Under the Veterans Health Administration (VHA), the Department of Veterans Affairs (DVA) operates one of the largest healthcare delivery systems in the world. The system consists primarily of centralized comprehensive medical centers, most of which are affiliated with university medical schools, complemented and supplemented by an extensive network of outpatient clinics and readjustment counseling centers, as well as nursing homes and domiciliaries. Eligibility for most DVA benefits is based on discharge from active military service under honorable conditions.
Prior to September 1, 1980 a veteran must have served one day or more of active duty to be eligible to receive healthcare. After this date, a veteran must have served twenty-four consecutive months of active duty. The exception to this rule is if the veteran has served one or more days in combat. You also currently have to meet certain income/asset guidelines. The Department of Veterans Affairs is authorized to bill insurance carriers for the cost of medical care furnished to all veterans for nonservice-connected conditions covered by health insurance policies. Veterans are not responsible and will not be charged for any co-payment or co-insurance required by their health insurance policies.
Local VA MedicalCenters and Clinics
1. John D. Dingell VAMC 4646 John R. Detroit, MI 48201 1-800-511-8056
2. Aleda E. Lutz VAMC 1500 Weiss Street Saginaw, MI 48602 1-800-406-5143
3. Ann Arbor VAMC 2115 Fuller Road Ann Arbor, MI48105 (734) 769-7100
Dental services are provided by the Department of Veterans Affairs (VA) to veterans on an outpatient basis under the following conditions:
1. Veterans are considered eligible and may apply at any time for outpatient dental services if:
a. Veteran receives service-connected compensation for a dental condition or disability.
b. Veteran is rated at 0% for service-connected dental conditions which are the result of combat wounds or service injuries.
c. Veteran was a prisoner of war for 90 days or more for any dental treatment.
d. Veteran receives disability compensation at the 100 percent rate for a service-connected condition(s), or rated 60% service-connected with a 100% individually unemployable rating.
e. Veterans dental condition is non-service connected and it is determined by the VA to be associated with and aggravating a service-connected condition.
f. Veteran is participating in a VA vocational rehabilitation program.
Eligibility and How to Apply for VA Authorization of Emergency-Outpatient Treatment
A. Service-connected 50% - 100% Any emergent condition
B. Service-connected less than 50% Emergent treatment for service-connected conditions only
C. Aid & Attendance, Housebound, or World War I veterans Any emergent conditions
D. VA facilities are not feasibly available
E. Must be reported within 15 days from the date of Emergent condition
F. Notification of such Emergency may be made by telephone, telegram or letter to the VA Medical Center you are enrolled in. Keep all copies and get first and last name of person you speak to!
G. When submitting payment, veteran must submit all invoices, emergency room report or doctor’s report; and must substantiate the existence of medical Emergency
H. Notification must be made to the VA Medical Center in which the veteran is enrolled
Non-service connected Emergency Care Benefits
The VA will pay for emergency care rendered for non-service-connected conditions for enrolled veterans who have no other source of payment for the care. If facilities accept VA reimbursement it is considered payment in full and qualifying veterans will not be held responsible for hospital charges. 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.
How to qualify: To qualify you must meet all of the following criteria
A. You are enrolled in the VA Health Care System
B. You have been provided care by a VA Clinician or provider within the last 24 months
C. You were provided care in a hospital emergency department, or similar facility providing emergency care.
D. You have no other form of health insurance
E. You do not have coverage under Medicare, Medicaid or a state program
F. You do not have coverage under any other VA programs
G. Department of Veterans Affairs or other Federal facilities are not feasibly available at time of emergency event H. A reasonable lay person would judge that any delay in medical attention would endanger your health or life
I. You are financially liable to the provider of the emergency treatment for that treatment.
J. You have no other contractual or legal recourse against a third party that will pay all or part of the bill.