One of the strategic goals of the Veterans Administration (VA) is to ensure a smooth transition for veterans from active military service to civilian life. An important component of this transition is the transfer of health care. VA’s health care mission covers the continuum of care providing both inpatient and outpatient care. They provide a wide range of services including pharmacy, prosthetics, and mental health as well as long-term care in both institutional, non-institutional settings, and other health care settings such as CHAMPVA and Readjustment Counseling.
The Veterans Health Administration (VHA) network is one of the most extensive in the nation and operates as a “hub and spoke” system. VHA delivers care through 21 Veterans Integrated Service Networks (VISN) that manage 153 medical centers, 731 community-based outpatient clinics, 135 nursing homes, 209 readjustment counseling centers (Vet Centers), and 47 domiciliaries. In 2007, VHA provided health care services to approximately 5.5 unique patients.
For most veterans, entry into the VA health care system begins by applying for enrollment. To apply, a veteran must complete VA Form 10-10EZ, Application for Health Benefits, which may be obtained from any VA health care facility or regional benefits office. Once enrolled, veterans can receive health care at VA facilities anywhere in the country.
During enrollment, each veteran is assigned to a priority group. VA uses priority groups to balance demand for VA health care enrollment with resources. Veterans who are 50 percent or more disabled from service-connected conditions, unemployable due to service-connected conditions, or are receiving care for a service-connected disability receive priority in scheduling of hospital or outpatient medical appointments.
Some veterans must make co-pays to receive VA health care. Veterans with income above the means test threshold and below a certain VA geographically based income threshold, as well as non service-connected veterans and non-compensable, zero percent service-connected veterans with certain gross annual household incomes will be charged deductibles. Co-pays do not apply to publicly announced VA health fairs and certain outpatient visits for preventive screenings, immunizations, smoking cessation counseling, laboratory, flat-film radiology, and electrocardiograms.
In the event that a veteran is unable to be seen at a VA health care facility, or approval is given for care at a private facility, VA is required to bill private health insurance providers or pay for medical care, supplies and prescriptions. All veterans applying for VA medical care are required to provide information on their health care coverage, including coverage provided under policies of their spouses.
Veterans receiving VA care for any condition are eligible for a variety of aids and services. Approved prosthetic appliances include home respiratory therapy, artificial limbs, orthopedic braces and therapeutic shoes, wheelchairs, crutches, canes, walkers, and other durable medical equipment. VA will also provide hearing aids and eyeglasses to qualified veterans based on service-connection or former POW status. Blind veterans may be eligible for services at a VA medical center or for admission to a VA blind rehabilitation center. A full spectrum of diagnostic, surgical, restorative, and preventive dental services are available to veterans who meet certain criteria, while special services such as PTSD and substance abuse treatment are available as well.
Most major VA health care facilities operate a full-service outpatient pharmacy. VA provides free outpatient pharmacy services to veterans who meet certain eligibility criteria, including service-connection, former POW status, income levels, and certain conditions. Other veterans are charged a co-pay of $8 for each 30-day or less supply of medicine (certain groups have a maximum annual co-pay limit).
It is also important to know that VA may reimburse or pay for medical care provided to enrolled veterans by non-VA facilities only in cases of medical emergencies where VA or other federal facilities were not readily available. In these cases, to initiate a claim, the veteran must contact the VA facility closest to where the emergency service was provided.
To learn more about eligibility for VA health care and benefits, call 1-877-222-VETS (8387) or visit www.va.gov. Information is also available through the VA guide entitled Federal Benefits for Veterans and Dependents, available at www.va.gov or at most VA facilities.
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