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Veterans Benefits - Health Care Benefits

Hospital and Nursing-Home Care

Eligibility for VA hospital care and nursing-home care is divided into two
categories: "mandatory and "discretionary." VA must provide hospital care
and may provide nursing-home care to veterans in the mandatory category.
VA may provide hospital and nursing-home care to veterans in the
discretionary category if space and resources are available in VA
facilities. VA makes an income assessment to determine whether a
nonservice-connected veteran is eligible for cost-free VA medical care.
These income levels are adjusted on Jan. 1 of each year, based on the
percentage of increase provided to VA improved-pension benefits.

The law requires that VA must provide hospital care to veterans in the
mandatory category at the nearest VA facility capable of furnishing the
care in a timely fashion. If no VA facility is available, care must be
furnished in a Defense Department facility or another facility with which
VA has a sharing or contractual relationship. If space and resources at VA
hospitals and nursing homes are available after caring for
service-connected veterans, then VA may furnish care to those in the
discretionary category. Veterans in the discretionary category must agree
to pay VA for their care.

Veterans who must be provided hospital care and may be provided
nursing-home care and who are not subject to an income eligibility
assessment are: veterans with service-connected disabilities, veterans who
were exposed to herbicides while serving in Vietnam, veterans exposed to
ionizing radiation during atmospheric testing or in the occupation of
Hiroshima and Nagasaki, veterans for a condition related to service in the
Persian Gulf, former prisoners of war, veterans on VA pension, veterans of
the Mexican Border period or World War I and veterans eligible for
Medicaid. The following income eligibility assessment applies to all other
nonservice-connected veterans:

MANDATORY: Veterans must be provided hospital care if the patient is a
nonservice-connected veteran with income of $19,912 or less if single with
no dependents, or $23,896 or less if married or single with one dependent.
The income maximum is raised $1,330 for each additional dependent.
Hospital care in VA facilities must be provided to veterans in the
mandatory category. Nursing-home care may be provided in VA facilities, if
space and resources are available.

DISCRETIONARY: Veterans may be provided hospital care if the patient is a
nonservice-connected veteran and income is above $19,912 if single with no
dependents, or $23,896 if married or single with one dependent, plus
$1,330 for each additional dependent. The patient must agree to pay an
amount equal to what would have been paid under Medicare. The Medicare
deductible currently is $696 and is adjusted annually. VA may provide
hospital, outpatient and nursing-home care in VA facilities to veterans in
the discretionary category, if space and resources are available.

If the patient's medical care is considered discretionary, VA holds the
patient responsible for the cost of care up to $696 for the first 90 days
of care during any 365-day period. For each additional 90 days of hospital
care, the patient is charged half the Medicare deductible. For each 90
days of nursing-home care, an amount equal to the Medicare deductible is
charged. In addition to these charges, the patient will be charged $10 per
day for hospital care and $5 a day for nursing-home care.

How Income is Assessed The patient's total income under the eligibility
assessment includes Social Security, U.S. Civil Service retirement, U.S.
Railroad Retirement, military retirement, unemployment insurance, any
other retirement income, total wages from all employers, interest and
dividends, workers' compensation, black lung benefits and any other gross
income for the calendar year prior to application for care. The income of
spouse and dependents as well as the market value of stocks, bonds, notes,
individual retirement accounts, bank deposits, savings accounts and cash
also are used. Debts are subtracted from the patient's assets to determine
net worth. The patient's primary residence and personal property are
excluded. The patient must fill out VA Form 10-lOf, Financial Worksheet,
at the time care is requested. VA has the authority to compare information
provided by the veteran with information obtained from the Department of
Health and Human Services and the Internal Revenue Service.

Billing Insurance Companies All veterans applying for medical care at a VA
facility will be asked if they have medical insurance. VA is authorized by
law to bill insurance companies for the cost of medical care furnished to
veterans, including service-connected veterans, for nonservice-connected
conditions covered by health insurance policies. A veteran may be covered
by such a policy or be covered as an eligible dependent on a spouse's
policy. Veterans are not responsible and will not be charged by VA for any
charge required by their health insurance policies. Veterans will not be
responsible for uncovered charges from the insurance company, except for
copayments required by federal law.

