Va Health Care Copays



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Pay Your VA Bill Online. It's fast, easy, and secure. Veterans can pay the balance of their VA bills from the comfort of their own home: no more writing checks or driving to the local VA to make a payment. Pay.Gov is the secure, free, fast and easiest way to pay your VA health care and prescription copayments online. Veterans may be charged a copayment for urgent care that is different from other VA medical copayments. Copayments depend on the Veteran’s assigned priority group and the number of times an urgent care provider is visited in a calendar year. Copayment charges are billed separately by VA as part of VA’s billing process.

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Preventive Care During COVID-19

Why should I keep in touch with my health care team?

The COVID-19 pandemic continues to affect all aspects of life. It has disrupted regular appointments with your health care team. You may have been connecting with them virtually instead using telephone, video, or secure messaging in My HealtheVet.
Without your regular appointments, important services may have been delayed. These services, known as preventive care, include things like vaccines, screening tests, and wellness checks. They help keep you healthy and prevent diseases. VA is reaching out to Veterans to talk about ways to meet your preventive care needs during the COVID-19 pandemic.

Why is preventive care important?

Staying up to date with your screening tests, immunizations and other wellness checks can help you:
  • Stay healthy and active.
  • Prevent serious complications, hospitalizations and even death from certain infections.
  • Check for health conditions before symptoms or problems start.
  • Help manage any long-term health conditions.


What preventive services are important for me?

Every person is different. Talk with your health care team to decide which preventive services are important for you. You can also take a look at the VA recommendation charts for men and women at www.prevention.va.gov.
Depending on your age, sex, health status, and family history, your health care team may be checking to see if you’re up to date on some of the following common preventive care services:
  • Screening for high blood pressure
  • Annual flu shot
  • Colorectal cancer screening
  • Mammogram
  • Cervical cancer screening
  • Mental Health screenings
  • Other relevant health and safety checks
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If you have diabetes, your health care team may also check your feet, eyes, kidneys, and blood glucose (sugar) level to make sure you’re staying well. If you have other long-term health issues, your health care team may ask to do other types of health or wellness checks.

How else can my health care team help me?

The COVID-19 pandemic has been physically and emotionally draining for many people. Your health care team can connect you with any needed resources.
This has been a challenging time, and you are not alone. If you or a loved one has thoughts about death or suicide, call 911 or the Veterans Crisis Line at 800-273-TALK (800-273-8255) and press 1. You can also chat with a trained responder or access other resources at www.VeteransCrisisLine.net.

What should I do next?

Contact your health care team to set up an appointment. Visit www.veteranshealthlibrary.va.gov to learn more about the importance of staying healthy and taking charge of your health.

When receiving VA health care, some veterans must make copays. Arm yourself with this knowledge before you need it, and add these expenses to your monthly budget and emergency fund as required.

Inpatient Care
Priority Group 7 (and certain other) veterans will pay 20 percent of the VA’s inpatient copay or $204.80 for the first 90 days of inpatient hospital care during any 365-day period. The charge decreases to $102.40 for each additional 90 days. Additionally, there is a $2 per diem charge.

The copay increases significantly for Priority Group 8 (and certain other) veterans. For the first 90 days of care during any 365-day period, the veteran is responsible for the VA’s inpatient copay of $1,024 and $10 per day. For each additional 90 days, the copay is $512 plus a $10 per diem charge.

Extended Care
The extended care copay amount is based on each veteran’s financial situation and will range from $0 to $97 per day. The copay determination is based on the information supplied by the veteran when completing a VA Form 10-10EC. VA social workers can help you interpret your eligibility and copay requirements.

Medication
For each 30-day or less supply of medication provided by VA for conditions that are not service-connected, most veterans are charged an $8 copay. The maximum copay for medications in 2008 is $960 for Priority Groups 2 through 6.

Some veterans are not charged copays for medication. These groups include:

  • veterans with a service-connected disability of 50 percent or more
  • veterans receiving medication for service-connected conditions
  • veterans whose annual income does not exceed the maximum annual rate of the VA pension
  • veterans enrolled in Priority Group 6 who receive medication under their special authority
  • veterans receiving medication for conditions related to sexual trauma related to service on active duty
  • certain veterans receiving mediation for treatment of cancer of the head or neck
  • veterans receiving medication for a VA-approved research project
  • former POWs

Va Copayment 2020 Pdf

Outpatient Care
For outpatient care services, a three-tiered copay system is used. Certain services are not charged copay. The copay is $15 for a primary care visit and $50 for some specialized care.

Va Medical Care Copayment

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