2023 VA Health Care Copay Rates

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2023 VA Health Care Copay Rates

Review 2023 copay rates for VA and VA-approved health care.

Effective January 1, 2023

Note: Some Veterans don’t have to pay copays (they’re “exempt”) due to their disability rating, income level, or special eligibility factors.

Learn how we determine whether you’ll pay copays

 

Urgent care copay rates

(Care for minor illnesses and injuries)

There’s no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, both of these must be true:

  • You must be enrolled in the VA health care system, and
  • You must have received care from us within the past 24 months (2 years)

If you’re only getting a flu shot at your visit, you won’t have to pay any copays, no matter your priority group.

Learn more about urgent care benefits

2023 urgent care copay rates
Priority group Copay amount for first 3 visits in each calendar year Copay amount for each additional visit in the same year
1 to 5 $0 (no copay) $30
6 If related to a condition that’s covered by a special authority: $0 (no copay)

If not related to a condition covered by a special authority: $30 each visit

 $30
7 to 8 $30 $30

Note: Special authorities include conditions related to combat service and exposures (like Agent Orange, active duty at Camp Lejeune, ionizing radiation, Project Shipboard Hazard and Defense (SHAD/Project 112), Southwest Asia Conditions) as well as military sexual trauma, and presumptions applicable to certain Veterans with psychosis and other mental illness.

Outpatient care copay rates

(Primary or specialty care that doesn’t require an overnight stay)

If you have a service-connected disability rating of 10% or higher

You won’t need to pay a copay for outpatient care.

If you don’t have a service-connected disability rating of 10% or higher

You may need to pay a copay for outpatient care for conditions not related to your military service, at the rates listed below.

2023 outpatient care copay rates
Type of outpatient care Copay amount for each visit or test
Primary care services
(like a visit to your primary care doctor)		 $15
Specialty care services
(like a visit to a hearing specialist, eye doctor, surgeon, or cardiologist)		 $50
Specialty tests
(like an MRI or CT scan)		 $50

Note: You won’t need to pay any copays for X-rays, lab tests, or preventive tests and services like health screenings or immunizations.

Inpatient care copay rates

(Care that requires you to stay one or more days in a hospital)

If you have a service-connected disability rating of 10% or higher

You won’t need to pay a copay for inpatient care.

If you’re in priority group 7 or 8

You’ll pay either our full copay rate or reduced copay rate. If you live in a high-cost area, you may qualify for a reduced inpatient copay rate no matter what priority group you’re in. To find out if you qualify for a reduced inpatient copay rate, call us toll-free at 877-222-8387 (TTY: 711). We’re here Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

2023 reduced inpatient care copay rates for priority group 7
Length of stay Copay amount
First 90 days of care during a 365-day period $320 copay + $2 charge per day
Each additional 90 days of care during a 365-day period $160 copay + $2 charge per day

Note: You may be in priority group 7 and qualify for these rates if you don’t meet eligibility requirements for priority groups 1 through 6, but you have a gross household income below our income limits for where you live and you agree to pay copays.

Review the current VA national income limits

2023 full inpatient care copay rates for priority group 8
Length of stay Copay amount
First 90 days of care during a 365-day period $1,600 copay + $10 charge per day
Each additional 90 days of care during a 365-day period $800 copay + $10 charge per day

Note: You may be in priority group 8 and qualify for these rates if you don’t meet eligibility requirements for priority groups 1 through 6, and you have a gross household income above our income limits for where you live, agree to pay copays, and meet other specific enrollment and service-connected eligibility criteria.

Learn more about priority groups

Medication copay rates

If you’re in priority group 1

You won’t pay a copay for any medications.

Note: You may be in priority group 1 if we’ve rated your service-connected disability at 50% or more disabling, if we’ve determined that you can’t work because of your service-connected disability (called unemployable), or if you’ve received the Medal of Honor.

Learn more about priority groups

If you’re in priority groups 2 through 8

You may pay a copay for these types of medications:

  • Medications your health care provider prescribes to treat non-service-connected conditions, and
  • Over-the-counter medications (like aspirin, cough syrup, or vitamins) that you get from a VA pharmacy. You may want to consider buying your over-the-counter medications on your own.

Note: The costs for any medications you receive while staying in a VA or other approved hospital or health facility are covered by your inpatient care copay.

The amount you’ll pay for these medications will depend on the “tier” of the medication and the amount of medication you’re getting, which we determine by days of supply. Once you’ve been charged $700 in medication copays within a calendar year (January 1 to December 31), you won’t have to pay any more that year—even if you still get more medications. This is called a copay cap.

2023 outpatient medication copay amounts
Outpatient medication tier 1-30 day supply 31-60 day supply 61-90 day supply
Tier 0
(prescription and over-the-counter medicines with no copay)		 $0 $0 $0
Tier 1
(preferred generic prescription medicines)
Review our list of tier 1 medications		 $5 $10 $15
Tier 2
(non-preferred generic prescription medicines and some over-the-counter medicines)		 $8 $16 $24
Tier 3
(brand-name prescription medicines)		 $11 $22 $33

If you have a service-connected rating of 40% or less and your income falls at or below the national income limits for receiving free medications, you may want to provide your income information to us to determine if you qualify for free medications.