Nursing-Home Care

Benefit Skilled nursing care and related medical care in VA or private
nursing homes is provided for convalescents or persons who are not acutely
ill and not in need of hospital care.

Eligibility Admission or transfer to VA nursing-home care is the same as
for hospital care. Veterans who have a service-connected disability are
given first priority. Direct admission to private nursing homes at VA
expense is limited to: (1) a veteran who requires nursing care for a
service-connected disability after medical determination by VA, (2) any
person in an Armed Forces hospital who requires a protracted period of
nursing care and who will become a veteran upon discharge from the Armed
Forces, and (3) a veteran who had been discharged from a VA medical center
and is receiving home health services from a VA medical center. VA may
transfer veterans who need nursing-home care to private nursing homes at
VA expense from VA medical centers, nursing homes or domiciliaries.
VA-authorized care normally may not be provided in excess of six months,
except for veterans whose need for nursing-home care is for a
service-connected disability or for veterans who were hospitalized
primarily for treatment of a service-connected disability. Nursing-home
care may be authorized for nonservice- connected veterans whose income
exceeds the income limit for hospital care if the veteran agrees to pay
the applicable copayment.

Domiciliary Care

Domiciliary care provides rehabilitative and long-term, health-
maintenance care for veterans who require minimal medical care but who do
not need the skilled nursing services provided in nursing homes. VA
provides domiciliary care to veterans whose annual income does not exceed
the maximum annual rate of VA pension and to veterans the Secretary of
Veterans Affairs determines have no adequate means of support.

Outpatient Medical Treatment

Benefit Outpatient medical treatment includes medical examinations and
related medical services, drugs and medicines, rehabilitation services,
and mental health services. As part of outpatient medical treatment,
veterans may be eligible for home health services for the treatment of
disabilities.

Eligibility

1. VA must furnish outpatient care without limitation to: o Veterans for
service-connected disabilities. o Veterans who have suffered an injury as
a result of VA hospitalization, for that condition only.

2. VA must furnish outpatient care for any condition to prevent the need
for hospitalization, to prepare for hospitalization or to complete
treatment after hospital care, nursing-home care or domiciliary care to: o
30-40 percent service-connected disabled veterans. o Veterans whose
annual income is not greater than the maximum annual pension rate of a
veteran in need of regular aid and attendance.

3. VA may furnish outpatient care without limitation to: o Veterans in a
VA-approved vocational rehabilitation program. o Former prisoners of war.
o World War I or Mexican Border Period veterans. o Veterans who receive
increased pension or compensation based on the need for regular aid and
attendance of another person, or who are permanently housebound.

4. VA may furnish outpatient care to prevent the need for
hospitalization, to prepare for hospitalization, or for a condition for
which the veteran was hospitalized to: o 0-20 percent service-connected
disabled veterans. o Veterans exposed to a toxic substance during service
in Vietnam; or to ionizing radiation following the detonation of a nuclear
device; or to environmental contaminants in the Persian Gulf Theater, for
conditions related to such exposures. o Mandatory category veterans whose
income is more than the pension rate of a veteran in need of regular aid
and attendance. o Discretionary category veterans, subject to a copayment
of $36 per outpatient visit. o Allied beneficiaries, beneficiaries of
other federal agencies and certain other nonveterans.

5. Counseling for Women Veterans. Counseling is provided to any woman
veteran who requires it to overcome psychological trauma resulting from
physical assault, battery of a sexual nature or sexual harassment during
active duty. The counseling is provided at VA medical centers and Vet
Centers.

Outpatient Pharmacy Services

Veterans receiving medication for treatment of service-connected
conditions and veterans rated with 50 percent or more service- connected
disability are not charged for pharmacy services. Veterans whose annual
income does not exceed the maximum VA pension are not charged. Veterans
with a service-connected condition rated less than 50 percent receiving
medication on an outpatient basis from VA facilities for the treatment of
nonservice-connected disabilities or ailments are charged $2 for each
30-day supply or less.

