Facing death is a universal human experience. It brings up feelings of sadness, grief, fear, and anger, which are all normal responses. As we or our loved ones face end-of-life situations, support for physical, psychological, spiritual and, yes, even financial needs can provide some peace of mind. That is the goal of hospice care. Hospice care focuses on the quality of care for those with life-limiting illnesses who are not expected to live more than six months where the treatment shifts from cure to comfort.
The VA offers a hospice benefit for qualified Veterans that typically covers 100% of the costs including medication, equipment, and team support with no co-pays. Unfortunately, many Veterans and their families are unaware of this benefit. Statistically Veterans are less likely to use hospice care than the general public.
Who Qualifies for the VA Hospice Benefit?
The qualification criteria are straightforward. Veterans just need to meet these few basic requirements to access this support.
- Discharge Status An honorable or general discharge usually qualifies you. Other than honorable (OTH) discharges might be eligible, but it's determined case-by-case. A dishonorable discharge typically bars you.
- Enrolled in VA Health care: The Veteran must be enrolled in the VA health care system.
- Clinical Diagnosis: A VA doctor must certify the need for hospice. The physician must certify that the Veteran has a terminal illness with a life expectancy of six months or less, if the illness follows its natural course.
- Choice of Comfort Care: The Veteran must choose to receive comfort-focused care (hospice) instead of curative treatments for their illness
Other Key Facts About the VA Hospice Benefit
- The Veteran’s terminal illness does not have to be service connected. It is available to all Veterans who meet the criteria outline above.
- Hospice care does not have to be conducted within a VA facility. It can occur at home, in VA Community Living Centers (nursing homes), or community facilities.
- Hospice care can last more than 180 days.
- The VA actively partners with local community hospice agencies through programs like We Honor Veterans, allowing Veterans to receive specialized, compassionate end-of-life care in their homes or preferred settings.
- Accepting the VA Hospice Benefit will not impact a Veteran's other earned benefits, such as their disability compensation or pension. Hospice is an additional layer of support designed to provide comfort and improve quality of life.
How VA Determines Your Health care Eligibility.
Because VA hospice care requires Veterans to be enrolled in the VA health care system, here is a brief rundown of how the VA determines your eligibility.
The number of Veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up Priority Groups to make sure certain groups of Veterans are able to enroll before others. These groups determine the level of benefits and the cost of care a Veteran may receive.
Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a Priority Group ranging from 1-8 with 1 being the highest priority.
The VA bases your Priority Group based on:
- Your military service history, and
- Your disability rating, and
- Your income level, and
- Whether or not you qualify for Medicaid, and
- Other benefits you may be receiving (like VA pension benefits)
Depending on their Priority Group assignment, some Veterans may have to pay a co-pay for treatment, and some may not be eligible for enrollment.
VA health care eligibility is a complex topic. For a more in-depth explanation see our blog post: “What Makes a Veteran Eligible for VA Health care?”
How to Apply for the VA Hospice Benefit
Step 1: Enroll in VA Health Care (If Not Already)
- Apply: If you aren't already enrolled in VA health care, you'll need to complete an Application for Health Benefits (VA Form 10-10EZ) on the {Link: VA.gov website}.
- Submit: You can apply online, by mail, or in person at a VA facility.
Step 2: Get a Medical Certification
- Life-Limiting Illness: A VA physician must diagnose a terminal illness.
- Comfort Goals: Treatment must focus on comfort and quality of life, not a cure, with a life expectancy of six months or less.
Step 3: Connect with Your VA Care Team
- Talk to Your Social Worker: This is the most crucial step; discuss your needs with your VA social worker or geriatric care team.
- Request a Referral: Ask for a referral to hospice care.
Step 4: Coordinate Care & Documentation
- Sign Election Statement: You'll sign a statement electing hospice care, similar to Medicare hospice rules, for comfort-focused care.
- Provide Documentation: Be ready to share your military service history (DD214) and other relevant medical documents.
Veterans: Boost Your Chances of Winning Disability Benefits.
When you hire an experienced VA disability attorney you have a much greater chance of winning your claim than if you have no representation. The VA’s own statistics from the Board of Veterans Appeals show that in fiscal 2024 nearly 43% of appeals were approved with attorney representation, compared to less than 30% without representation.
Veterans represented by attorneys also experience a lower denial rate for their claims. The denial rate for Veterans with attorney representation before the BVA was less than 15% compared to more than 21% of claims were denied among those Veterans with no representative to fight for their rights. VA disability attorneys also had a higher success rate than any of the Veteran Service Organizations.
Source: Department of Veterans Affairs (VA) Board of Veterans’ Appeals Annual Report Fiscal Year (FY) 2024
Call or email us at Cuddigan Law for a free evaluation and advice for your individual situation. And if you hire us, we only get paid when we win your case.
