Disclaimer


VA Medical Benefits Package

The following are the main care services that veterans who are covered will qualify for:

  • Health care services for medical needs as well as mental health care (including substance abuse) for outpatient services.
  • Health care services for medical needs including mental health care (including substance abuse) for inpatient services.
  • Access to prescription medicine, which includes over-the-counter medicine plus surgical resources, accessible under the VA National Formulary System.
  • Access to emergency health care services at VA facilities.
  • Access to emergency services from non-VA centers under special conditions. This is an ideal benefit to veterans who need emergency services related to a disability or for those who do not have another way for covering their private-center emergency bill. If part or all of the bill is covered by another insurance firm, VA will not compensate you.

To be eligible for compensation for non-VA emergency care (services related to disability) you need to fulfill the following:

  • The care needs to be for a medical emergency.
  • You cannot access VA or other federal centers or service at the time of the emergency.
  • The emergency care is related to disability.

For one to be eligible for compensation for a non-VA emergency, and non-service related condition, you need to fulfill the following:

  • Need to be registered to the VA health care system.
  • Need to have received care from a VA service provider within 24 hours.
  • Received care at a hospital emergency section or another center that offer such services.
  • You don’t possess another type of health cover.
  • Not covered by Medicaid, Medicare, or another state program.
  • Not covered by any other VA program.
  • A reliable layperson determines that any delay in medical care would have endangered your life.
  • Capable of financially covering for the emergency treatment you received.
  • Don’t have a contract or legal connection to a 3rd party that will cover all or part of the bill.

The services that you may be eligible under VA health care entail the following:

  • Affliction counseling
  • Extensive rehab services plus vocational services
  • Expert counseling, consultation, training, and mental health services for beneficiary’s family or guardian
  • Reliable medical, prosthetic, and orthotic devices ( eyeglass and hearing aids)
  • Residential health care services

Frequently Asked VA Health Questions

How do I register?

One can get an application form from any of the VA centers or by contacting for an appointment. Form are also available from http://www.va.gov/healthbenefits/apply/.

What are the services I get from the VA health system?

You will get the vital outpatient and inpatient services, which also entails preventive and primary health services, diagnostic and treatment services, plus rehab, mental care, substance abuse help, residential coverage, hospice care, women’s clinic services, and prescribed medicine.

What is the cost for VA care?

There is no premium monthly fee for VA care, but co-payments may be required, which will depend on your qualifications and finances. (If insured, it may entail copayments).

What are the restrictions of receiving care from private centers at the VA’s expense?

Health services received from private centers at VA expenses are only under special conditions. To get more info, get in touch with your local health care center.

What happens if I become ill while traveling?

If you do fall ill while traveling, you can obtain care from any VA center in the United States. To obtain a list of VA facilities, visit www.va.gov/facilities.

Can I receive free prescriptions under the VA?

Medicine is given to those veterans who are registered with the VA and get health services from a VA Primary Care Provider. The drugs are prescribed for the care of a condition that the veteran received from the VA health care provider. A co-payment may be needed.

Do I get dental care?

These services are limited to services that are related to dental conditions or to those who have permanent disability from active-duty related issues.

Will the VA give me hearings aids or eyeglasses?

Yes, you will be provided with these materials if the injury is connected to military service, with a rate of 10% disability or more. Other than that, hearing aids and glasses will be provided only under special conditions and not for common hearing or vision impairment.

Are maternity services covered by the VA?

Yes, maternity services are covered, but they do not offer care for a newborn, including immediate care after birth.

I heard that bills from care at emergency rooms at private hospitals are not covered by the VA. Can I get the VA to pay the bill?

This a new concept for non-VA emergency health services and has very special conditions. It is limited to veterans who may not be able to cover their own emergency health care bills. If a person receives care at a public health care facility or for non-emergency reasons, you will not be covered.

Source: Dept. of Veterans Affairs

Take Advantage

My HealthVet is the arch of veteran benefits and services. It allows veterans to have access to reliable health info, links to federal VA resources, online VA prescription refills, and the Personal Health Journal. For more info visit www.myhealth.va.gov/. The following is also offered:

  • Cosmetic surgery needed due to disease or injury, excluding surgery which is not medically required
  • Palliative, respite, and hospice health care
  • Payment for accessible travel and expenses for qualified veterans
  • Maternity care, to the level authorized by law.
  • Filling of forms
  • Occasional medical check-ups
  • Health advice, including info on nutritional care
  • Maintenance of drug-use profiles, monitoring, and education
  • Services for mental illness and drug addiction rehab

VA Enrollment Priority Groups

Enrollment Priority One:

  • Veterans who have disabilities related to military services, with a rate of 50% or more.
  • Member rendered unemployable due to conditions relating to military service

Enrollment Priority Two:

  • Veterans with disabilities caused by military service, with a rate of 30% or more

Enrollment Priority Third:

  • Former POW
  • Veterans awarded the Purple Heart
  • Veterans discharged due to a disability caused while in the line of duty
  • Veterans with a military service-related disability with a rate of 10% or 20%.
  • Veterans who have been awarded qualification under Title 38, U.S.C., Section 1151, “benefits for individuals disabled by treatment or vocational rehabilitation”

Enrollment Priority Four:

  • Veterans who are getting assistance and attendance or residential benefits
  • Those determined by VA to be severely disabled

Enrollment Priority Five:

  • Veterans who have non-service related and non-compensable service-related with a rate of 0% disability, who have a yearly salary below the set VA levels
  • Veterans getting VA pension benefits
  • Those who qualify for Medicaid benefits

Enrollment Priority Six:

  • WW1 veterans
  • Mexican border war veterans
  • 0% service-related compensation veterans
  • Those who were exposed to ionizing radiation while testing or occupation or Hiroshima and Nagasaki
  • Those who took part in Project 112/SHAD

Enrollment Priority Seven:

  • Veterans who have a salary more than the VA national income level, and below the geographical income level, who accept the payment of co-pays

Enrollment Priority Eight:

  • Veterans who accept to make payment for certain copayments (who have an income or net worth more than VA means test level and HUD geographic index)
  • Non-compensable 0% service-related, with:
  • Sub-priority a: Registered since January 16, 2003, and have stayed registered or have been put in this sub-priority due to an alteration to a qualification status
  • Sub-priority b: Registered after or on June 15, 2009 with an income that is higher than the VA National Income levels or VA national Geographical Income Levels with 10% or below.
  • Non-related service, with:
  • Sub-priority c: Registered from January 16, 2003, and have stayed registered or have been put in this sub-priority due to alteration to qualification status.
  • Sub-priority d: Registered afteror on June 15, 2009, with an income that is higher than the VA National Income levels or VA national Geographical Income Levels with 10% or below.

Note: With the newer regulations, VA can reopen health care registration to veterans who have a household income that is higher than the VA income levels, but not exceeding 10%.

Limited Coverage

The following are the specific advantages covered by the Medical Benefits Package:

  • One can get specific variations from the VA hospital. The outpatient care that is not in the Medical Benefits Package is humanitarian emergency services (which you are billed for), pension and compensation exams, dental service, readjustment counseling, services due to a VA-certified research program, guide dogs, sexual trauma service, or certain registry check-ups.
  • One can get a check-up to find out if they are severely incapacitated, making them qualified for a specific priority category.
  • New Philippine Scouts and Commonwealth Army Veterans can get hospital care including outpatient service within the Medical Benefits Package.
  • To get details on non-registered veterans, get in touch with your local VA office.

If you acquired a military service-related disability, alternate regulations, and other requirements, you may be considered to have a non-related military service medical condition.

Veteran Benefits which are Not Covered

Health care not in included in the Veterans Benefits program are as follows:

  • Abortion or counseling due to abortion
  • In-vitro fertilization
  • Medicines and medical resources not approved by the FDA FDA (Foods and Drug Administration)  unless the medical center is conducting clinical trials under the IDE (Investigational Device Exemption) or IND (Investigation New Drug) application orif medicine and medical resources are given under a compassionate-use exemption.

Co-payments for VA Health Care 

Veterans in specific priority groups may receive copayments:

  • Medication – for every supply of medications (30 days or less) given for outpatient reasons for non-service related conditions, it is $8. The payments affect those in Priority 2, 3, 5 and 6. If you are in priority 7 or 8, you will pay $9. Note: veterans who have problems with the copayments for outpatient medications should consult with the local VA registration coordinator.
  • Outpatient – Preventive care visit (free), primary care ($15), and specialty care ($50). These apply to those in Priority 7 and 8.
  • Inpatient – Co-pay for inpatient for first 90 days (within a year) is $1,156, which reduces to $578  for each additional 90 days of care. Per diem fees are $10 per day.

Note: Veterans with low wages living in high-end areas, may be eligible for an 80% deduction for inpatient charges.

  • Extended Care Services – Institutional nursing home care unit, generic evaluation, and respite payments range from free to $92 each day. For non-institutional care, the payment is $15 and $5 for domiciliary. This only refers to priority groups 4, 5, 7 and 8.
  • Veterans who receive care for hospital and outpatient care and are a patient or inmate of another agency, and that agency has the duty to dispense care services.
  • Enrolled in spas or health clubs

Take Advantage

To receive the latest on veterans’ health services and fees, you need to keep in touch with their local VA office or visit www.va.gov/healtheligibility/costs or military report website www.militaryreport.com, and you will be able to keep up with latest changes to benefits.

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