Review the current VA national income limits

Find out how we determine your health care costs

Find a full list of medications in each tier on our pharmacy benefits website

Geriatric and extended care copay rates

You won’t need to pay a copay for geriatric care (also called elder care) or extended care (also called long-term care) for the first 21 days of care in a 12-month period. Starting on the 22nd day of care, we’ll base your copays on these 2 factors:

  • The level of care you’re receiving, and
  • The financial information you provide on your Application for Extended Care Services (VA Form 10-10EC).

Get VA Form 10-10EC to download

2023 geriatric and extended care copay amounts by level of care
Level of care Types of care included Copay amount for each day of care
Inpatient care
  • Short-term or long-term stays in a community living center (formerly called nursing homes)
  • Overnight respite care (in-home or onsite care designed to give family caregivers a break, available up to 30 days each calendar year)
  • Overnight geriatric evaluations (evaluations by a team of health care providers to help you and your family decide on a care plan)
 Up to $97
Outpatient care
  • Adult day health care (care in your home or at a facility that provides daytime social activities, companionship, recreation, care, and support)
  • Daily respite care (in-home or onsite care designed to give family caregivers a break, available up to 30 days each calendar year)
  • Geriatric evaluations that don’t require an overnight stay (evaluations by a team of health care providers to help you and your family decide on a care plan)
 Up to $15
Domiciliary care for homeless Veterans
  • Short-term rehabilitation
  • Long-term maintenance care
 Up to $5

Learn more about long-term care options

Services that don’t require a copay

You won’t need to pay a copay for any of the services listed here, no matter what your disability rating is or what priority group you’re in.

Past rates

Review health care copay rates for past years.

2022 rates (effective January 1, 2022)
2021 rates (effective January 1, 2021)
2020 rates (effective January 1, 2020)

Other information you may need

Find out how to pay your copay bill—and what to do if you disagree with the charges or are having trouble making payments.

Learn how we assess and verify your income to help determine if you’re eligible for VA health care and whether you’ll need to pay copays for certain types of care, tests, and medications.

We cover maternity care for eligible Veterans through arrangements with community providers. Download this fact sheet to find out more about copays.

 

VA Wants Vets to Use Their Benefits When Choosing a Final Resting

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VA Wants Vets to Use Their Benefits When Choosing a Final Resting Place

25 Jan 2023

Military.com | By Patricia Kime

The Department of Veterans Affairs is raising awareness of little-used benefits for veterans: burial at a VA, state or tribal veteran’s cemetery, and headstones or markers for veterans buried in private cemeteries.  According to VA officials, just 20% of eligible veterans who died last year were buried in a VA-managed or -supported cemetery, a benefit that comes at no cost to the veteran’s family. And fewer than half who qualified for a burial allowance or headstone used the opportunity, according to Under Secretary for Memorial Affairs Matt Quinn.

As the VA nears the 50th anniversary of assuming management of national cemeteries, the department is spreading the word to veterans and families that vets can apply for eligibility before they die, taking care of the needed paperwork beforehand to ease the financial and emotional burden on their families and make their wishes known.

“I want families to know that they can honor the services of their veteran with a VA-provided headstone, marker or medallion, but I also want every veteran or veteran’s family to know they have the option of being interred in a national, state, territorial or tribal veterans cemetery,” Quinn said during a roundtable with reporters Tuesday.

The VA manages 155 cemeteries nationwide and funds an additional 121 state, territorial and tribal veteran’s cemeteries. Veterans who are eligible for VA burial benefits include all who were discharged under something other than dishonorable conditions; spouses or surviving spouses of eligible veterans; dependent children; and some others.  The VA has a goal to ensure that 95% of the nation’s 19 million veterans live within 75 miles of a VA or VA-supported cemetery; currently, the department is “just shy” of 94%, according to Quinn.  “It’s that final benefit that the veteran has earned and that the nation can show to that veteran’s family appreciation for their sacrifice and service,” Quinn said.

During a meeting of the Veterans’ Family, Caregiver and Survivor Advisory Committee on Wednesday, VA Secretary Denis McDonough noted that the burial benefits are underutilized and said the department is planning additional outreach to veterans to publicize them, rolling information on their availability into the information provided to those who use the VA’s new life insurance program, VALife.  About 85% of eligible veterans use education benefits offered through the VA, while roughly 66% of eligible vets utilize VA health care. But just 15% of veterans are buried in VA-managed cemeteries.

“The uptake on the NCA [National Cemetery Administration] benefit is nowhere near where it should be,” McDonough said. “We are meant to be there for you every step of the way.”

The department is expanding opportunities for veterans to be buried in VA or supported cemeteries as it closes in on its goal to make them more accessible. The VA plans to open a columbarium-only cemetery in Queens, New York, this year, part of an urban initiative for the NCA that will provide burial sites for cremated remains in cities with few in-ground burial options. A columbarium is a building that holds cremated remains.  Along with another urban columbarium in Indianapolis, Indiana, and two new rural cemeteries in Elko, Nevada, and Cedar City, Utah, the VA plans to add 310,000 sites for interment of cremains in the next several years, for a total of 4.2 million gravesites.

