VA Health Care Priority Groups: Where You Stand

VA health care eligibility runs through eight priority groups. Here is what each group covers, the 2026 copay rates, the rating rule that overrides the group system, and how to enroll.

VA health care is not a simple yes-or-no system. Every enrolled veteran is assigned to one of eight priority groups based on service history, disability rating, income, and special eligibility such as a Purple Heart or Medal of Honor. Your group affects what you pay and, when demand exceeds capacity, how quickly you get enrolled.

But the group number is only half the story. A separate set of rules — tied to your disability rating and to what the care is for — overrides the group system for most veterans and makes their care free regardless of which group they landed in. Here is how both halves work.

The eight priority groups

Group 8 has subgroups, and they matter. Subgroups 8a through 8d cover veterans who enrolled during specific windows or whose income exceeds the limit by no more than 10%. Subgroup 8e limits care to the service-connected condition only, and subgroup 8g is not eligible for enrollment at all. If you were told you do not qualify for VA health care on income grounds, the specific subgroup on your letter is worth reading closely — the answer often changes when income does.

What you actually pay in 2026

These are the copay rates in effect as of January 1, 2026.

The inpatient copay is the one figure that moved for 2026 — the full rate rose from $1,676 to $1,736, tracking the Medicare Part A hospital deductible. Everything else held steady from 2025. The reduced inpatient rate applies to Group 7; the full rate applies to Group 8.

The rule that overrides the group system

Here is the part that gets lost in every priority-group explainer, including older versions of this one: for outpatient care, the VA frames the copay exemption around your disability rating, not your group number. If you have a service-connected disability rating of 10% or higher, you do not pay a copay for outpatient care. Copays apply to care for conditions unrelated to your military service.

Medications work slightly differently. Veterans in Priority Group 1 pay no medication copays at all. Veterans in Groups 2 through 8 may owe copays for medications treating non-service-connected conditions and for over-the-counter drugs from VA pharmacies — but not for medications treating a service-connected condition.

What is always free, in every group

Regardless of your priority group or your rating, the VA does not charge for:

Readjustment counseling and related mental health services. Counseling and care for military sexual trauma. Care related to combat service. Care related to a VA-rated service-connected disability. Laboratory tests and preventive services. And VA claim exams — the Compensation and Pension exams that support your disability claim.

That list covers a lot of ground. A veteran in Group 8 who is being seen for a service-connected knee and for PTSD-related counseling may pay nothing at all, while a veteran in the same group being treated for an unrelated condition pays the standard copay.

Priority Group 6 and toxic exposure

Group 6 has grown considerably and is now where most toxic-exposure eligibility lands. It covers a compensable 0% service-connected disability, Project 112/SHAD participation, World War II service, Gulf War service, 30 or more days at Camp Lejeune between August 1953 and December 1987, and a long list of Agent Orange, ionizing radiation, and post-9/11 deployment locations. Participation in a Toxic Exposure Risk Activity also qualifies.

It also covers combat-theater service after November 11, 1998 for veterans discharged on or after October 1, 2013. Those veterans get 10 years of enhanced eligibility from the date of discharge; at the end of that period the VA assigns them to the highest priority group they qualify for. Note what that 10-year window is and is not — it is enhanced eligibility to enroll in Group 6, not a blanket guarantee of free care, and it is not a deadline that closes VA health care to you afterward.

The one-year special enrollment window that the PACT Act created for combat veterans who had never enrolled ran from October 1, 2022 through September 30, 2023 and has closed. But the phased eligibility schedule that followed it was superseded: starting in March 2024, the VA opened enrollment to all veterans exposed to toxins and hazards, years ahead of the statutory schedule. If you were told you had to wait for your cohort's date, that is no longer the case.

How to enroll

Submit VA Form 10-10EZ, the Application for Health Benefits. You can apply online at VA.gov, by phone, by mail, or in person at any VA medical center or clinic. If you have a service-connected rating, include your rating decision — it feeds directly into which group you are assigned and therefore what you pay.

Your group is not permanent. It is reassessed when your rating changes, when your income changes, and at the end of the 10-year enhanced eligibility window. If your rating went up and your copays did not go down, that is worth a call.

The bottom line

Find your group, but do not stop there. The rating rule and the always-free list decide what most veterans actually pay, and they cut across the group system entirely. If you have a 10% or higher rating, expect no outpatient copays. If you are in Group 1, expect no medication copays either. And if you have never enrolled because you assumed your income disqualified you, the toxic-exposure pathways into Group 6 have opened wide enough that the assumption is worth retesting.

Frequently Asked Questions

How do I find out which VA priority group I am in?

Your priority group is listed in the enrollment letter the VA sends after you are accepted into VA health care, and you can confirm it by signing in at VA.gov or by calling your local VA medical center's enrollment office. It is based on your service history, disability rating, income, and any special eligibility such as a Purple Heart, POW status, or the Medal of Honor.

What is the VA copay for a doctor visit in 2026?

As of January 1, 2026, a primary care outpatient visit is $15 and a specialty care visit or specialty test such as an MRI or CT is $50. X-rays, lab tests, and preventive services are $0. But if you have a service-connected disability rating of 10% or higher, you do not pay outpatient copays at all.

Which priority groups have no copays?

The VA frames outpatient copay exemption around your rating rather than your group: a service-connected rating of 10% or higher means no outpatient copay. For medications, Priority Group 1 pays nothing; Groups 2 through 8 may owe copays only for medications treating non-service-connected conditions and for over-the-counter drugs. Certain care is free in every group, including combat-related care, service-connected care, MST counseling, readjustment counseling, lab tests, preventive services, and VA claim exams.

What are the 2026 VA prescription copays?

For a 30-day supply, Tier 1 medications are $5, Tier 2 are $8, and Tier 3 are $11, with proportionally higher amounts for 60- and 90-day supplies. There is an annual cap of $700 per calendar year, and veterans in Priority Group 1 pay no medication copays at all.

Does the PACT Act give combat veterans 10 years of free VA health care?

Not quite. Veterans who served in a combat theater after November 11, 1998 and were discharged on or after October 1, 2013 get 10 years of enhanced eligibility from their discharge date, which places them in Priority Group 6. That is priority for enrollment, not a guarantee that all care is free — though combat-related care is free in every group. At the end of the 10 years the VA reassigns you to the highest group you qualify for.

Did I miss the PACT Act enrollment deadline?

The special one-year enrollment window for combat veterans who had never enrolled ran from October 1, 2022 to September 30, 2023 and has closed. But the phased schedule that was supposed to follow it was superseded — starting in March 2024 the VA opened enrollment to all veterans exposed to toxins and hazards, ahead of the statutory timeline. There is no toxic-exposure enrollment deadline closing in 2026.

How do I enroll in VA health care?

Submit VA Form 10-10EZ online at VA.gov, by phone, by mail, or in person at any VA medical center or clinic. Include your disability rating decision if you have one, since it determines your priority group and what you pay. Your group is reassessed when your rating or income changes.