, if it is 0%, whether it is compensable).
- 2Check any recognitions or status: TDIU, Medal of Honor, Purple Heart, POW, line-of-duty discharge, 38 U.S.C. 1151, or catastrophic disability.
- 3Mark any combat service or toxic exposure: Agent Orange, Gulf War, Camp Lejeune, radiation, Project 112/SHAD, or other PACT Act exposure.
- 4Tell us how your household income compares with VA limits (use the income-limits link to look up your ZIP code), and whether you get a VA pension or Medicaid.
- 5Review your estimated group and copay tier, then apply for VA health care to get your official assignment.
What it covers
- Estimated priority group (1–8), including the 5-vs-6 and 7-vs-8 distinctions
- The specific reason you may fall into that group
- Your likely copay tier: none, reduced (up to 80% inpatient reduction), or full
- Group 6 toxic-exposure and combat-service eligibility
- Links to apply and to check the income limits for your area
Work with our accredited claims agents
Ready to turn this estimate into a claim? Let a specialist handle it.
Calculators are a starting point. Our VA-accredited claims agents can review your situation, make sure you’re not leaving benefits on the table, and file or appeal your claim for you — your first case evaluation is free, with no obligation.
This tool provides a general estimate only and does not cover every situation that affects your priority group. VA Benefits Calculators is not affiliated with the VA — the VA makes all final decisions about eligibility and payment amounts. Always confirm details at va.gov.