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VETERANS' CORNER: Veterans eligible for emergency medical care

on July 07, 2013 2:00 AM

EDITOR’S NOTE: Veterans’ Corner, a column to inform armed-forces veterans about services and benefits available to them, is printed the first Sunday of each month.

At some time in your life, you may need emergency care. This article explains what VA might be able to do for you. When it is not possible for you to go to a VA medical center, 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 room.

A medical emergency is an injury or illness that is so severe that without immediate treatment, it threatens your life or health.

You, your family, friends or hospital staff should contact the nearest VA medical center as soon as possible, preferably within 72 hours of your emergency, so you are better aware of what services VA covers. Provide VA with information about your emergency and what services are being provided to you. Ask VA for guidance on what emergency charges may be covered so you can plan accordingly.

If the admission is an emergency, prompt notification of the VA is not necessary. If the admission is not an emergency, it is necessary to obtain advance approval from the VA. If a VA bed is available and you can be safely transferred, you must be transferred if you want VA to continue to pay for your care. If you refuse to be transferred, VA will not pay for further care.

The amount VA will pay for your care depends on your VA eligibility.

VA may pay all, some, or none of the charges.

For service-connected conditions here are some of the criteria that must be met:

• Care or services were provided in a medical emergency.

• VA or another federal facility was not feasibly available.

• VA was notified with 72 hours of the admission.

For non-service-connected conditions:

• Veteran is enrolled in the VA Health Care System.

• Vet has received health care services from VA in the previous 24 months.

• Vet has no other health insurance coverage.

A service-connected condition refers to an illness or injury that was incurred in or aggravated by military service and has a rating assigned by the Veterans Benefits Administration.

File your claim with the nearest VA medical center quickly because time limits usually apply. For non-service-connected care, the limit is 90 days.

VA will only pay for emergency care outside the U.S. if your emergency is related to a service-connected condition. For more information about care provided outside the U.S., contact the Foreign Medical Program (FMP) at (877) 345-8179, or go to the FMP website at www.vs.gov/hax/forbeneficiaries/fmp.

 

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