Outpatient Dental Treatment

Outpatient dental treatment may include examinations and the full spectrum
of diagnostic, surgical, restorative and preventive techniques. (a) Dental
conditions or disabilities that are service connected and compensable in
degree will be treated. (b) Service-connected dental conditions or
disabilities that are not compensable in degree may receive one-time
treatment if the conditions can be shown to have existed at discharge or
within 180 days of release from active service. Veterans who served on
active duty for 90 days or more during the Persian Gulf War are included
in this category. Veterans must apply to VA for care for the
service-connected dental condition within 90 days following separation.
Veterans will not be considered eligible if their separation document
indicates that necessary treatment was completed by military dentists
during the 90 days prior to separation. (c) Service-connected,
noncompensable, dental conditions resulting from combat wounds or service
injuries, and service-connected, noncompensable, dental conditions of
former prisoners of war who were incarcerated less than 90 days may be
treated. (d) Veterans who were prisoners of war for more than 90 days can
receive complete dental care. (e) Veterans can receive complete dental
care if they are receiving disability compensation at the 100-percent rate
for service-connected conditions or are eligible to receive it by reason
of unemployability. (f) Nonservice-connected dental conditions that are
determined by VA to be associated with an aggravated, service-connected
medical problem can be treated. (g) Disabled veterans participating in a
vocational rehabilitation program will be treated. (h) Veterans can be
treated for nonservice-connected dental conditions or disabilities when
treatment was begun while in a VA medical center, when it is
professionally determined to be reasonably necessary to complete such
dental treatment on an outpatient basis. (i) Veterans scheduled for
admission to inpatient services or who are receiving medical services can
be provided outpatient dental care if the dental condition is
professionally determined to be complicating a medical condition currently
under treatment by VA.

Nonservice-connected veterans who are authorized outpatient dental care
may be billed the applicable copayment if their income exceeds the maximum
threshold.

Persian Gulf, Agent Orange and lonizing Radiation

Registry Examination Programs Under the auspices of VA's Persian Gulf,
Agent Orange and lonizing Radiation Registries, veterans who served in the
Persian Gulf War or who claim exposure to Agent Orange or atomic radiation
are provided with free, comprehensive medical examinations, including
base-line laboratory tests and other tests determined necessary by an
examining physician to determine current health status. Results of the
examinations, which include completion of a questionnaire about the
veteran's military service and exposure history, are entered into special,
computerized programs maintained by VA. These data bases assist VA in
analyzing the types of health conditions being reported by veterans.
Registry participants are advised of the results of their examinations by
personal consultation. Each registry serves as an outreach mechanism which
assists VA in providing participants with significant information of
concern to them. Veterans wishing to participate should contact the
nearest VA health-care facility to request an examination. Appointments
generally can be arranged within two to three weeks.

Agent Orange, Nuclear Radiation and Environmental Contamination Treatment
VA provides priority treatment to any Vietnam-Era veteran who, while
serving in Vietnam, may have been exposed to dioxin or to a toxic
substance in a herbicide or defoliant used for military purposes. Priority
health-care services are available for any veteran exposed to ionizing
radiation from the detonation of a nuclear device in connection with
nuclear tests or with the American occupation of Hiroshima and Nagasaki,
Japan, during the period beginning Sept. 11, 1945, and ending July 1,
1946. Treatment was authorized through June 30, 1994, for veterans exposed
to Agent Orange or nuclear radiation. VA also provides priority treatment
to any Persian Gulf veteran who requires treatment for a condition
medically determined to be possibly related to service in the Persian Gulf
area.

Beneficiary Travel

Payment or reimbursement for travel costs to receive VA medical care,
called beneficiary travel payment, may be made to the following: (a)
Veterans whose service-connected disabilities are rated at 30 percent or
more. (b) Veterans who are traveling in connection with treatment of a
service-connected condition. (c) Veterans who are in receipt of VA
pension. (d) Veterans traveling in connection with a compensation and
pension examination. (e) Veterans whose income is less than or equal to
the maximum base VA pension rate. (f) Veterans whose medical condition
requires use of a special mode of transportation, if the veteran is unable
to defray the costs and travel is pre-authorized˜ unless the medical
condition is a medical emergency.

Travel is subject to a deductible of $3 for each one-way tripËœwith an $18
per month cap. Two exceptions to this rule are travel for a compensation
and pension examination and travel by special modes of transportation.

Counseling for Persian Gulf Veterans

Marital and family counseling is provided to veterans of the Persian Gulf
War and their spouses and children. The counseling is provided at VA
medical centers and Vet Centers.

