A health benefits plan is generally available to all enrolled veterans. Like other standard health care plans, the Medical Benefits Package emphasizes preventive and primary care, offering a full range of outpatient and inpatient services. The following is a summary of the Veteran's Medical Benefits Package:
Veteran's Medical Benefits Package Eligibility
The Medical Benefits Package is generally provided to all enrolled veterans regardless of your priority group.
The law calls for VA to provide you hospital care and outpatient care services that are defined as "needed". VA defines "needed" as care or service that will promote, preserve, and restore health. This includes treatment, procedures, supplies, or services. This decision of need is based on the judgment of your health care provider and in accordance with generally accepted standards of clinical practice.
The following is a general list of health care services that are provided by VA, and a list of other services that are provided under special authority.
- Outpatient medical, surgical, and mental health care, including care for substance abuse.
- Inpatient hospital, medical, surgical, and mental health care, including care for substance abuse.
- Prescription drugs, including over-the-counter drugs and medical and surgical supplies available under the VA national formulary system.
- Bereavement counseling.
- Comprehensive rehabilitative services other than vocational services.
- Consultation, professional counseling, training, and mental health services for the members of the immediate family or legal guardian of the veteran.
- Durable medical equipment and prosthetic and orthotic devices, including eyeglasses and hearing aids.
- Home health services.
- Preventative Care such as:
- Periodic medical exams
- Health Care Assessments
- Health education, including nutrition education
- Screening Tests
- Reconstructive (plastic) surgery required as a result of a disease or trauma but not including cosmetic surgery that is not medically necessary.
- Respite, hospice, and palliative care.
- Payment of travel and travel expenses for eligible veterans.
- Pregnancy and delivery service, to the extent authorized by law.
- Completion of forms.
- Emergency care in VA facilities.
- Emergency care in non-VA facilities in certain conditions: This benefit is a safety net for veterans requiring emergency care for a service connected disability or 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 can't provide any reimbursement. To qualify for payment or reimbursement for non-VA emergency care service for a service-connected disability, you must meet all of the following criteria:
- You were provided care in a hospital emergency department or similar emergency care facility
- You are enrolled in the VA health care system
- You have been provided care by a VA health care provider within the last 24 months.
- You have no other form of health care insurance including Medicare, Medicaid, or a state program.
- You do not have coverage under any other VA programs.
- You have no other contractual or legal recourse against a third party that will pay all or part of the bill.
- VA or military facilities weren't feasibly available at time of the emergency.
- The care must have been rendered in a medical emergency of such nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health.
VA cannot provide the following services:
- Abortions and abortion counseling
- Cosmetic surgery except where determined by VA to be medically necessary for reconstructive or psychiatric care
- Drugs, biologicals, and medical devices not approved by the FDA unless the treating medical facility is conducting formal clinical trials under an Investigational Device Exemption (IDE) or an Investigational New Drug (IND) application, or the drugs, biologicals, or medical devices are prescribed under a compassionate use exemption.
- Gender alteration
- Health club or spa membership
- In vitro fertilization
- Services not ordered and provided by licensed/accredited professional staff
- Special private duty nursing
- Hospital and outpatient care for a veteran who is either a patient or inmate in an institution of another government agency if that agency has a duty to give the care or services.
How To Apply For VA Health Care
You can apply on the phone by calling 877-222-VETS (8387), Mon-Fri between 8 am and 8 pm, Eastern Time. You can also apply online by visiting the VETS.GOV website.