Did you know that you can get emergency healthcare outside the VA?

2015-10-11T20:46:54-04:00

In 2001, the U.S. Congress provided the Department of Veterans Affairs (VA) with authorization to pay for emergency care in non-VA facilities for veterans enrolled in the VA health care system. The benefit will pay for emergency care rendered for non-service-connected conditions for enrolled veterans who have no other source of payment for the care. However, the VA will only pay to the point of medical stability.

There are very strict guidelines concerning these types of claims. Veterans and their non-VA providers should be aware that these claims must be filed with the VA within 90 days from the last day of the emergent care. This benefit is a safety net for enrolled veterans who have no other means of paying a private facility emergency bill. If another health insurance provider pays all or part of a bill, VA cannot provide any reimbursement. Veterans who retired from the U.S. military are covered by Tricare/CHAMPUS insurance and cannot file such a claim.

To qualify:

>>A veteran must be provided care in a hospital emergency department or similar facility providing emergency care.
>>The veteran must be enrolled in the VA Health Care System and must have been provided care by a VA health care provider within the last 24 months.
>>The veteran must be financially liable to the provider of the emergency treatment for that treatment, and have no other form of health care insurance including Medicare, Medicaid, or a state program.
>>The veteran cannot have any other contractual or legal recourse against a third party (such as a Workman’s Comp Claim or a Motor Vehicle Accident) that will pay all or part of the bill.
>>The care must have been rendered in a medical emergency of such nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health.

If you are an eligible veteran, and a VA facility is not feasibly available when you believe your health or life is in immediate danger, report directly to the closest emergency room.

See a local VSO for stipulations...

Response by SSG Private RallyPoint Member made Oct 11 at 2015 8:51 PM

2015-10-11T20:51:05-04:00

You have obviously done your homework! Well done, and thanks for spreading the word to fellow veterans!

Response by LTC John Shaw made Oct 11 at 2015 9:02 PM

2015-10-11T21:02:52-04:00

SGT Mark Stevens All the caveats in VA care makes it difficult for Veterans to trust the VA system will have their back in an Emergency. No one wants to go to an Emergency Room and then find out they have to fight between the multiple bureaucracies on who will pay, only to be handed the bill in the end.

Response by PFC Al Sethre made Oct 12 at 2015 9:49 AM

2015-10-12T09:49:11-04:00

I would highly suggest letting the VA know as soon as you are admitted to the hospital, if possible.