Counseling for Sexual Trauma

Counseling may be furnished to a woman veteran to overcome psychological
trauma which, in the judgment of a mental health professional employed by
VA, resulted from physical assault of a sexual nature, battery of a sexual
nature, or sexual harassment which occurred while serving on active duty.

Alcohol and Drug Dependence Treatment

Veterans without service-connected disabilities whose incomes exceed the
threshold for free medical care may be authorized treatment for alcohol
and drug dependence only if the veteran agrees to pay the applicable
copayment. After hospitalization for alcohol or drug treatment, veterans
may be eligible for outpatient care or may be authorized to continue
treatment or rehabilitation at VA expense in private facilities such as
halfway houses.

Prosthetic Services

Veterans may apply for prosthetic services to treat any condition when
receiving hospital, domiciliary or nursing-home care in a VA facility.
Veterans who meet the basic requirements for outpatient medical treatment
may be provided needed prosthetic services: (1) For a service-connected
disability or adjunct condition. (2) For any medical condition for a
veteran with a service-connected disability rated at 50 percent or more or
for a veteran receiving compensation as a result of treatment in a VA
facility. (3) For a disability for which a veteran was discharged or
released from active service. (4) For a veteran participating in a
rehabilitation program under 38 USC Chapter 31. (5) As part of outpatient
care to complete treatment of a disability for which hospital, nursing
home or domiciliary care was provided. (6) For a veteran in receipt of
increased pension or allowance based on needing aid and attendance or
being permanently housebound. (7) For a veteran of World War I or the
Mexican Border period. (8) For a former prisoner of war.

Blind Aids and Services

Veterans are eligible to receive VA aids for the blind if their blindness
is a service-connected disability, if they are entitled to compensation
from VA for any service-connected disability or if they are eligible for
VA medical services. Veterans with corrected vision of 20/200 or less in
the better eye or field defect of 20 degrees or less are considered to be
blind. Blind veterans need not be receiving compensation or pension to be
eligible for admission to a VA blind rehabilitation center or clinic, or
to receive services at a VA medical center. Benefits include: (a) A total
health and benefits review by a VA Visual Impairment Services Team (VIST).

(b) Adjustment to blindness training. (c) Home improvements and structural
alterations to homes (HISA Program). (d) Specially adapted housing and
adaptations. (e) Low-vision aids and training in their use. (f) Approved
electronic and mechanical aids for the blind, and their necessary repair
and replacement. (g) Guide dogs, including the expense of training the
veteran to use the dog and the cost of the dog's medical care. (h) Talking
books, tapes and Braille literature, provided from the Library of
Congress.

Readjustment Counseling

Veterans who served on active duty during the Vietnam Era or served in the
war or conflict zones of Lebanon, Grenada, Panama or the Persian Gulf
theaters during periods of hostilities or war are entitled to counseling
to assist in readjusting to civilian life.

Counseling is provided at Vet Centers of the VA's Readjustment Counseling
Service to help veterans resolve war-related psychological difficulties
and to help them achieve a successful post-war readjustment to civilian
life. Assistance includes group, individual and family counseling,
community outreach and education. Vet Center staff help veterans find
services from VA and non-VA sources if needed. One common readjustment
problem is post-traumatic stress disorder, or PTSD.

This refers to such symptoms as nightmares, intrusive recollections or
memories, flashbacks, anxiety or sudden reactions after exposure to
traumatic conditions. Readjustment difficulties may affect functioning in
school, family or work. Counseling also is provided veterans for
difficulties due to sexual assault or harassment while on active duty.

The location of the nearest Vet Center usually can be found in the U.S.
Government section of the phone book under Department of Veterans Affairs.
All Vet Centers are listed in the back of this booklet. In areas which are
distant from Vet Centers or VA medical facilities, veterans may obtain
readjustment counseling from private sector counselors, psychologists,
social workers or other professionals who are on contract with VA. To
locate a contract provider, contact the nearest Vet Center.

Income Verification Matching

Income of veterans receiving VA medical care based on income is verified
with records maintained by the Internal Revenue Service and the Social
Security Administration. Service-connected veterans are not subject to the
verification even when evaluated or treated for a nonservice-connected
condition. The purpose of the verification is to ensure proper VA medical
care is administered to eligible veterans.

