Emergency medical care for Veterans: eligibility and VA payments


shadow

During a medical emergency, Veterans should immediately seek care at the nearest medical facility. A medical emergency is an injury, illness or symptom so severe that without immediate treatment, you believe your life or health is in danger. If you believe your life or health is in danger, call 911 or go to the nearest emergency department (ED) right away.

Veterans do not need to check with VA before calling for an ambulance or going to an ED. During a medical emergency, VA encourages all Veterans to seek immediate medical attention without delay. A claim for emergency care will never be denied based solely on VA not receiving notification prior to seeking care.

In general, VA can pay for emergency medical care at a local ER for a Veteran’s service-connected condition, or if the care is related to a Veteran’s service-connected condition. VA can also pay for emergency medical care for a Veteran’s non-service connected condition.

However, there are specific requirements in federal law and regulation that detail the conditions for eligibility for both service-connected and non-service connected conditions.

Eligibility requirements notwithstanding, Veterans should always seek care at the nearest medical facility during a medical emergency, and never delay emergency medical care.

Here’s more information on emergency care.


About the author: VA’s Office of Community Care (OCC) operates two main service lines, Delivery Operations and Revenue Operations, that support medical care delivery and services for Veterans and their families. OCC is also responsible for functions that support these service lines such as administration, planning, oversight and stakeholder relations.

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Restituto Diaz Barraquias    

    How to get healthcare card and Medicare assistance from va for homeless veteran member our claim. I am suffering of high blood”pressure and temporary blind

    please advice

  2. Ginger Palumbo    

    These fact sheets leave out the important part–where to send the bill to for payment!!!! I mistakenly sent my father’s ambulance bills to the VISN Community Care Unit for our area within the proper time frame. After 6mos one rep told me “Ambulance bills to a VA facility need to go to your local Benefits Travel Office”, then I was told by another rep that was not correct. After 11months I learned if the Vet is transported to a VA facility their local Benefit Travel Office needs several items from the ambulance service for adminstrative review, then for payment review & the process takes about three months.
    If the Vet is transported to a non-VA facility, then the VISN Community Care unit for the Vet’s area processes it.
    These “Fact Sheets” only state “the VA must receive it”, but does not inform the reader WHERE to send it, which is the most vital part…

  3. Ben    

    VA really needs to be careful when adjudicating coverage for veterans seeking payment for emergency room visits. I was stuck with a $6k bill before I contacted Kare 11 News for help from the press. https://www.disabledveterans.org/2018/05/27/non-va-emergency-room-health-care/

  4. Mark R Klouda    

    Hello,

    I’m a 100% service connected permanent and total and I went to an emergency room in Cedar Rapids Iowa right before I move to Puerto Rico therefore I didn’t find out about this until a couple years later when $2,000 showed up on my credit report and I’m just wondering is there any kind of relief for me because I can’t get anybody to help me with it they denied it for whatever reason I don’t know but I never got any paperwork any help I can get I preciate it

  5. Herbert Eplee    

    I am trying to get a return call on my hearing aids and as of yet no reply, my phone number is *redacted) Thank you.

  6. Ellen K Ellis    

    VA denied my emergency room visit for a broken ankle because the hospital took too long to bill for it, I had to pay out of pocket.
    Then they denied the ambulance bill so I had to pay that out of pocket.
    Now I live in fear that I will need an ambulance again because I can’t afford it.
    1

  7. LOUISE P CHAMBERS    

    I went to the Elsmere VA hospital back in May to the ER and there was only one doctor on. He said it would take him 3 hours to prep me for a CT because of pain I was having on my side. So I had to come back 4 days later for a walk in x-ray. This hospital only has 1 CT scan and MRI in the whole hospital to care for 15,000 to 16,000 veterans that have to go to that hospital. And 1 doctor in the ER with 20 rooms. What is wrong with this picture? We are not taking care of our veterans and most hospitals are under staffed. The public and the President needs to know this. Is there an address I can write to him and let him know personally about how our veterans are being treated because I’m tired of watching the suicide rate go up among these guys because they aren’t getting the help they need. Thank you And God Bless all Our Veterans

Comments are closed.