The VA provided roughly 350,000 headstones for veterans’ graves and 35,000 medallions to adorn the private gravestones of veterans in 2021. But given that nearly 642,000 veterans die each year, the number is a fraction of those eligible for those benefits and more.  In addition to burial at no cost in VA and VA-supported cemeteries, veterans are eligible for headstones or medallions to place on private headstones as well as burial allowances for veterans who die of service-connected conditions and prefer to be buried in a non-VA cemetery.

Veterans who die in a VA medical facility of a non-service-connected condition also are eligible for limited burial and plot allowances for interment at a private cemetery.  Quinn urged veterans to consider applying for eligibility for burial benefits as part of their estate planning. They can learn about applying for benefits on the VA’s website without any obligation to be buried in a national cemetery or charge, Quinn said.  “This is one of the best ways to ensure a veteran’s family knows their loved ones’ wishes and that NCA is able to provide the benefits for service to our country. I have done this myself,” he said.

 

100% Disabled Veterans, Military Retirees and Dependents With ID Cards That Don’t Expire Need to Get Replacements Within 4 Years

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https://www.military.com/daily-news/2022/07/14/military-retirees-and-dependents-id-cards-dont-expire-need-get-replacements-within-4-years.html

100% Disabled Veterans, Military Retirees and Dependents With ID Cards That Don’t Expire Need to Get Replacements Within 4 Years

14 Jul 2022

Military.com | By Travis Tritten

 

Retirees and military family members who have identification cards with no expiration date can choose to upgrade to the new Next Generation Uniform Services Identification, or USID, cards whenever it’s convenient — as long as it’s done within the next four years, according to the Defense Department.

There is no looming deadline for use of those old non-active duty cards without expiration dates, but the department expects to completely phase out and replace them with the next-generation IDs, which are more durable and have enhanced security features, by 2026, Maj. Charlie Dietz, a spokesman, told Military.com.

In the meantime, cards with expiration dates are required to be replaced within 90 days of elapsing. The Defense Department began the effort to update all those IDs to the new format in July 2020, but the changeover hit delays caused by the pandemic.

“DoD plans to phase out and cancel the existing card forms in 2026 when all existing cards with an actual expiration date will have expired,” Dietz wrote in an email. “After then, only the USID card will be accepted for installation and benefits access.”

The USID format for military retirees and dependents represents the first change to those identification cards in nearly 30 years; the last update was in 1993. The new design closely resembles the Common Access Card, or CAC, format issued to active-duty troops and department civilians.

But there was uncertainty among those with cards that list the expiration as indefinite. The IDs are needed to access military facilities and to confirm eligibility for various military benefits, so missing a deadline or losing the identification could disrupt cardholders’ lives. Expired cards can be confiscated at base gates.

Those with cards with no expiration dates “may have the card replaced at their convenience,” according to Dietz. The department recommends they go to the ID Card Office Online and use the office locator to find a site that issues the new cards and book an appointment.

Retirees and their dependents, dependents of active-duty troops, reserve members and Medal of Honor recipients and 100% Disabled Veterans are among those who will receive the USID cards. A description of the new cards and a complete list of who is eligible can be found here.

At the onset of the pandemic in April 2020, the Defense Department extended the deadlines for replacing expiring cards in an attempt to keep the military community from gathering in issuance offices and spreading COVID-19. By February 2021, more than 200,000 of the new IDs had been issued.

“Social distancing and other pandemic safety precautions at DoD ID card sites worldwide has delayed the progress of existing card replacement, but generally most of those cardholders who needed to replace an expired card have done so,” Dietz said Wednesday.

 

web-sites that provide information on Veterans benefits and how to file for them

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War related Illness and Injury Study Center  http://www.wri.med.va.gov/

Depression and Trauma http://www.ptsd.va.gov/public/pages/depression-and-trauma.asp

Appeals http://www.warms.vba.va.gov/admin21/m21_1/mr/part1/ch05.doc

Board of Veteran’s Appeals http://www.va.gov/vbs/bva/

CARES Commission http://www.va.gov/vbs/bva/

CARES Draft National Plan http://www1.va.gov/cares/page.cfm?pg=105

Center for Minority Veterans http://www1.va.gov/centerforminorityveterans/

Center for Veterans Enterprise http://www.vetbiz.gov/default2.htm

Center for Women Veterans http://www1.va.gov/womenvet/

Clarification on the changes in VA healthcare for Gulf War Veterans http://www.gulfwarvets.com/ubb/Forum1/HTML/000016.html

Classified Records – American Gulf War Veterans Assoc http://www.gulfwarvets.com/ubb/Forum18/HTML/000011.html

Compensation for Disabilities Associated with the Gulf War Service http://www.warms.vba.va.gov/admin21/m21_1/part6%20/ch07.doc

Compensation Rate Tables, 12-1-03 http://www.vba.va.gov/bln/21/Rates/comp01.htm

Department of Veterans Affairs Home Page http://www.va.gov/

Directory of Veterans Service Organizations http://www1.va.gov/vso/index.cfm?template=view