Home Improvements and Structural Alterations

The Home Improvements and Structural Alterations (HISA) program helps pay
for home improvements necessary to assume continuation of treatment or
provide access to the home and essential lavatory and sanitary facilities.
For alterations, VA will pay up to $4,100 for veterans being treated for a
service-connected disability, and up to $1,200 for the
nonservice-connected disability of a veteran receiving post-hospital care
or a veteran rated 50 percent or more disabled.

Medical Care for Merchant Seamen

Those Merchant Marine seamen whose World War II service qualifies them for
veterans' benefits must present their DD-214 discharge certificate when
applying for medical care benefits at VA medical centers. VA regional
offices can provide information on obtaining a certificate.

Medical Care for Allied Veterans

VA is authorized to provide reciprocal medical care to veterans of nations
allied or associated with the United States during World War I or World
War II. Such treatment is available at any VA medical facility but must be
authorized and reimbursed by the foreign government. VA also is authorized
to provide hospitalization, outpatient and domiciliary care to former
members of the armed forces of the governments of Czechoslovakia or Poland
who participated during World Wars I and II in armed conflict against an
enemy of the United States, if they have been citizens of the United
States for at least 10 years. Benefits are the same as those provided to
U.S. veterans.

Medical Care for Dependents and Survivors (CHAMPVA)

The VA Civilian Health and Medical Program, known as CHAMPVA, shares the
cost of medical services and supplies obtained by eligible dependents and
survivors of certain veterans. The following are eligible for CHAMPVA
benefits, provided they are not eligible for medical care under CHAMPUS
(Civilian Health and Medical Program of the Uniformed Services) or
Medicare, Part A, as a result of reaching age 65:

(a) The spouse or child of a veteran who has a permanent and total
service-connected disability. (b) The surviving spouse or child of a
veteran who died as a result of a service-connected condition; or who at
the time of death was permanently and totally disabled from a
service-connected condition. (c) The surviving spouse or child of a person
who died while on active military service in the line of duty.

Beneficiaries age 65 or older who lose eligibility for CHAMPVA by becoming
potentially eligible for Medicare, Part A, or who qualify for Medicare,
Part A, benefits on the basis of a disability may re-establish CHAMPVA
eligibility by submitting documentation from the Social Security
Administration certifying their nonentitlement to or exhaustion of
Medicare, Part A, benefits. Persons under age 65 who are enrolled in both
Medicare Parts A and B may become eligible for CHAMPVA as a secondary
payer to Medicare. Apply to the CHAMPVA Center, 4500 Cherry Creek Drive
South, Denver, CO 80222, or call 1-800-733-8387.

Homeless Veterans

A number of VA benefits assist eligible homeless veterans, including
disability compensation, pension, education and burial benefits. Homeless
veterans also are provided special assistance through many program
initiatives.

VA also continues to expand its health and rehabilitation programs for
homeless veterans. Homeless Chronically Mentally Ill Veterans programs at
50 sites provide comprehensive medical, psychological and rehabilitation
treatment programs through case management and community-based residential
care. Domiciliary Care for Homeless Veterans programs at 31 sites provide
active residential rehabilitation services. VA has a growing number of
Compensated Work Therapy/Therapeutic Residence group homes; special
day-time, drop-in centers; and Comprehensive Homeless Centers.

VA has joined with the Department of Housing and Urban Development, the
Social Security Administration, veterans service organizations, and
community nonprofit homeless service providers in special partnerships
that help VA provide comprehensive care for homeless veterans. For
information, contact the nearest VA regional office or medical center.

Veterans Benefits - Health Care Benefits

Hospital and Nursing-Home Care

Eligibility for VA hospital care and nursing-home care is divided into two categories:
"mandatory and "discretionary." VA must provide hospital care and may provide
nursing-home care to veterans in the mandatory category. VA may provide hospital and
nursing-home care to veterans in the discretionary category if space and resources are
available in VA facilities. VA makes an income assessment to determine whether a
nonservice-connected veteran is eligible for cost-free VA medical care. These income
levels are adjusted on Jan. 1 of each year, based on the percentage of increase
provided to VA improved-pension benefits.

