VA Priority Group 7 Benefits: Who Qualifies and What’s Covered?

By
Farheen Ashraf
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VA Priority Group 7 Benefits: The U.S. Department of Veterans Affairs (VA) uses a system that sorts veterans into eight groups. These groups help decide who gets medical care first. Veterans who don’t have service-connected disabilities but still need help paying for health care usually end up in Priority Group 7. While this group doesn’t offer as many free benefits as some others, it still gives access to important health care services with lower costs than what someone might pay outside the VA system.

Who Can Be Placed in Priority Group 7

According to the VA and Hill & Ponton specialists, veterans will be in Group 7 if they:

  • Do not have a service-linked condition or have one rated at 0%
  • Make more money than the VA’s set limit, but less than the VA’s geographically adjusted income limit (Geographic Means Test (GMT)
  • Agree to pay copayments in some areas for care

Even though these veterans don’t get full free care, Group 7 still helps by lowering health care costs. Veterans just need to share their income and household size when they apply for VA care to see if they fit the group’s rules.

What do Group 7 Vets receive?

Vets in Group 7 can:

  • Enrollment in VA health care
  • Get basic and special care, like mental health services
  • Have prescription drug cover, but must pay some costs
  • Get services to stop sickness, like tests and shots
  • Go to the hospital or clinic, but need to pay part of the cost

But, unlike top groups, Group 7 vets must often pay fees for:

  • Clinic visits
  • Hospital stays
  • Medications

What each veteran is obliged to pay changes based on the care type and their income level.

Income and GMT

The Geographic Means Test, or GMT, looks at how much it costs to live in the place where the vet stays. So if a veteran lives in an expensive city like San Francisco, they might still get into Group 7 even if their income looks high just ’cause the living costs are more there. But if someone earns the same in a cheaper city, they might not get in.

Vets just need to tell the VA about their income and who lives in their house when they apply for health care to see if they qualify.

Can a Veteran’s Group Change?

Yes, it’s possible. If a veteran’s income, health status, or other details change over time, the VA might move them to a different priority group. When a veteran qualifies for more than one group, the VA will place them in the one that gives the best benefits.

Group 7 is there for those who are in the middle they don’t get full care due to service injuries or pensions, but they also can’t afford full medical costs on their own.

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