Disability Examination Worksheets Index, Comp http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

Due Process http://www.warms.vba.va.gov/admin21/m21_1/mr/part1/ch02.doc

Duty to Assist http://www.warms.vba.va.gov/admin21/m21_1/mr/part1/ch01.doc

Electronic Code of Federal Regulations http://www.gpoaccess.gov/ecfr/

Emergency, Non-emergency, and Fee Basis Care http://www1.va.gov/opa/vadocs/fedben.pdf

Environmental Agents http://www1.va.gov/environagents/

Environmental Agents M10 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1002

Establishing Combat Veteran Eligibility http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=315

EVALUATION PROTOCOL FOR GULF WAR AND IRAQI FREEDOM VETERANS WITH POTENTIAL EXPOSURE TO DEPLETED URANIUM (DU) http://www1.va.gov/gulfwar/docs/DUHandbook1303122304.DOC and http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1158

See also, Depleted Uranium Fact Sheet http://www1.va.gov/gulfwar/docs/DepletedUraniumFAQSheet.doc

EVALUATION PROTOCOL FOR NON-GULF WAR VETERANS WITH POTENTIAL EXPOSURE TO DEPLETED URANIUM (DU) http://www1.va.gov/gulfwar/docs/DUHANDBOOKNONGW130340304.DOC

Fee Basis, PRIORITY FOR OUTPATIENT MEDICAL SERVICES AND INPATIENT HOSPITAL CARE http://www1.va..gov/vhapublications/ViewPublication.asp?pub_ID=206 Federal Benefits for Veterans and Dependants 2005 http://www1.va.gov/opa/vadocs/fedben.pdf OR, http://www1.va..gov/opa/vadocs/current_benefits.htm

Forms and Records Request http://www.va.gov/vaforms/

General Compensation Provisions http://www.access.gpo.gov/uscode/title38/partii_chapter11_subchaptervi_.html

Geriatrics and Extended Care http://www1.va.gov/geriatricsshg/

Guideline for Chronic Pain and Fatigue MUS-CPG http://www.oqp.med.va.gov/cpg/cpgn/mus/mus_base.htm

Guide to Gulf War Veteran’s Health http://www1.va.gov/gulfwar/docs/VHIgulfwar.pdf

Gulf War Subject Index http://www1.va.gov/GulfWar/page.cfm?pg=7&template=main&letter=A

Gulf War Veteran’s Illnesses Q&As http://www1.va.gov/gulfwar/docs/GWIllnessesQandAsIB1041.pdf

Hearings

http://www.warms.vba.va.gov/admin21/m21_1/mr/part1/ch04.doc

Homeless Veterans http://www1.va.gov/homeless/

HSR&D Home http://www.hsrd.research.va.gov/

Index to Disability Examination Worksheets C&P exams http://www.vba.va.gov/bln/21/benefits/exams/index.htm

Ionizing Radiation http://www1.va.gov/irad/

Iraqi Freedom/Enduring Freedom Veterans VBA http://www.vba.va.gov/EFIF/

M 10 for spouses and children < http://www1..va.gov/vhapublications/ViewPublication.asp?pub_ID=1007

M10 Part III Change 1 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1008

M21-1 Table of Contents http://www.warms.vba.va.gov/M21_1.html

Mental Disorders, Schedule of Ratings http://www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_130.DOC

Mental Health Program Guidelines http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1094

Mental Illness Research, Education and Clinical Centers http://www.mirecc.med.va.gov/

MS (Multiple Sclerosis) Centers of Excellence http://www.va.gov/ms/about.asp

My Health e Vet http://www.myhealth.va.gov/

NASDVA.COM http://nasdva.com/

National Association of State Directors http://www.nasdva.com/

National Center for Health Promotion and Disease Prevention http://www.nchpdp.med.va.gov/postdeploymentlinks.asp

Neurological Conditions and Convulsive Disorders, Schedule of Ratings http://www.warms.vba.va.gov/regs/38cfr/bookc/part4/s4%5F124a.doc

OMI (Office of Medical Inspector) http://www.omi.cio.med.va.gov/

Online VA Form 10-10EZ https://www.1010ez..med.va.gov/sec/vha/1010ez/

Parkinson’s Disease and Related Neurodegenerative Disorders http://www1.va.gov/resdev/funding/solicitations/docs/parkinsons.pdf

and, http://www1va.gov/padrecc/

Peacetime Disability Compensation http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=browse_usc&docid=Cite:+38USC1131

Pension for Non-Service-Connected Disability or Death http://www.access.gpo.gov/uscode/title38/partii_chapter15_subchapteri_.html and, http://www.accessgpo.gov/uscode/title38/partii_chapter15_subchapterii_.html

and, http://www.access.gpo.gov/uscode/title38/partii_chapter15_subchapteriii_.html

Persian Gulf Registry http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1003

This program is now referred to as Gulf War Registry Program (to include Operation Iraqi Freedom) as of March 7, 2005: http://www1..va.gov/vhapublications/ViewPublication.asp?pub_ID=1232

Persian Gulf Registry Referral Centers http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1006

