Does the VA cover rehab for a Priority Group 5 veteran after femur surgery? (non-service connected)

1. Who Priority Group 5 is, in plain terms

Priority Group 5 generally includes veterans who do not have compensable service‑connected disability ratings (non‑service‑connected or 0% SC) and who meet certain income or pension/Medicaid criteria; VA documents and legal summaries list receiving VA pension, being eligible for Medicaid, or having income below the VA’s geographically‑adjusted limits as typical qualifiers for Group 5 ^{[1] [3] [5]}.

2. What being in Group 5 means for enrollment and costs

Being placed in Priority Group 5 affects how the VA assigns enrollment priority and whether copays apply. Multiple sources explain that higher priority groups get preference and that veterans in Groups 1–5 often have lower copay responsibilities than Groups 7–8, but VA guidance also clarifies that inpatient care not for a service‑connected condition may trigger inpatient copays depending on priority and other factors ^{[2] [6] [4]}.

3. Rehab after femur surgery: service‑connected vs non‑service‑connected care

The sources differentiate care for service‑connected conditions (which VA will provide) from care for non‑service‑connected conditions (which can be provided but may carry copays or limits). None of the provided documents state that a Priority Group 5 veteran is automatically entitled to fully VA‑funded rehabilitation after a non‑service‑connected femur surgery; instead, cost responsibilities and availability can depend on whether the care is inpatient vs outpatient and the veteran’s specific eligibility and income status ^{[2] [4] [3]}.

4. Inpatient rehab: copays and thresholds to watch

VA materials warn that inpatient care for non‑service‑connected conditions may require inpatient copays and that copay rules vary by priority group and length/type of stay. One VA page flags that inpatient care not for a service‑connected condition may require a copay based on priority group 7 or 8 income limits if certain conditions apply — indicating that inpatient rehab could incur charges for lower‑priority or higher‑income veterans ^{[2] [4]}.

5. Outpatient rehab and community care considerations

Sources note that VA provides a broad set of outpatient and specialty services but also that enrollment group and income affect copays for outpatient medication and services for non‑service‑connected conditions. Community care (non‑VA providers) and authorization rules are not described in detail in the supplied sources, so available sources do not mention the specific process for getting VA‑authorized community rehabilitation after femur surgery ^{[4] [3]}.

6. Exceptions, catastrophic disability, and other prioritization rules

VA will place a veteran in the highest applicable priority group if multiple criteria apply; special classifications (Title 38 §1151, catastrophic disability, aid & attendance) can move someone into higher priority groups with different coverage rules. That can change whether certain extended care services are covered without copays ^{[4] [1]}.

7. What to do next — practical steps and what the sources suggest

Given the nuance, the most reliable course (not detailed fully in the supplied sources) is to contact your local VA medical center or Enrollment Coordinator to ask: (a) whether your specific post‑op rehab qualifies as VA‑provided care for non‑service‑connected conditions; (b) whether it would be inpatient or outpatient for VA billing purposes; and (c) what copays or means‑test thresholds apply to you. The VA site and fact sheets emphasize that priority group, income, and the nature of the care determine costs and eligibility, so individualized verification is required ^{[1] [2] [4]}.

Limitations and disagreements in reporting

• The official VA priority‑group descriptions are consistent across VA pages and public summaries about who is in Group 5 ^{[1] [3] [5]}.
• Reporting and law‑firm or advocacy summaries agree that Group 5 veterans may still face copays for non‑service‑connected care; however, some third‑party summaries assert broader access to services for Group 5 that the VA guidance conditions on income and service connection, so readers should prefer VA sources for billing specifics ^{[3] [4]}.
• Available sources do not provide a single sentence saying “VA will/ will not pay for rehab after non‑service‑connected femur surgery for Group 5”; instead, they explain the framework (priority, inpatient vs outpatient, copays) that determines coverage ^{[2] [4]}.