The law requires that VA must provide hospital care to veterans in the mandatory
category at the nearest VA facility capable of furnishing the care in a timely
fashion. If no VA facility is available, care must be furnished in a Defense
Department facility or another facility with which VA has a sharing or contractual
relationship. If space and resources at VA hospitals and nursing homes are available
after caring for service-connected veterans, then VA may furnish care to those in the
discretionary category. Veterans in the discretionary category must agree to pay VA
for their care.

Veterans who must be provided hospital care and may be provided nursing-home care and
who are not subject to an income eligibility assessment are: veterans with
service-connected disabilities, veterans who were exposed to herbicides while serving
in Vietnam, veterans exposed to ionizing radiation during atmospheric testing or in
the occupation of Hiroshima and Nagasaki, veterans for a condition related to service
in the Persian Gulf, former prisoners of war, veterans on VA pension, veterans of the
Mexican Border period or World War I and veterans eligible for Medicaid. The following
income eligibility assessment applies to all other nonservice-connected veterans:

MANDATORY: Veterans must be provided hospital care if the patient is a
nonservice-connected veteran with income of $19,912 or less if single with no
dependents, or $23,896 or less if married or single with one dependent. The income
maximum is raised $1,330 for each additional dependent. Hospital care in VA facilities
must be provided to veterans in the mandatory category. Nursing-home care may be
provided in VA facilities, if space and resources are available.

DISCRETIONARY: Veterans may be provided hospital care if the patient is a
nonservice-connected veteran and income is above $19,912 if single with no dependents,
or $23,896 if married or single with one dependent, plus $1,330 for each additional
dependent. The patient must agree to pay an amount equal to what would have been paid
under Medicare. The Medicare deductible currently is $696 and is adjusted annually. VA
may provide hospital, outpatient and nursing-home care in VA facilities to veterans in
the discretionary category, if space and resources are available.

If the patient's medical care is considered discretionary, VA holds the patient
responsible for the cost of care up to $696 for the first 90 days of care during any
365-day period. For each additional 90 days of hospital care, the patient is charged
half the Medicare deductible. For each 90 days of nursing-home care, an amount equal
to the Medicare deductible is charged. In addition to these charges, the patient will
be charged $10 per day for hospital care and $5 a day for nursing-home care.

How Income is Assessed
The patient's total income under the eligibility assessment includes Social Security,
U.S. Civil Service retirement, U.S. Railroad Retirement, military retirement,
unemployment insurance, any other retirement income, total wages from all employers,
interest and dividends, workers' compensation, black lung benefits and any other gross
income for the calendar year prior to application for care. The income of spouse and
dependents as well as the market value of stocks, bonds, notes, individual retirement
accounts, bank deposits, savings accounts and cash also are used. Debts are subtracted
from the patient's assets to determine net worth. The patient's primary residence and
personal property are excluded. The patient must fill out VA Form 10-lOf, Financial
Worksheet, at the time care is requested. VA has the authority to compare information
provided by the veteran with information obtained from the Department of Health and
Human Services and the Internal Revenue Service.

Billing Insurance Companies
All veterans applying for medical care at a VA facility will be asked if they have
medical insurance. VA is authorized by law to bill insurance companies for the cost of
medical care furnished to veterans, including service-connected veterans, for
nonservice-connected conditions covered by health insurance policies. A veteran may be
covered by such a policy or be covered as an eligible dependent on a spouse's policy.
Veterans are not responsible and will not be charged by VA for any charge required by
their health insurance policies. Veterans will not be responsible for uncovered
charges from the insurance company, except for copayments required by federal law.

Nursing-Home Care

Benefit
Skilled nursing care and related medical care in VA or private nursing homes is
provided for convalescents or persons who are not acutely ill and not in need of
hospital care.

Eligibility
Admission or transfer to VA nursing-home care is the same as for hospital care.
Veterans who have a service-connected disability are given first priority. Direct
admission to private nursing homes at VA expense is limited to: (1) a veteran who
requires nursing care for a service-connected disability after medical determination
by VA, (2) any person in an Armed Forces hospital who requires a protracted period of
nursing care and who will become a veteran upon discharge from the Armed Forces, and
(3) a veteran who had been discharged from a VA medical center and is receiving home
health services from a VA medical center. VA may transfer veterans who need
nursing-home care to private nursing homes at VA expense from VA medical centers,
nursing homes or domiciliaries. VA-authorized care normally may not be provided in
excess of six months, except for veterans whose need for nursing-home care is for a
service-connected disability or for veterans who were hospitalized primarily for
treatment of a service-connected disability. Nursing-home care may be authorized for
nonservice- connected veterans whose income exceeds the income limit for hospital care
if the veteran agrees to pay the applicable copayment.