Persian Gulf Veterans’ Illnesses Research 1999, Annual Report To Congress http://www1.va.gov/resdev/1999_Gulf_War_Veterans’_Illnesses_Appendices.doc Persian Gulf Veterans’ Illnesses Research 2002, Annual Report To Congress http://www1.va.gov/resdev/prt/gulf_war_2002/GulfWarRpt02.pdf

Phase I PGR http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1004

Phase II PGR http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1005

Policy Manual Index http://www.va.gov/publ/direc/eds/edsmps.htm

Power of Attorney http://www.warms.vba..va.gov/admin21/m21_1/mr/part1/ch03.doc Project 112 (Including Project SHAD) http://www1.va.gov/shad/

Prosthetics Eligibility http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=337

Public Health and Environmental Hazards Home Page http://www.vethealth.cio.med.va.gov/

Public Health/SARS http://www..publichealth.va.gov/SARS/

Publications Manuals http://www1.va.gov/vhapublications/publications.cfm?Pub=4

Publications and Reports http://www1.va.gov/resdev/prt/pubs_individual.cfm?webpage=gulf_war.htm

Records Center and Vault Homepage http://www.aac.va.gov/vault/default.html

Records Center and Vault Site Map http://www.aac.va.gov/vault/sitemap.html

REQUEST FOR AND CONSENT TO RELEASE OF INFORMATION FROM CLAIMANT’S RECORDS http://www.forms.va.gov/va/Internet/VARF/getformharness.asp?formName=3288-form.xft

Research Advisory Committee on Gulf War Veterans Illnesses April 11, 2002 http://www1.va.gov/rac-gwvi/docs/Minutes_April112002.doc

Research Advisory Committee on Gulf War Veterans Illnesses

http://www1.va.gov/rac-gwvi/docs/ReportandRecommendations_2004.pdf

Research and Development http://www.appc1.va.gov/resdev/programs/all_programs.cfm

Survivor’s and Dependents’ Educational Assistance http://www.access.gpo.gov/uscode/title38/partiii_chapter35_.html

Title 38 Index Parts 0-17

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?sid=1b0c269b510d3157fbf8f8801bc9b3dc&c=ecfr&tpl=/ecfrbrowse/Title38/38cfrv1_02.tpl

Part 18

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?sid=1b0c269b510d3157fbf8f8801bc9b3dc&c=ecfr&tpl=/ecfrbrowse/Title38/38cfrv2_02.tpl

Title 38 Part 3 Adjudication Subpart A “Pension, Compensation, and Dependency and Indemnity Compensation http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=1b0c269b510d3157fbf8f8801bc9b3dc&tpl=/ecfrbrowse/Title38/38cfr3_main_02.tpl

Title 38 Pensions, Bonuses & Veterans Relief (also �§ 3.317 Compensation for certain disabilities due to undiagnosed illnesses found here) http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=1b0c269b510d3157fbf8f8801bc9b3dc&tpl=/ecfrbrowse/Title38/38cfr3_main_02.tpl Title 38 PART 4–SCHEDULE FOR RATING DISABILITIES Subpart B–DISABILITY RATINGS

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=ab7641afd195c84a49a2067dbbcf95c0&rgn=div6&view=text&node=38:1.0.1.1.5.2&idno=38

Title 38§ 4.16 Total disability ratings for compensation based on unemployability of the individual. PART A “SCHEDULE FOR RATING DISABILITIES Subpart �”General Policy in Rating http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=1b0c269b510d3157fbf8f8801bc9b3dc&rgn=div8&view=text&node=38:1.0.1.1.5.1..96.11&idno=38

U.S. Court of Appeals for Veterans Claims http://www.vetapp.gov/

VA Best Practice Manual for Posttraumatic Stress Disorder (PTSD) http://www.avapl.org/pub/PTSD%20Manual%20final%206.pdf

VA Fact Sheet http://www1.va.gov/opa/fact/gwfs.html

VA Health Care Eligibility http://www.va.gov/healtheligibility/home/hecmain.asp

VA INSTITUTING GLOBAL ASSESSMENT OF FUNCTION (GAF) http://www.avapl.org/gaf/gaf.html

VA Life Insurance Handbook ¬” Chapter 3 http://www.insurance.va.gov/inForceGliSite/GLIhandbook/glibookletch3.htm#310

VA Loan Lending Limits and Jumbo Loans http://valoans.com/va_facts_limits.cfm

VA MS Research http://www.va.gov/ms/about.asp

VA National Hepatitis C Program http://www.hepatitis.va.gov/

VA Office of Research and Development http://www1.va.gov/resdev/

VA Trainee Pocket Card on Gulf War http://www.va.gov/OAA/pocketcard/gulfwar.asp

VA WMD EMSHG http://www1.va.gov/emshg/

VA WRIISC-DC http://www.va.gov/WRIISC-DC/

VAOIG Hotline Telephone Number and Address http://www.va.gov/oig/hotline/hotline3.htm

Vet Center Eligibility – Readjustment Counseling Service http://www.va.gov/rcs/Eligibility.htm

