Most veterans must apply for enrollment in
order to receive health care benefits. Veterans may apply at any
time. Once enrolled, veterans are eligible for a comprehensive
benefits package of inpatient and outpatient services that include:
- Drugs and pharmaceuticals
- Preventive medicine services
- Primary care
- Surgery
- Emergency care
- Mental health and substance abuse treatment
- Home health care
- Respite and hospice Care
- Homeless veterans programs
Service-connected veterans are eligible for
treatment of their service-connected disability even if they have
not enrolled.
Health Care Enrollment
To receive care, veterans generally must be enrolled with
VA. A veteran may apply for enrollment at any time by calling 1-877-222-VETS(8387).
Once enrolled, veterans are part of a national health care system
with over 1,100 service sites.
Financial Assessment for Health Care
Certain veterans applying for enrollment for health care must
provide VA with information on their annual income and net worth in
order to determine whether they are below the Means Test
threshold. For those veterans who measure above the Means Test,
the law requires that the veteran agrees to pay a co-payment.
(Except veterans who were awarded the Purple Heart.) VA forms are
available on the VA website, http://www.va.gov/forms
What is the Means Test?
The Means Test is an annual measure of your household income and
assets; this currently includes your spouse's income and your dependent
children's income. For information on how to do a Means Test, call
toll-free, 1-877-222-VETS(8387).
Billing Health Insurance Companies
When applying for medical care, all veterans must provide
information pertaining to their health insurance coverage, including
policies held by spouses.
A veteran's eligibility for VA health care benefits is
not affected by health insurance coverage. Eligibility criteria
relate to military service and, in some cases, to income and type of
medical service needed.
If a veteran is currently covered by a health plan
(insurance policy), VA must be notified when registering for VA health
care. Regardless of the insurance company, and no matter how the
veteran is enrolled on a policy, VA is required by law to bill that
health insurance company for nonservice-connected medical care.
If the full cost of a veteran's care is not recovered,
VA will not collect nor hold the veteran responsible for the charges not
covered by the insurance company. However, there are instances
where a veteran co-payment is required, due to exceeding certain income
and asset information.
Family Health Benefits
CHAMPVA, the VA Civilian Health and Medical Program, shares the
cost of medical care for dependents and survivors of veterans. If
not eligible for TRICARE (the medical program for civilian dependents
provided by the Department of Defense) or Medicare, Part A, as a result
of reaching age 65, the following are eligible for CHAMPVA.
- The spouse or child of a veteran with a permanent
and total service-connected disability.
- The spouse or child of a veteran who died of a
service-connected condition or was totally disabled from a
service-connected condition at the time of death.
- The spouse or child of a person who died in the
line of duty, and not due to misconduct.
For more information call our toll-free number, 1-877-222-VETS(8387),
or visit our website at www.va.gov/hac/champva/champva.html
Outpatient Pharmacy Services
Outpatient pharmacy services are provided to all enrolled
veterans receiving VA health care. The following veterans however
are not required to pay a co-payment:
- Veterans receiving medication for treatment of a
service-connected condition.
- Veterans who are 50% or more service-connected
- Veterans whose income does not exceed the annual
maximum VA pension income amount.
Other veterans may be charged a co-payment for each
30-day or less supply of medication.
Eyeglasses, Hearing Aids, and Dental Care
Eyeglasses and hearing aids normally require a service-connected
rating of 10% or more. These are not usually provided for normal
hearing or vision loss.
Routine dental treatment for teeth or jaw is provided
only to veterans who are 100% service-connected or are ex-prisoners of
war who were detained 90 days or more. Limited dental treatment
may be provided if the dental problem is affecting a medical condition. Vet
Centers
VA provides readjustment counseling to any veteran who served in
the military in a theater of combat operations during any period of war,
or in any area during a period in which armed hostilities
occurred. VA Vet Centers are small community based facilities that
provide a holistic mix of counseling and community social services,
psychological counseling for veterans exposed to war trauma to include
post-traumatic stress disorder, family counseling when needed for the
veteran's readjustment, community outreach and education, and extensive
case management and referral activities. The Vet Centers are
located in the community, outside of the larger medical facilities. Women's
Programs
Women veterans are eligible for the same VA benefits as male
veterans. Services and benefits for women
veterans include breast and pelvic examinations and other general
reproductive health care services, except in vitro fertilization. Preventive
health care includes counseling, contraceptive services, menopause
management, Pap smears, and mammography. If VA is unable to
provide such services, referrals are made to private practitioner for
such services. VA health care professionals
provide counseling and treatment to help women overcome psychological
trauma resulting from personal and sexual assault during military
service. Care also is provided for any injury, illness, or
psychological condition resulting from such trauma. Women
Veterans Coordinators are available at all VA facilities to assist women
seeking treatment and benefits. VA medical centers have made many
structural changes to ensure privacy for women veterans. National
Mammography Hotline: 1-888-492-7844. For
more information on health care benefits, please call our toll-free
number, 1-877-222-VETS(8387) or visit our website at www.va.gov/health/elig Change
in Eligibility for Veterans Awarded the Purple Heart.
Effective November 30, 1999, veterans who present verifiable
proof of being awarded the Purple Heart are no longer required to
complete a Means Test or pay a co-payment for their medical care.
However, unless you fall within one of the groups listed in the Fact
Sheet under Outpatient Pharmacy Services, you will still be required to
pay applicable medication co-payments. |