Can Veterans Get Emergency Care Reimbursement?

Emergency Medical Care for Veterans

In the event of a medical emergency, the last thing you should be thinking about is how you are going to pay for it. It is very important and critical that if you are experiencing a medical emergency, that you seek medical attention immediately from the nearest emergency medical facility, even if it is not at a VA Medical Center. There many veterans who do not live close to a VA Medical Center so they have no other choice but to go to a local emergency medical facility. The VA can pay for a veteran’s emergency medical care at a non-VA medical facility. In order to qualify, a veteran must meet a certain set of requirements.

The VA states that a veteran’s claim for reimbursement for emergency care will never be denied based solely on them not receiving prior notification that you are receiving medical care at a location emergency facility. However, they would like notification to be made within 72 hours of admission to your local emergency facility. This will give the VA the time they need to assist you in coordinating necessary care or transfer and also to ensure that all of the requirements in order for the VA to pay for your medical care is been met.

What if My Service-Connected Disability Requires Emergency Care?

For veterans who need to be treated for a service-connected disability or if the care that is needed is related to a service-connected disability, as long as the VA was not reasonably available to provide care,  then the following requirements need to be met in order for the VA to pay you for your visit at a non-VA emergency department:

1. You must be permanently and totally disabled as a result of a service-connected condition or conditions or,
2. You are participating in a VA Vocational Rehabilitation Program and would require emergency treatment to expedite your return to the program, and
3. The emergency resulted in you reasonably believing that any delay in seeking immediate medical attention would cause your life or health to be placed in jeopardy.
4. You must be enrolled and already receiving care at a VA facility during the 24 months before the emergency care

The VA can also pay you for your emergency care for a non-service connected disability if you meet the following requirements:

1. Your care was provided in a hospital emergency department; and
2. Your emergency resulted in you reasonably believing that any delay in seeking immediate medical attention would cause your life or health to be placed in jeopardy; and
3. A VA medical facility was not reasonably available to provide the emergency care; and
4. You are enrolled and have received care within a VA facility during the 24 months before your emergency occurred.

Veteran Emergency Care Reimbursement

As discussed above, the VA will not deny veterans reimbursement for emergency care just because they were not notified before the emergency care visit. In order to receive reimbursement, you must notify the VA within 72 hours of receiving treatment. You must also file a claim. And of course, there are certain deadlines that need to be met. If your emergency care was for a service-connected condition, you have two years from the date from when the emergency medical care took place to file a claim. If you received treatment for a non-service connected condition, you only have 90 days from the date of discharge to file a claim for reimbursement.

After you have filed the claim to receive reimbursement, the VA will review your claim to determine if you are eligible for payment.