Veterans Benefits Administration Main Web Page http://www.vbava.gov/

Veterans Legal and Benefits Information http://valaw.org/

VHA Forms, Publications, Manuals http://www1.va.gov/vhapublications/

VHA Programs – Clinical Programs & Initiatives http://www1.va.gov/health_benefits/page.cfm?pg=13 http://webmaila.juno.com/webmail/new/UrlBlockedError.aspx>

VHA Public Health Strategic Health Care Group Home Page http: // www.publichealth.va.gov/

VHI Guide to Gulf War Veterans ¬(tm) Health http://www1.va.gov/vhi_ind_study/gulfwar/istudy/index.asp

Vocational Rehabilitation http://www.vba.va.gov/bln/vre/

Vocational Rehabilitation Subsistence http://www.vba.va.gov/bln/vre/InterSubsistencefy04.doc

VONAPP online http://vabenefits.vba.va.gov/vonapp/main.asp

WARMS – 38 CFR Book C http://www.warms.vba.va.gov/bookc.html

Wartime Disability Compensation http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=browse_usc&docid=Cite:+38USC1110

Welcome to the GI Bill Web Site http://www.gibill.va.gov/

What VA Social Workers Do http://www1.va.gov/socialwork/page.cfm?pg=3

WRIISC Patient Eligibility http://www.illegion.org/va1.html

Print this out and save it in your VA files. There may be a time for use in the future.

Apply in Advance for Burial Eligibility in a VA National Cemetery

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Apply in Advance for Burial Eligibility in a VA National Cemetery

VA’s new pre-need eligibility determination program allows you to find out in advance if you are eligible for burial in a VA national cemetery.This allows families to plan ahead, and streamlines access to the burial benefits that Veterans have earned through military service for themselves and their eligible family members.Want more information about this new program? Visit ExploreVA or click the button below to learn how to apply in advance for burial in a VA national cemetery.

Here is the direct link: https://explore.va.gov/memorial-benefits?utm_source=govdelivery&utm_medium=email&utm_campaign=april-memorial-monthly_4.5&utm_term=body-button-page&utm_content=memorial-application-all-null

VA Individual Unemployability Update 04 ►  No Cuts in 2018

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VA Individual Unemployability Update 04 ►  No Cuts in 2018

Months after Veterans Affairs officials dropped plans for a controversial benefits cut, the families of those who would have been affected still fear they could lose thousands in monthly payouts. Confusion over the short-lived plan this week forced department leaders to issue a letter to veterans groups clarifying they will not change the Individual Unemployability program in fiscal 2018, and are looking for other cost-saving solutions in the future. “The department does not support a termination of [the program],” VA Secretary David Shulkin wrote in a letter to veterans groups Thursday. “We are committed to finding ways that empower disabled veterans through vocational rehabilitation and employment opportunities.”

Advocates praised the move, noting they have been inundated with questions about the potential cut, even months after Shulkin said the department was abandoning the proposal. At issue is a provision in the federal budget plan unveiled by the White House last spring. Included in plans for a $186.5 billion VA budget for fiscal 2018 was a provision to dramatically change eligibility rules for the IU program, which awards payouts at the 100-percent disabled rate to veterans who cannot find work due to service-connected injuries, even if their actual rating decision is less than that. The program is essentially an unemployment benefit for veterans not officially labeled as unable to work.

Administration officials had considered stopping those payouts once veterans become eligible for Social Security retirement benefits, arguing that retirement-age individuals should no longer qualify for unemployment payouts. Veterans ineligible for Social Security would be exempt. The move would have saved $3.2 billion next year alone. But it also would have taken away thousands of dollars annually from up to 210,000 veterans over the age of 60, a move which veterans groups decried as devastating. After a public outcry, Shulkin publicly dropped the idea in June. “The budget is a process, and it became clear this [plan] would hurt some veterans,” he told lawmakers during a Senate hearing. “I’m not going to support policies that hurt veterans.”

But concerns about a potential cut have lingered. Leaders from veterans groups said they have received numerous letters and calls in recent months from veterans who still believe the cuts are under consideration. Shulkin’s latest letter is designed to end that speculation. In it, he promises to continue working with veterans groups on future changes to the program. Administration officials have said they want to re-examine the IU program in the future but don’t want that debate to take away from other budget priorities. The federal government is currently operating under a three-month extension of the fiscal 2017 budget. Congress must find a long-term solution or a short-term fix for the funding fight by mid-December, or trigger a partial government shutdown.  [Source:  MilitaryTimes |  Leo Shane III | October 13, 2017 ++]

VA Rating Criteria ► Review & Update | Dental and Oral Conditions

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VA Rating Criteria ► Review & Update | Dental and Oral Conditions

If you’ve ever wondered how VA rates disabilities for compensation, you’ll be interested to know that after more than 70 years they are doing a review and update of the rating criteria for all 15 body systems. Previous updates have been done as needed, but this is the first comprehensive review of the VA Schedule for Rating Disabilities. https://www.benefits.va.gov/WARMS/bookc.asp.  The first of these updates, for Dental and Oral Conditions, went into effect 10 SEP. This update includes updated medical terms, new diagnostic codes for conditions previously rated under other conditions, and added disability levels. No existing dental or oral conditions were removed.

