Health Care Benefits Overview, 2017 Edition Vol. 1

This guide is designed to provide Veterans and their families with the information they need to understand VA’s health care system – eligibility requirements, health benefits and services available to help Veterans and copayments that certain Veterans may be charged.

Updated Topics and Benefits Include:

• Stay Connected With VA 
• Veterans Can Apply for Enrollment by Telephone 
• Seamless Care for Traveling Veterans 
• Medication Copay Update 
• VA Dental Insurance Program 
• Veterans Crisis Line 
• Free Transportation to VA Appointments 
• Do I Declare Health Care Coverage to IRS? 

Get a first-hand account of this book on our blog: https://govbooktalk.gpo.gov/2017/12/05/new-centers-of-excellence-in-prim...

Related products:

Other products produced by the United States Department of Veterans Affairs can be found here: https://bookstore.gpo.gov/agency/department-veterans-affairs-va

Code of Federal Regulations, Title 38, Pensions, Bonuses, and Veterans' Relief, Pt. 0-17, Revised as of July 1, 2017 is available here:  https://bookstore.gpo.gov/products/cfr-t38-pt0-17-code-federal-regulatio...

Code of Federal Regulations, Title 38, Pensions, Bonuses, and Veterans' Relief, Pt. 18-End, Revised as of July 1, 2017 is available here: https://bookstore.gpo.gov/products/cfr-t38-pt18-end-code-federal-regulat...

Table of Contents:

Benefits of Enrolling.....................................................................................................2

Medical Care for Service-Connected Veterans Abroad..........................................2

High Quality Care............................................................................2

Stay Connected With VA......................................................2

VA Health Care Enrollment and Eligibility..................................................................3

Quickly Find Out If You May Be Eligible For Enrollment...................................................................3

Easy Ways to Apply for Enrollment............................................................................................................................3

You Select Where You Want to Receive Your Care................................................................................................3

VA Veterans Choice Program..............................................................................................................4

Enrollment Priority Groups - What are they and how do they work?..............................................4

Basic Eligibility for VA Health Care..............................................................................7

Minimum Duty Requirements ............................................................................................................7

Returning Service Members (OEF/OIF/OND)...................................7

New Enrollees Will Receive a Welcome to the VA Call and a Personalized Veterans Health Benefits

Handbook ............................................................................................................................................7

Keep your Personal Information Updated with All VA Organizations...........................................................8

Your Information is Secure with the Veteran Health Identification Card.....................................................8

Schedule an Appointment ...............................................................9

You Will Be Assigned a Personal Care Team....................................9

Seamless Care for Traveling Veterans......................................................................9

Coordination of Care among VA Facilities...............................................................................................................9

Enrolled, but Later Determined Ineligible.........................................................................................9

Financial Reporting Requirements......................................................... 10

Net Worth Information No Longer Required ........................................ 10

Use Our Online Tool to Determine Your Eligibility Based on Income............................... 10

Medication Copayments ............................................................................................11

Copay rates may change annually, including the annual cap on medication copayments. .......11

Inpatient Copayments....................................................................................... 11

Long-Term Care Copay Rates*.................................................................. 11

Cost-Free Care for Certain Veterans.............................................................. 11

VA Has Programs That Can Help Veterans Pay Copays ...................................................................12

Veterans with Catastrophic Disabilities................................................................................................................. 13

Coverage Under The Affordable Care Act.................................................................14

Three things you should know: ........................................................................................................14

Tax Credit .......................................................................................................... 14

VA and Other Health Insurance.................................................................................15

Private Health Insurance...................................................................................................................15

Medicare Coverage............................................................................................................................15

Creditable Coverage ..................................................... 15

Medical Benefits Package ..........................................................................................17

Meeting Women Veterans’ Unique Needs .......................................................................................17

Available Long-Term Care Services ..................................................................................................17

VA Community Living Centers (Nursing Home) Programs..................................................... 18

Domiciliary Care ........................................................................................................... 18

Medical Foster Home............................................................................ 18

State Veterans Homes................................................. 18

Additional Services ...........................................................................................................................18

Geriatric Evaluation............................................................................................................. 18

Geriatrics and Extended Care ....................................................................................... 18

Adult Day Health Care................................................................................................................................................. 18

Respite Care.................................................. 18

Home Health Care............................................................... 18

Home Telehealth ...................................................................... 19

Hospice/Palliative Care ........................................................ 19

Some Veterans receive Free Long-Term Care Services.................................................................................... 19

Benefits with Special Eligibility Criteria.................................................. 19

Hearing Aids and Eyeglasses................................................................... 19

Highly Rural Transportation Grants........................................................................................................................ 20

Additional VA Health Benefits Programs..................................................................21

Dependents and Survivors ...............................................................................................................21

CHAMPVA...................................................................................................... 21

Children of Women Vietnam Veterans Health Care Benefits.......................................... 21

Spina Bifida Health Care Benefits............................................................................................................................ 21

Emergency Care.................................................................................................................................22

VA Payment for Emergency Care of your Service-connected Conditions

without Prior Authorization ...................................................................................... 22

VA Payment for Emergency Care of your NonService-connected Conditions

without Prior Authorization ...................................................................................... 22

VA Dental Insurance Program ..........................................................................................................23

Mental Health Services .....................................................................................................................23

Veterans Crisis Line............................................................................................. 23

Military Sexual Trauma........................................................................................................................... 24

In-/outpatient and Residential Services Available............................................................................................ 24

Receive Free MST-Related Care..................................................................................... 24

Readjustment Counseling Services.......................................................................... 24

Homeless Veterans.......................................................................... 24

Caregivers Program...........................................................................................................................24

Camp Lejeune Water Contamination Benefits ................................................................................25

Camp Lejeune Veterans: ........................................................ 25

Family members: .............................................................................................. 25

Free Transportation to VA Appointments........................................................................................26

Medically Related Travel Benefits ....................................................................................................26

No More Standing In Line ....................................................................................... 27

Health Benefits for Service-Connected Conditions are Never Out of Reach ................................27

Notice of Privacy Practices................................................................................................................27

Services and Tools Available Online ................................................................................................28

VA’s Health Benefits website ....................................................................... 28

Office of Public Health..................................................................................................................... 28

Self-Service Kiosks..................................................................................................................................... 28

Your Personal VA Health Information At Your Finger Tips..............................................................29

MyHealtheVet............................................................................................................. 29

Special Care Access Network – Extension for Community Healthcare Outcomes (SCAN- ECHO)... 29

Mobile Apps.................................................................................................................... 29

eBenefits................................................................................................................ 30

Veterans Canteen Service ..................................................................................... 30

Frequently Asked Questions .....................................................................................31

Military veterans and their families seeking to use the U.S. Department of Veterans Affairs health care system and learn more about how it works, with contact information for a variety of VA health care services.