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Frequently Asked Questions
How do I get enrolled in the VA system?
You can apply for VA health care by completing VA form 10-10EZ. The 10-10EZ may be obtained by visiting, calling, or writing any VA health care facility or veterans' benefits office. You can also call toll-free 1-877-222-VETS (1-877-222-8387) or access the form on the Internet at http://www.va.gov/1010ez.htm.
If I receive medical care at the VA, how much will it cost?
Most nonservice-connected veterans and noncompensable 0% service-connected veterans are required to complete an annual means test or to agree to pay VA the applicable copayment. The means test is based on their family's income and net worth. Some veterans are required to make copayments for their care and medications.
There are four basic types of charges:
Medication - Prescription copayment charges were established by Congress. The charge is $7 for each 30 day or less supply of medications provided on an outpatient basis for nonservice-connected conditions.
Outpatient - The copayments will be based on primary care visits ($15), specialty care visits ($50) and no copayment designations.
Inpatient - Congress determined the appropriate inpatient copayment should be the current inpatient Medicare Deductible Rate plus $10 for the first 90 days that you remain in the hospital.
Nursing Home - Congress determined the copayment should be the current Medicare deductible rate plus $5.00 for each day.
The Debt Collection Improvement Act of 1996 (Public Law 104-134) requires the Department of Veterans Affairs (VA) to refer any unpaid bills over 180 days old to the Treasury Department for potential offset. The Treasury Department or other authorized representatives will offset all or a portion of what you owe VA against almost any monies paid to you by the Federal Government. This could include, but is not limited to, social security benefits, federal income tax refunds and federal salary, or retirements benefits. Referral of your bills to Treasury may result in processing fees being charged to you. Processing fees will be charged for the referral and for each offset made.
If you can't afford to make copayments there are two options:
The first option is to request a waiver for paying your current debt. If you request a waiver, you must submit sufficient proof that you cannot financially afford to make payment to VA. This process could take several months; please contact the Revenue Coordinator at the VA health care facility where you receive care.
The second option is to request a hardship determination to avoid future debts. You will need to submit specific financial information about your current year income. A decision will be made based on information you provide.
Can I order prescription refills via the web?
Yes, you can request refills on the Internet. Register with MyHealtheVet:
<http://www.myhealth.va.gov>. Prescription refills are located under the “My Care” tab. Visit our medication refills page for full details on all methods of requesting refills.
Can my wife also receive care at the VA?
Spouses of eligible veterans may be treated by VA if the spouse gains eligibility under the Tri-Care or CHAMPVA programs. Tri-Care eligibility is extended to veterans who have completed at least 20 years active military service. CHAMPVA eligibility is extended to spouses of veterans who have been rated 100 percent service-connected disabled and are further rated as permanently and totally disabled.
Will I have to pay for my medications?
If you are being provided treatment, necessary prescriptions will be provided. For more information on the current copayment rates, go to http://www.va.gov/revenue. Service-connected veterans rated 50% or more, service-connected veterans receiving medications for a service-connected condition, or nonservice-connected veterans who meet the low-income criteria are exempt from the prescription copayment. This income threshold changes annually.
Will VA bill my insurance?
Whether or not you have insurance does not affect your eligibility for VA health care benefits. If you are receiving care for a nonservice-connected condition and have health insurance, your insurance carrier will be billed. VA does not bill your health insurance carrier for VA-adjudicated service-connected disabilities. An adjudicated service-connected disability is one that VA has determined was incurred or aggravated in the line of active duty. If you are a veteran in priority group 7, providing us your insurance information will allow us to bill your insurance carrier, which may offset part or all of your copayment. The law requires VA to bill private health insurance companies for all care provided for veterans' nonservice-connected disabilities. VA's medical care budget is supplemented by the amount VA is able to collect from private health insurance carriers.
You will NOT be responsible for any unpaid balance that the insurance carrier does not pay except for VA copayments. In addition, many insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.
I go to a private physician for specialty care. If I enroll in VA, do I have to quit seeing that specialist?
No. However, if VA is providing medication for a particular health condition, VA must monitor that condition. That does not mean that the veteran may not seek the advice, treatment, and counsel of a private sector physician.
My private physician wrote prescriptions for medications I can't afford. Can I get them at the VA?
In most cases, prescription medications that are filled by a VA Pharmacy must be prescribed by a VA physician.
I went to a private hospital in an emergency situation. I have no insurance. Will VA pay the bill?
Urgent and limited emergency care services are available to enrolled veterans at VA health care facilities or non-VA health care facilities at which VA has a sharing agreement or contract. Veterans with special eligibility may obtain emergency care, at VA expense, in a non-VA facility where VA does not have a sharing agreement or contract.
Under certain conditions, other veterans who have no health insurance coverage may be eligible for payment or reimbursement of emergency medical services provided outside VA. Contact the VA Health Benefits Service Center at 1-877-222-VETS (1-877-222-8387) for more information.
Why do I have to pay the VA for my care and my neighbor doesn't?
Access to medical and dental services as well as the costs that veterans pay for such services are determined by the priority group to which the veteran is assigned. Assignment to a priority group is determined by a veteran's service-connected disability as well as his or her ability to defray a part of the cost of the health care. The seven priority groups to which veterans are assigned as outlined at http://www.va.gov/elig.
Can I get dentures/eyeglasses/a wheelchair?
Dental benefits are generally restricted to 100 percent service-connected veterans, former Prisoners of War, and other veterans who have a specific service-connected dental disability.
Eyeglasses are normally available to all 7 priority groups.
Wheelchairs are normally available to all 7 priority groups depending upon the individual medical needs of the veteran.
More Frequently Asked Questions from the VA's Inquiry Routing and Information System
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