Often referred to as the “VASRD” or rating schedule, directs claims processors on how to assess the severity of disabilities related to military service. While VA has routinely updated parts of the VASRD, for the first time since 1945, VA is updating the entire rating schedule to more accurately reflect modern medicine. Since 2009, subject matter experts, including physicians, reviewed each of the 15 body systems that make up the VASRD. This effort is part of VA’s continued commitment to improving the delivery of disability compensation benefits to Veterans and modernizing our systems.

If you have a claim or appeal pending for a dental or oral condition before Sept. 10, 2017, VA will consider both the old and new rating criteria when making a decision. All claims for dental or oral conditions received by VA on or after Sept. 10 will be rated under the new rating criteria.  If you are already service-connected for a dental or oral condition and submit a claim for increase, your disability rating may increase (or decrease) based on the new rating criteria. However, VA will not change your disability rating just because of the update to the rating criteria.  In the coming months, more body systems will be updated until all 15 are modernized, ensuring VA provides the most accurate ratings for disability compensation claims based on modern medicine.   [Source: VAntage Point  | September 8, 2017 ++]

VA Burial Benefits: The VA offers two different types of Burial Benefits when a Veteran passes away

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VA Burial Benefits: The VA offers two different types of Burial Benefits when a Veteran passes away-

Service Connected Burial Benefit– If a Veteran passes away from a service connected condition or a presumptive condition that was not previously claimed, the VA will pay a one-time payment of $2,000.

Non-Service Connected Burial Benefit– If a Veteran is in receipt of a monetary award from the VA (VA Disability Compensation or Non-Service Connected Pension) or passes away at a VA Medical Center or VA Contract Care Facility while enrolled in VA Medical Care, the VA will pay a one-time payment of $300 and possibly reimburse the person who paid for the funeral the cost of transportation of remains from the place of death to the funeral home as long as the amount is broken out in the itemized funeral bill.

Plot Allowance– The VA will pay a $749 Plot Allowance for internment costs of the Veteran as long as the Veteran is eligible for receipt of service connected or non-service connected burial benefits. The VA will pay the $749 Plot Allowance to a State Veteran Cemetery for internment of a Veteran regardless of eligibility of the Service Connected or Non-Service Connected Benefit.

Survivor’s Benefits– There are two different Survivor Benefits that a Surviving Spouse/Child under 18 (or unmarried child enrolled in school under the age of 23)/or Adult Helpless Child of the Veteran may be eligible for:

Dependency Indemnity Compensation (DIC)– DIC is paid to an eligible spouse/dependent if the Veteran passed away from a service connected condition, a previously unclaimed presumptive condition, or from any condition if the Veteran was rated 100% (or Individual Unemployability) for 10 years or longer. Note- The Spouse had to be married to the Veteran for at least one year prior to the Veteran’s death and will lose the DIC award if they remarry before the age of 57. If they do remarry before age 57 and lose the DIC Award and that subsequent marriage ends in divorce or death, the Surviving Spouse may file for DIC again due to the Veteran’s passing.

– Basic DIC Rate is $1,257.95/Month

– If the Veteran was rated 100% (or I.U.) for 8+ years and married to the same spouse for at least 8 years, the Spouse will receive an additional $267.12/month

– If the Surviving Spouse is entitled to the Aid and Attendance Rate (Based upon the need of help

With activities of daily living), the spouse will receive an additional $311.64/month.

** Note- If the Veteran was a DOD Retiree and paid into the DFAS Survivor Benefit Plan (SBP) (6% of the monthly retired pay which allows the Surviving Spouse to receive 55% of the Veteran’s Retired Pay at the time of their death) and also qualifies for DIC based upon a service connected cause of death, the current Federal Law does not permit payments of both SBP and DIC. The current Federal Law only allows the payment of the greater amount and possibly the SBP/DIC Offset which is currently $310/month.

Survivor’s Pension– This is the only other type of Survivor Benefit. To be eligible, the Veteran had to have wartime service, had to have at least 90 days of active duty service before 1980 or at least 2 years after 1980, been married to the surviving spouse for at least one year prior to the Veteran’s passing, and then meet the financial requirements of having less than $80k in assets (not to include the spouse’s primary residence). Assets include additional houses, excessive property, amounts in checking/savings accounts, IRAs, stocks, bonds, mutual funds, trusts, etc… If below the $80k threshold, the VA will determine the Pension Rate that the spouse would be eligible for. Once the rate is determined, the surviving spouse’s annual income- which includes all sources of income to include Social Security (which will be adjusted by subtracting recurring monthly medical costs) must be below the Maximum Annual Pension Rate for that specific level of Pension. Note- If a surviving Spouse remarries after the death of the Veteran, they will lose the Pension and can never claim it again regardless of what happens to the subsequent marriage.

– Basic Pension Rate– If the surviving spouse can live on their own and take care of themselves.

Maximum Annual Pension Rate is $8,656.00/year

– Housebound Rate– If the surviving spouse can live on their own and take care of themselves but are indoors all day and need help to leave their residence.

