Veterans’ Affairs Healthcare and Prescription Drug Benefits

Veterans’ Affairs Healthcare Eligibility

To qualify for Veterans’ Affairs (VA) health care benefits, you must meet basic eligibility requirements. If you have a service-related disability you are eligible for VA health care benefits automatically for care in connection with your service-connected condition.

Depending on the circumstances of your service, your income level, and your level of disability rating, you will either qualify for free services or you will have to make copayments. In general, if you have a service-connected disability that is rated 50% or more, or you have been exposed to certain environmental or biological warfare, you will receive free healthcare through the VA. Otherwise, you will have to pay a copayment for all or some of the services provided.

VA Healthcare Benefits

Your benefits package typically covers preventative care, inpatient and outpatient medical, surgical and mental health services, prescription drug coverage, as well as home health care, long-term health care and hospice care. VA Benefits also cover other services on a more limited basis, such as dental care, eyeglasses, hearing aids, travel expenses to medical appointments, prosthetic devices and durable medical equipment and ambulance services.

The basic coverage also includes additional services for certain types of individuals and situations, such as the Women Veterans Program, the Blind Veterans Program, Readjustment Counseling, Bereavement Counseling and Military Sexual Trauma Counseling. Certain services are not covered by VA benefits, including cosmetic surgery that is not medically required, abortions, gender alterations, in-vitro fertilization, health club memberships, and drugs not approved by the FDA.

The VA has its own healthcare system that is run by the federal government. In general, you must use an authorized VA provider for your medical treatment, but sometimes the VA will authorize services by a non-VA provider, such as in an emergency situation, or when the VA facility cannot provide the services you need or you are unable to travel to the VA provider. If you use a non-VA facility, you will pay for the treatment and then seek reimbursement from the VA.

Legal Editor: Kent Eiler, City Bar Justice Center