VA health care eligibility for veterans without a compensable service-connected rating is generally governed by a means test under 38 CFR 17.36. Each year VA compares the veteran's prior-year gross household income (and net worth, in some cases) to a published National Income Threshold. If income exceeds that threshold, VA can place the veteran in a lower priority group, charge copays, or in some cases determine the veteran is not eligible for VA-provided care for that period, which can also trigger billing for care received.
Under 38 CFR 17.36(b), VA allows certain deductions from gross income, including unreimbursed medical, dental, and funeral/burial expenses that were actually paid during the calendar year being assessed. As a general rule, expenses must have been paid in the same year as the income being tested — expenses paid in a later year to deduct against an earlier year's income are typically not allowed under the plain language of the regulation, though veterans can still submit documentation and ask VA to review contested amounts, since local Health Eligibility Center adjudicators do sometimes work with claimants on documentation gaps.
Official 2026 VA monthly compensation, including the 2.8% COLA increase.
Dependent add-ons start at a 30% rating. Child-only and dependent-parent rates: see the full 2026 pay chart.
| Rating | Monthly (2026, incl. 2.8% COLA) |
|---|---|
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 40% | $795.84 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
| 70% | $1,808.45 |
| 80% | $2,102.15 |
| 90% | $2,362.30 |
| 100% | $3,938.58 |
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Analyze my claim free →A separate avenue is a hardship determination under 38 CFR 17.37. If paying the debt or losing eligibility would create a financial hardship, a veteran can request that VA either waive the income limit for that year or adjust the priority group, based on current financial circumstances rather than strictly the prior year's return. This is distinct from disputing the medical-expense math and should be requested explicitly, in writing, before the response deadline.
Establishing a compensable service-connected disability rating changes eligibility entirely: veterans with a rated service-connected condition move into a higher priority group and are generally not subject to the same income test for care related to VA enrollment. However, a pending claim does not retroactively change eligibility for the year already assessed unless VA later grants service connection effective in that period.
If VA's income determination is contested, veterans also retain normal appeal rights — a Higher-Level Review, Supplemental Claim, or Notice of Disagreement to the Board — though these apply to the eligibility/billing decision itself, not the underlying disability claim.
The concrete next step is to respond in writing before the stated deadline, submitting all documented 2024 medical expenses along with a written hardship request under 38 CFR 17.37, and to keep a copy of everything submitted in case an appeal of the eligibility determination becomes necessary.
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