The Department of Veterans Affairs (VA) is required by law to charge veterans, in certain income categories, a co-payment for their outpatient visits. Co-payments are based on primary care visits ($15), specialty care visits ($50), and no co-payment designations.
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Veterans in the VA health care system will be eligible to receive necessary hospital and outpatient services, including preventive and primary care. These include: diagnostic and treatment services; rehabilitation; mental health and substance abuse treatment; home health, respite and hospice care; and drugs in conjunction with VA treatment.
VA health benefits are established by Federal law and regulations and funded through appropriations. They are not the same as an insurance contract. Also, veterans do not pay monthly premiums to receive VA health care. In addition, you are not required to use VA as your exclusive health care provider. If you have health insurance, or eligibility for other programs such as Medicare, Medicaid, or TRICARE, you may continue to use services under those programs. We recommend that you keep any other insurance or HMO coverage.
Yes. Care in private facilities at VA expense is provided only under certain circumstances. To determine if you are eligible for private care at VA expense, you will need to contact the nearest VA health care facility.
Usually not. VA provides care in private facilities at VA expense when VA has a contract arrangement for certain services or, under very limited circumstances, when VA approves the care in advance.
VA provides urgent and limited emergency care in VA facilities. However, VA’s ability to pay for emergency care in non-VA facilities is very limited. The Veterans Millennium Health Care and Benefits Act authorized VA to expand emergency care coverage. Refer to the last paragraph for additional details.
You may receive health care at any VA health care facility in the country. To minimize any “out-of-pocket” expenses while traveling, you should familiarize yourself with the location of any VA health care facilities in the area. VA’s authority to reimburse you for care in non-VA facilities is very limited.
In general, dental benefits are limited to service-connected dental conditions or to veterans who are permanently and totally disabled from service-connected causes. For specifics, contact the VA health benefits advisor at your local VA health care facility.
Nursing home care in VA or private nursing homes may be provided to certain veterans as space and resources permit. The Veterans Millennium Health Care and Benefits Act has authorized VA to expand long-term care services. Refer to the last paragraph for additional details. To determine if you are eligible for VA nursing home care, you will need to contact the nearest VA health care facility.
Yes, if you are receiving VA care and are service-disabled with a disability rating of 10% or greater or are a former POW. Otherwise, hearing aids and eyeglasses will only be provided in special circumstances and not for generally occurring hearing or vision loss.
VA provides maternity care, but cannot provide care to a newborn child, even in the immediate aftermath of the birth. The veteran mother must make other arrangements for payment for the care of the child.
No, your treating physician will determine what is considered appropriate and necessary hospital care or outpatient services and will provide such care consistent with current medical care practices.
On November 30, 1999, the President signed Public Law 106-117, the Veterans Millennium Health Care and Benefits Act. This legislation authorizes VA to expand long-term care services and to reimburse for the emergency treatment of certain enrolled veterans. The law also requires VA enroll veterans awarded the Purple Heart into Priority Group Three. VA is currently in the process of drafting regulations required to implement these new authorities. For specifics, contact the Health Benefits Service Center at 877-222-8387.