Maximum Annual Pension Rate is $10,580.00/year

Aid and Attendance Rate– If the Surviving Spouse requires assistance from someone else to Take care of activities of daily living (Bathing, dressing, feeding, etc…) then the cost of Home Healthcare, Assisted Living or Skilled Nursing can be counted as recurring monthly medical Expenses. This is the only level that these costs will be counted as medical expenses.

Maximum Annual Pension Rate is $13,836.00/year

The VA will never pay above the Maximum Annual Pension Rate for the level that they qualify for. For example, if a spouse is entitled to pension at the A&A Rate and the cost of assisted living is more than his/her income, the VA will pay $13,836.00/year or $1,153.00/month.

VA Health Care Access Update 57►   Tips to Reduce Wait Time

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VA Health Care Access Update 57►   Tips to Reduce Wait Time

Wait times at Veterans Affairs medical centers continue to be an issue. Here are a few tips to help save you time and energy as you manage your way through the VA:

  1. Schedule your appointment first thing in the morning or right after lunch. Many doctors, outside of the VA, are bound by quotas and have to see as many patients as possible. VA doctors focus on quality instead of quantity. Because of this, they tend to run over scheduled times. Making an appointment for either first thing in the morning all but guarantees that you’ll be seen on time.
  1. Have a referral to a specialty clinic? Schedule that appointment yourself! Don’t wait around for the clinic to call you, this could take a while. Sometimes the VA just automatically schedules you for your appointment, but you can always take control of this. Ask the physician or nurse for the number to the clinic. You can either call or go there in person and let them know you have a referral and set up an appointment time that works best for you.
  1. Ask for an appointment tomorrow. According to the VA, the majority of veterans receive their appointments within 14 days of the desired date. That’s a rather odd statement because when was the last time you were asked and not told when you could have your appointment? It never hurts to ask for a specific appointment time and from what I hear, it works a good amount of times too.
  1. Use MyHealtheVet (https://www.myhealth.va.gov/mhv-portal-web/home)  secure messenger to talk to your physician. Need an appointment? Just have a question? Need to check your appointment schedule? Want to refill your meds? You can do all of this by downloading the VA’s MyHealtheVet app. Every VA facility has a coordinator who can help you with any issues that come up with the app and most staff can help you if you have a technical problem. If you haven’t tried this yet, from what I hear it’s a game changer!
  1. Choose a different VA. You have the right to go to any VAMC you choose. If you don’t like the one closest to you, try another one. You can use the VA’s Access to Care site to check wait times for all VA facilities. And this breaks down into types of care too.
  1. Go to the emergency room if you need anything. If you can’t wait, use the emergency room at the VAMC closest to you. If they can’t help you, they’ll at least get a referral in for you. This isn’t something you should do every time you need to see a doctor! But if your condition is getting worse, go get help!
  1. Use the kiosks. You can check in for an appointment or look for future ones by using one of these kiosks. They are in VAMC’s and outpatient clinics. Most facilities have staff that will show you how they work. Soon you’ll even be able to pay your copay through one as well! The kiosk will even tell you if you’re in the right place or not.
  1. Prepare and double check! Show up with a list of questions written out. Check them off as you go over each one with your doctor. Take notes and then verify that the physician did enter the referrals if any are needed.
  1. Have a problem? Tell someone about it! Every VAMC has quarterly town hall meetings that you can attend. These meetings are held specifically so you can talk to leadership and give feedback. The majority of VA employees want to help you so let them!

[Source: CBS News Radio | Andrea Estes | October 9, 2017 ++]

VA Rating Criteria ► Review & Update | Dental and Oral Conditions

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VA Rating Criteria ► Review & Update | Dental and Oral Conditions

If you’ve ever wondered how VA rates disabilities for compensation, you’ll be interested to know that after more than 70 years they are doing a review and update of the rating criteria for all 15 body systems. Previous updates have been done as needed, but this is the first comprehensive review of the VA Schedule for Rating Disabilities. https://www.benefits.va.gov/WARMS/bookc.asp.  The first of these updates, for Dental and Oral Conditions, went into effect 10 SEP. This update includes updated medical terms, new diagnostic codes for conditions previously rated under other conditions, and added disability levels. No existing dental or oral conditions were removed.

Often referred to as the “VASRD” or rating schedule, directs claims processors on how to assess the severity of disabilities related to military service. While VA has routinely updated parts of the VASRD, for the first time since 1945, VA is updating the entire rating schedule to more accurately reflect modern medicine. Since 2009, subject matter experts, including physicians, reviewed each of the 15 body systems that make up the VASRD. This effort is part of VA’s continued commitment to improving the delivery of disability compensation benefits to Veterans and modernizing our systems.

If you have a claim or appeal pending for a dental or oral condition before Sept. 10, 2017, VA will consider both the old and new rating criteria when making a decision. All claims for dental or oral conditions received by VA on or after Sept. 10 will be rated under the new rating criteria.  If you are already service-connected for a dental or oral condition and submit a claim for increase, your disability rating may increase (or decrease) based on the new rating criteria. However, VA will not change your disability rating just because of the update to the rating criteria.  In the coming months, more body systems will be updated until all 15 are modernized, ensuring VA provides the most accurate ratings for disability compensation claims based on modern medicine.   [Source: VAntage Point  | September 8, 2017 ++]