VA Health Care Services
Frequently Asked Questions About Veterans' Benefits
By: the Department of Veterans Affairs
The questions and answers below provide general information about an often confusing and complex subject – eligibility for Veterans Administration (VA) care.
Eligibility for VA health care is dependent upon a number of variables, which may influence the final determination of the services for which you qualify. These factors include the nature of a veteran's discharge from military service (e.g., honorable, other than honorable, dishonorable), length of service, VA adjudicated disabilities (commonly referred to as service-connected disabilities), income level, and available VA resources among others.
For specific information regarding your individual situation, you are encouraged to contact the nearest VA facility for assistance. Staff there can provide further help in evaluating your health care needs and answering other questions you may have about VA health care services.
Q: Who is eligible for VA health care benefits?
Under current law, any veteran who served in the active military, naval, or air service and was discharged or released under honorable conditions has basic eligibility for VA care. On Oct. 9, 1996, the president signed into law the Veterans Health Care Eligibility Reform Act of 1996. This law establishes two eligibility categories.
The first category includes veterans to whom VA shall furnish needed hospital and outpatient care, and may furnish nursing home care, but only to the extent and in the amount that Congress appropriates funds to provide the care. These veterans include those with compensable service-connected disabilities, former POWs, World War I veterans, low income veterans (based on legally established income threshold), veterans exposed to environmental contaminants for conditions related to such exposure, and 0-percent service- connected veterans for the treatment of the service-connected disability.
The second group includes veterans to whom VA may furnish needed hospital care, outpatient care, and nursing home care, but only to the extent resources and facilities are available, and only if the veteran agrees to pay VA a copayment in exchange for the care. This group includes those veterans not listed above.
Q: Can I obtain free prescriptions from VA?
VA provides medication to eligible veterans who are receiving care from VA medical facilities, and to those veterans authorized by VA to receive care from private physicians at VA expense. VA pharmacies cannot fill prescriptions written by a private physician unless the veteran is specifically eligible.
Examples of those who are eligible include: veterans with service-connected conditions who have been approved by VA to have their medical care provided by their local physician, and veterans who are receiving increased VA pension or compensation benefits because they need the regular aid and attendance of another person.
Q: Is dental care available to me through VA?
Veterans receiving outpatient care or who are scheduled for inpatient care may receive dental care if the dental condition is clinically determined to be complicating a medical condition currently under treatment. In addition, hospitalized veterans may also receive dental treatment for a nonservice-connected dental disability when it is medically determined that it is aggravating a condition for which the veteran is being hospitalized. Inpatient dental care may also be given for any compelling medical reason or dental emergency requiring dental treatment.
Basically, VA outpatient dental treatment is restricted by law to certain categories of veterans who have VA rated service-connected dental disability. According to current VA directives, veterans who do not qualify for care as a service-connected veteran are eligible only for one complete episode of dental treatment following discharge from military service.
Q: Can I get medical care from my private physician or at a private hospital at VA expense?
Current law requires all veterans who seek VA care, including those with special eligibility, to obtain such care in VA facilities. Only when appropriate VA officials determine that certain VA services are unavailable, or cannot be economically provided, can a veteran be authorized to obtain care through private sources at VA expense.
VA can pay only for private medical care services not previously authorized by VA officials when the care was provided under the following circumstances:
- Treatment was provided for an adjudicated service-connected disability, for any condition for a permanently and totally disabled service-connected veteran, or for a nonservice-connected disability associated with and aggravating a service-connected disability
- Medical care and services were provided in a medical emergency
- VA or other federal medical facilities were not feasibly available. In the absence of any one of these three conditions, VA cannot assume responsibility for the payment or reimbursement for the cost of non-VA care.
Q: I'm a military retiree. Can I receive VA care?
Individuals who retire from the military are veterans and as such are eligible for VA medical care benefits.
Q: As a veteran, can I get nursing home care in the community through VA?
The VA Community Nursing Home Care Program is designed to assist veterans and their families in making the transition from the hospital to the community. Although some veterans, such as those who were hospitalized for an adjudicated service-connected condition, are eligible for indefinite placement in community nursing facilities at VA expense, other veterans are limited to short-term contracts. These contracts are intended to provide the veteran's family with temporary financial relief while they pursue alternative financial arrangements for the veteran's care.
Q: I need a copy of my VA medical records. How can I get them?
Your VA medical records are maintained at the facility or facilities where you were provided medical care. You will need to contact each facility to personally request a copy of any medical records maintained at that facility. Requests must be in writing and should indicate what records you are requesting, why you are requesting those records, and to whom they are to be released.
VA does not maintain or have copies of any military medical records. If you need copies of your military records, write to the branch of service in which you served and request copies of those records.
Q: How do I apply for VA health care benefits?
You can apply for VA health care benefits by going to the VA health care facility nearest your home or by calling them for information regarding the application process. You can also find the telephone number and address in the telephone directory under the "Government" listings.
Q: If I have further questions about VA medical care benefits, where can I get answers to those questions?
If you have questions about VA medical care benefits you should contact the patient representative at the VA health care facility nearest your home. The telephone number can be found in the telephone directory under the "Government" listing.
Q: I understand that there is a VA health benefits program called CHAMPVA (Civilian Health and Medical Program of VA) which is available to certain dependents and survivors. Tell me more about the program including what benefits are offered, who is eligible and who I can talk to for more information.
CHAMPVA is a health benefits program in which VA shares with eligible beneficiaries the cost of certain health care services and supplies. Eligibility for CHAMPVA is restricted to the following, providing they are not eligible for CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) or Medicare Part A as a result of reaching age 65:
- The spouse or child of a veteran who has been rated by a VA regional office as having a permanent and total service-connected condition
- The surviving spouse or child of a veteran who died as result of a VA rated service-connected condition; or who at the time of death, was rated permanently and totally disabled from a service-connected condition
- The surviving spouse or child of a person who died in the line of duty and not due to misconduct within 30 days of entry into active military service
Due to the similarity between CHAMPVA and CHAMPUS (which is administered by the Department of Defense for military retirees as well as families of active duty, retired, and deceased service members), the two programs are often mistaken for each other. Please note that CHAMPVA is separate from CHAMPUS and that there are distinct differences between them.
Administration of CHAMPVA is handled at the CHAMPVA Center in Denver. Additional program information, including application procedures, is available by the calling the CHAMPVA Center at 800-733-8387. For questions about CHAMPUS, the toll-free number is 800-538-9552. Information about DoD's other health care programs (for example, TRICARE) is available from DoD under the category "Beneficiary Information."
Department of Veterans Affairs