Yes. Care in private facilities at Veterans Affairs expense is provided only under certain circumstances. To determine if you are eligible for private care at Veterans Affairs expense, you will need to contact the nearest Veterans Affairs health care facility.
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Veterans in the Veterans Affairs health care system will be eligible to receive necessary hospital and outpatient services, including preventive and primary care. These include:
The Department of Veterans Affairs 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.
Veterans Affairs 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 Veterans Affairs health care. In addition, you are not required to use Veterans Affairs 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.
Usually not. Veterans Affairs provides care in private facilities at Veterans Affairs expense when Veterans Affairs has a contract arrangement for certain services or, under very limited circumstances, when Veterans Affairs approves the care in advance.
Veterans Affairs provides urgent and limited emergency care in Veterans Affairs facilities. However, Veterans Affairs' ability to pay for emergency care in non-Veterans Affairs facilities is very limited. The Veterans Millennium Health Care and Benefits Act authorized Veterans Affairs to expand emergency care coverage. Refer to the last paragraph for additional details.
You may receive health care at any Veterans Affairs health care facility in the country. To minimize any “out-of-pocket” expenses while traveling, you should familiarize yourself with the location of any Veterans Affairs health care facilities in the area. Veterans Affair’s authority to reimburse you for care in non-Veterans Affairs 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 Veteran Affairs health benefits advisor at your local Veteran Affairs health care facility.
Nursing home care in Veterans Affairs 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 Veterans Affairs to expand long-term care services. Refer to the last paragraph for additional details. To determine if you are eligible for Veterans Affairs nursing home care, you will need to contact the nearest Veterans Affairs health care facility.
Yes, if you are receiving Veterans Affairs care and are service-disabled with a disability rating of 10% or greater or are a former prisoner of war. Otherwise, hearing aids and eyeglasses will only be provided in special circumstances and not for generally occurring hearing or vision loss.
Veterans Affairs 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 Veterans Affairs to expand long-term care services and to reimburse for the emergency treatment of certain enrolled veterans. The law also requires Veterans Affairs enroll veterans awarded the Purple Heart into Priority Group Three.
Veterans Affairs is currently in the process of drafting regulations required to implement these new authorities. For specifics, call the Health Benefits Service Center at 877-222-8387.