Income Verification
By law VA is required to verify the self-reported gross household income (veteran, spouse and dependents, if any) of certain nonservice-connected or noncompensable 0% service-connected veterans to confirm the accuracy of their
- Eligibility for VA health care
- Copay status, and
- Enrollment priority group assignment.
VA verifies veterans' gross household income (spouse and dependents, if any) provided by the veteran on the financial assessment (means test). This financial information is verified by matching financial records maintained by the Internal Revenue Service (IRS) and the Social Security Administration (SSA). If the result of the income match reveals that the veteran's gross household income is higher than the established VA national means test threshold, the veteran will be contacted via mail.
Most veterans not receiving VA disability compensation or pension payments must provide information on their annual gross household income and net worth to determine whether they are below the annually-adjusted VA national means test threshold (income threshold).
The financial assessment includes all gross household income and net worth, including Social Security, retirement pay, unemployment insurance, interest and dividends, workers' compensation, black lung benefits and any other gross household income. Also considered are assets such as the market value of property that is NOT the primary residence, stocks, bonds, notes, individual retirement accounts, bank deposits, savings accounts and cash.
VA also compares veterans' financial assessments with geographically based income thresholds. If the veteran's income is above the VA national means test threshold and below the geographic means test (GMT) thresholds where the veteran lives, they are eligible for an 80 percent reduction in inpatient co-pay rates. For more information about geographically based income thresholds, go to the GMT eligibility page.
The veteran (and spouse if applicable) will be provided an opportunity to review the discrepancy between their reported income and the IRS and SSA data. If there is an error or other explanation for the discrepancy this information is provided by the veteran to VA for review. If we have not received a response from the veteran with 45 days, we will attempt to independently verify the total gross household income. This process entails us contacting all employers and financial institutions that reported income to the Internal Revenue Service and Social Security Administration. If no response is received from the veteran within 75 days, VA considers that due process requirements have been met and action is initiated to make appropriate eligibility, copay and enrollment status changes. Veterans subject to this process are individually notified by mail and provided with all related information.
* Enrollment Restriction:
Effective January 17, 2003, VA suspended NEW enrollment of veterans assigned to Priority Group 8e and 8g (VA's lowest priority group consisting of higher income veterans). Veterans assigned to Priority Group 8e and 8g are veterans who are enrolling for the first time on or after January 17, 2003, and whose income exceeds the current year income threshold, who have no other special eligibilities such as a compensable service connected condition or recent combat service, and who refuse to provide income information are not eligible for enrollment at this time. Veterans enrolled in Priority Group 8a and 8c on or before January 16, 2003, will remain enrolled and continue to be eligible for the full-range of VA health care benefits.
At the end of the income verification process, if it is determined that the veteran's gross household income is higher than the VA national means test income threshold:
- The veteran's priority group assignment will be changed
- The veteran will be required to pay health care and medication copayments
- VA health care facilities that provided care to the veteran will be notified to bill the veteran for services provided for their nonservice-connected conditions during the period covered by the income assessment
- The veteran will be provided with due process/appeal rights
If the veteran is financially unable to pay for that care, a waiver or a compromise can be requested:
- A waiver applies only to copays currently owed. To request a waiver, veterans must submit proof that he/she cannot financially afford to make payments to VA. The request must be in writing and should outline any undue financial hardship the veteran may have which would be caused by collection of the debt. For additional information, contact the Revenue Coordinator at the VA health care facility where the care was received.
- A compromise is an offer and acceptance of a partial payment in settlement and full satisfaction of the debt as it exists at the time the offer is made. Most compromise offers that are accepted must be for a lump sum payment payable in full 30 days from the date of acceptance of the offer. For additional information, contact the Revenue Coordinator at the VA health care facility where the care was received.
Federal Benefits for Veterans and Dependents |
VA National Means Test Income Threshold |
GMT Income Threshold
Viewers, Plug-Ins, & Readers |
Health Care Eligibility Site Map
For questions about Health Care Eligibility, please visit the VA inquiry website.
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