How the Veterans Health Care Package Works
As a veteran, you are entitled to receive health care under the VA's medical benefits package, as long as you meet the VA's eligibility requirements for the medical benefit you are seeking (this is true, even if your medical condition is not service-related).
Once enrolled in the VA's medical benefits program, you’re assigned to the VA medical center closest to where you live. The fine folks who work there become your primary provider, and you receive most of your medical care from that VA medical facility or one of its outpatient clinics.
This doesn’t mean you get all your care from the facility to which you’re assigned. If your chosen facility can’t provide the care you need in a reasonable period of time, it can refer you to another facility that can meet your needs.
You can also use your VA health care benefits when you travel. That’s right, they’re portable! Enrolled veterans who are traveling or who spend time away from their primary treatment facility may obtain care at any VA health care facility across the country without having to reapply.
What’s covered under the VA health care package
Like other standard health care plans, the VA Medical Benefits Package emphasizes preventive and primary care, offering a full range of outpatient and inpatient services, including:
Outpatient and inpatient medical, surgical, and mental health care, including care for substance abuse
Prescription drugs, including over-the-counter drugs and medical and surgical supplies, when prescribed by a VA physician
You can get the VA to fill prescriptions prescribed by a private physician if your primary VA provider is provided with your medical records and agrees with the medication prescribed.
Physical examinations, health care assessments, and screening tests
Health education programs
Emergency care in VA facilities
To have the VA pay for emergency care in non-VA facilities, you must meet the criteria. For example, you can be treated for a disability or medical condition that the VA has already determined is connected with your service, provide that no VA health care facility is readily available, your life or health is in danger, and you're personally liable for the care.
You may also be eligible to be reimbursed for emergency care, even when the condition is non-service related, if immediate care was needed, no VA facility was nearby, and you have no other insurance.
Dental care for eligible veterans
Bereavement counseling for veterans and (their spouses, children, and parents, if the veteran died while in service)
Comprehensive rehabilitative services other than the vocational services
For example, blind veterans can receive training to help them adjust.
Blind veterans also qualify for home adaptation, electronic and medical aids, and guide dogs.
Disabled veterans may qualify for assistance in purchasing an adaptive automobile, if there is a service-connected loss or permanent loss of one or both hands, feet, knees, or hips, or a permanent loss of vision.
Consultation, professional counseling, training, and mental health services for the veteran’s immediate family members or legal guardian
Durable medical equipment and prosthetic and orthotic devices. This includes eyeglasses and hearing aids for eligible veterans.
Reconstructive (plastic) surgery required as a result of a disease or trauma, but not including cosmetic surgery that’s not medically necessary
Respite, hospice, and palliative care
Pregnancy and delivery service, to the extent authorized by law. This means the VA can provide services to the pregnant veteran, up to and including delivery, but can’t provide free services for the child. The veteran must reimburse the VA for any services associated with the child after birth.
The VA provides counseling and treatment to help male and female veterans overcome psychological trauma resulting from sexual trauma while serving on active duty. This counseling is usually conducted at VA vet centers.
In addition to counseling for sexual trauma, related services are available at VA medical facilities. You don’t have to enroll in the VA health care program to receive these services. Veterans can receive care at no charge for conditions related to military sexual trauma.
What’s not covered under the Veterans Affairs medical benefits package
The preceding list of covered services probably seems to include everything but the kitchen sink, right? It really doesn’t. Under current laws, the VA isn’t allowed to provide the following services:
Abortions and abortion counseling
Cosmetic surgery except where determined by the 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
Health club or spa membership
In vitro fertilization
Services not ordered and provided by licensed or accredited professionals
Special private-duty nursing
Hospital and outpatient care for a veteran who is a patient or inmate in an institution of another government agency if that agency is required to provide care or services
Emergency care in non-VA facilities, except as explained earlier.