The following information is taken directly from VA Information --- everything except the phone number you need to call.
At some time in your life, you may need emergency care. This information explains what the VA might be able to do for you if you need emergency care. When it is not possible for you to go to a VA medical center, you should go to the nearest hospital that has an emergency room. If you are in an ambulance, the paramedics will usually take you to the closest emergency. Here is what you should know……
What is an emergency?
A medical emergency is when you have an injury or illness that it so severe that without immediate treatment, the injury or illness threatens your health of life.
How do I know my situation is an emergency?
Use your best judgment. If you believe your health or life is in danger call 911 or go to the nearest emergency room.
If I believe my life or health is in danger, do I need to call the VA before I call for an ambulance or go into an emergency room?
NO. Call 911 or go to the nearest emergency room right away.
Do I need to notify the VA after an ambulance takes me to an emergency room, or when I am treated and released?
YES. You, your family, friends or hospital staff should contact the nearest VA medical center as soon as possible – preferably within 72 hours, so you are better aware of service the VA may limit payment for. Provide the VA with information about your emergency event and services being provided to you. Ask the VA for guidance on how they will consider reimbursing these emergency charges on your behalf, so you can plan accordingly.
1-888-795-0773
If the doctor then wants to admit me to the hospital, must I obtain advance approval from the VA?
If the admission is an emergency, NO; although prompt notification of the VA is necessary.
If the admission is not an emergency, YES. You MUST contact the VA.
1-888-795-0773
If a VA bed is available and I can be safely transferred, do I have to move to the VA hospital?
YES. If you refuse to be transferred, the VA will not pay for any future care.
If I am admitted to the hospital as a result of an emergency, how much will VA pay?
This depends on your VA eligibility. The VA may pay all, some or none of the charges. Ask your local VA medical center’s patient benefits counselor about what is allowed under non-VA emergency care programs:
Remember this number: 1-888-795-0773
Will I have to pay for any part of my emergency care?
It is possible. Sometimes co-pays are required based on you VA enrollment. Sometimes the extent of healthcare services reimbursable by the VA are limited by federal law.
Will VA pay for the ambulance and any possible emergency room charges if I leave the emergency room before being treated by a doctor?
Probably not. If you leave the emergency room prior to being treated by a physician, the VA may not consider claims for that emergency event. You may be liable for some or all resulting ambulance and emergency room charges, regardless of your Veteran eligibility.
Does my enrollment in the VA Health Care System affect my eligibility for emergency care at VA expense?
YES. Your local VA medical center’s benefits counselor can explain how enrollment (or other special status categories) affect your eligibility.
But remember this number: 1-888-795-0773
If I have other insurance (TRICARE, Medicare, Medicaid, Blue Cross, etc.), will it affect whether claims for emergency services will be paid at VA expense?
YES, it may. Your local VA medical center’s benefits counselor can explain how other insurance can affect whether the VA can pay for you non-VA medical claims.
Will VA pay for emergency care if I am in jail?
NO. The VA is prohibited, by federal law, from paying for the medical claims of incarcerated veterans (or fugitive felons).
How long do I have to file a claim for reimbursement for emergency medical care?
File your claim with the nearest VA medical Center quickly. Time limits of 90-days usually apply. Contact your local VA medical center’s patient benefits counselor for more information on the timely filing requirements for non-VA care programs.
Will VA pay for emergency care received outside the United States?
YES, in certain cases. VA will only pay for emergency care outside the US if your emergency is related to a service-connected condition. For more information, contact the VA Health Administration Center at (877) 345-8179 or consult with web site: http://www4.va.gov/hac/forbeneficaries/fmp/fmp.asp
Don't forget. Your authorization comes from 1-888-795-0773.
RETURN TO Newspage