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 Patient
Resource Guide
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Index > Patient Resource Guide > Frequently
Asked Questions
Frequently
Asked Questions & Answers
Q:
Who is eligible for VA health care benefits?
A: Any veteran who served in the
active military, naval or air service, was
discharged or released under honorable conditions,
and falls within priority groups 1-7 has
basic eligibility for VA health care. Priority
group funding may change from year to year,
depending on congressional appropriations.
If VA cannot renew your enrollment for the
following year, you will be notified 60 days
before your current enrollment expires. For
more information about VA health care eligibility,
please contact the Enrollment Center for
the VA Maryland Health Care System at 1-800-463-6295,
extension 7324.
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Q:
If I am enrolled with the VA, what benefits will I receive?
A: Veterans in the VA health care
system will be eligible to receive necessary
hospital and outpatient services, including preventive
and primary care. These include: diagnostic and
treatment services; rehabilitation; mental health
and substance abuse treatment; home health, respite
and hospice care; and drugs in conjunction with
VA treatment.
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Q:
If I enroll for VA health care, what cost will there be for me?
A: There is not a monthly premium required
to use VA care. However, you may have to agree
to pay some co-payments depending on your priority
group and income level. If you have insurance,
it may cover the cost of the co-payments. VA will
bill and receive payment from your insurance company
(if you are covered) for care received for your
nonservice-connected conditions. Veterans with
disability ratings for injury or disease incurred
during military service receive most care without
any cost. For more information about VA co-payments,
please contact your local VA medical center or
outpatient clinic or the Enrollment Center for
the VA Maryland Health Care System at 1-800-463-6295,
extension 7324.
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Q:
Is the VA an insurance policy or an HMO?
A: It is neither. VA health benefits
are established by federal law and regulations
and funded through congressional appropriations.
They are not the same as an insurance contract.
Also, veterans do not pay monthly premiums to receive
VA health care. In addition, you are not required
to use VA as your exclusive health care provider.
If you have private health insurance or are eligible
for other programs such as Medicare, Medicaid or
TRICARE, you may continue to use services under
those programs. If you have other insurance or
HMO coverage, the VA recommends that you should
keep that coverage to provide you with options
and flexibility in the future.
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Q:
I am presently covered by my spouse’s insurance policy.
Do I need to tell VA this when I register?
A: Yes. Regardless of the insurance
company, and no matter how you are enrolled on
the policy, VA has the right to bill that company
for nonservice-connected medical care.
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Q:
Do enrolled veterans have to pay the deductible that their insurance
carrier requires when treated at a VA health care facility?
A: No. VA does not require veterans
to pay those charges. In addition, many insurance
companies will apply VA co-payment charges toward
satisfaction of their annual deductible.
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Q:
Are there any restrictions on getting care in private facilities
at VA expense?
A: Yes. Care in private facilities at
VA expense is provided only under certain circumstances.
To determine if you are eligible for private care
at VA expense, you will need to contact your local
VA medical center or outpatient clinic, or Fee
Services for the VA Maryland Health Care System
at 1-800-949-1003, extension 6980.
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Q:
What about emergency care services?
A: VA provides urgent and emergency
care in VA facilities. The coverage for non-VA
emergency care has a narrow scope. It is designed
as a safety net for veterans who do not have any
way to pay for emergency health care services.
If you are treated at a civilian facility for a
non-emergency, you will not be covered under this
benefit. To be eligible for emergency room coverage,
veterans must have no other form of health coverage,
including Medicare or Medicaid. They must be enrolled
in VA’s health care system and have been
seen by a VA health care professional within the
past 24 months. The civilian facility typically
files the paperwork to be reimbursed by VA. For
information about VA’s emergency care benefits,
contact your local VA medical center or outpatient
clinic, or Fee Services for the VA Maryland Health
Care System at 1-800-949-1003, extension 6980.
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Q:
What if I get sick while on travel?
A: You may receive health care at any
VA health care facility in the country. To minimize
any “out-of-pocket”expenses while traveling,
you should familiarize yourself with the location
of any VA health care facilities in the area where
you will be traveling. VA’s authority to
reimburse you for care in non-VA facilities is
very limited. For a listing of VA health care facilities
throughout the country, you can contact the VA
Health Benefits Service Center at 1-877-222-8387
or visit the VA web site at www.va.gov/health_benefits/ and
click on “Locate a VA Medical Center.”
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Q:
Will VA take care of my nursing home and other long-term care
needs?
A: Nursing home care in VA or private
nursing homes may be provided to certain veterans
as space and resources permit. Other long-term
care benefits that may be available to eligible
veterans include domiciliary care, adult day health
care, geriatric evaluation and respite care. Some
veterans may be required to pay a co-payment for
nursing home and other long-term care services.
To determine if you are eligible for VA nursing
home care and other long-term care services or
to find out if you will be required to pay a co-payment,
you will need to contact the VA Maryland Health
Care System Long-Term Care Information Line at
1-800-949-1003, extension 1121, or the VA Health
Benefits Service Center at 1-877-222-8387.
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Q:
Can I get free prescriptions from VA?
A: Medications are provided to veterans
receiving care from VA health care 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
doctor or for patients being treated as a TRICARE
beneficiary. Additionally, some veterans may have
to pay a co-payment for their prescriptions from
VA.
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Q:
If enrolled, can I get dental care?
A: In general, dental benefits are limited
to service-connected dental conditions, to veterans
who are permanently and totally disabled from service-connected
causes or to veterans who are former prisoners
of war. For specifics, contact your local VA medical
center or outpatient clinic, or the Enrollment
Center for the VA Maryland Health Care System at
1-800-463-6295, extension 7324.
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Q:
Does VA provide hearing aids and eyeglasses?
A: Yes, if you are receiving VA care
and you are service-disabled with a disability
rating of 10% or more or you are a Purple Heart
recipient or a former prisoner of war. Otherwise,
hearing aids and eyeglasses will only be provided
in special circumstances, and not for generally
occurring hearing or vision loss.
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Q:
Does VA provide maternity services?
A: VA does provide maternity care, but
cannot provide care to a newborn child, even in
the immediate aftermath of the birth. The veteran
mother must make arrangements for payment for the
care of the child.
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Q:
Are there any limits on days of hospital care or outpatient visits
VA will provide?
A: No. Your treating physician will
determine what is considered appropriate and necessary
hospital care or outpatient services and will provide
such care consistent with current medical care
practices.
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Q:
Is there someone I can call if I have a health care question?
A: You should contact your VA primary
care provider if you have any questions about your
health care. You can also contact the Telephone
Care Line for the VA Maryland Health Care System
to receive medical advice or to schedule an urgent
appointment by calling 1-800-865-2441.
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Q:
How do I schedule a primary care appointment at a facility in
the VA Maryland Health Care System?
A: After you are enrolled, you can contact
your local VA medical center or outpatient clinic
directly to schedule an outpatient clinic appointment.
Please see the Facility
Address and Phone Number Page for a
listing of phone numbers for all medical centers
and outpatient clinics located throughout the VA
Maryland Health Care System. If you need to schedule
an urgent appointment, please contact the Telephone
Care Line at 1-800-865-2441. If you have a life-threatening
emergency, please dial 911.
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Q:
How do I find out about service-connected benefits other than
health care?
A: To find out about your service-connected
benefits other than health care, contact the Veterans
Benefits Admin-istration at 1-800-827-1000.
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