Domiciliary Care

Domiciliary care provides rehabilitative and long-term, health- maintenance care for
veterans who require minimal medical care but who do not need the skilled nursing
services provided in nursing homes. VA provides domiciliary care to veterans whose
annual income does not exceed the maximum annual rate of VA pension and to veterans
the Secretary of Veterans Affairs determines have no adequate means of support.

Outpatient Medical Treatment

Benefit
Outpatient medical treatment includes medical examinations and related medical
services, drugs and medicines, rehabilitation services, and mental health services. As
part of outpatient medical treatment, veterans may be eligible for home health
services for the treatment of disabilities.

Eligibility

1. VA must furnish outpatient care without limitation to:
o Veterans for service-connected disabilities.
o Veterans who have suffered an injury as a result of VA
hospitalization, for that condition only.

2. VA must furnish outpatient care for any condition to prevent the
need for hospitalization, to prepare for hospitalization or to complete
treatment after hospital care, nursing-home care or domiciliary care to:
o 30-40 percent service-connected disabled veterans.
o Veterans whose annual income is not greater than the maximum
annual pension rate of a veteran in need of regular aid and attendance.

3. VA may furnish outpatient care without limitation to:
o Veterans in a VA-approved vocational rehabilitation program.
o Former prisoners of war.
o World War I or Mexican Border Period veterans.
o Veterans who receive increased pension or compensation based on
the need for regular aid and attendance of another person, or who are
permanently housebound.

4. VA may furnish outpatient care to prevent the need for
hospitalization, to prepare for hospitalization, or for a condition for
which the veteran was hospitalized to:
o 0-20 percent service-connected disabled veterans.
o Veterans exposed to a toxic substance during service in Vietnam;
or to ionizing radiation following the detonation of a nuclear device; or
to environmental contaminants in the Persian Gulf Theater, for
conditions related to such exposures.
o Mandatory category veterans whose income is more than the
pension rate of a veteran in need of regular aid and attendance.
o Discretionary category veterans, subject to a copayment of $36 per outpatient visit.
o Allied beneficiaries, beneficiaries of other federal agencies and
certain other nonveterans.

5. Counseling for Women Veterans. Counseling is provided to any
woman veteran who requires it to overcome psychological trauma
resulting from physical assault, battery of a sexual nature or sexual
harassment during active duty. The counseling is provided at VA
medical centers and Vet Centers.

Outpatient Pharmacy Services

Veterans receiving medication for treatment of service-connected conditions and
veterans rated with 50 percent or more service- connected disability are not charged
for pharmacy services. Veterans whose annual income does not exceed the maximum VA
pension are not charged. Veterans with a service-connected condition rated less than
50 percent receiving medication on an outpatient basis from VA facilities for the
treatment of nonservice-connected disabilities or ailments are charged $2 for each
30-day supply or less.

Outpatient Dental Treatment

Outpatient dental treatment may include examinations and the full spectrum of
diagnostic, surgical, restorative and preventive techniques.
(a) Dental conditions or disabilities that are service connected and compensable in
degree will be treated.
(b) Service-connected dental conditions or disabilities that are not compensable in
degree may receive one-time treatment if the conditions can be shown to have existed
at discharge or within 180 days of release from active service. Veterans who served on
active duty for 90 days or more during the Persian Gulf War are included in this
category. Veterans must apply to VA for care for the service-connected dental
condition within 90 days following separation. Veterans will not be considered
eligible if their separation document indicates that necessary treatment was completed
by military dentists during the 90 days prior to separation.
(c) Service-connected, noncompensable, dental conditions resulting from combat wounds
or service injuries, and service-connected, noncompensable, dental conditions of
former prisoners of war who were incarcerated less than 90 days may be treated.
(d) Veterans who were prisoners of war for more than 90 days can receive complete
dental care.
(e) Veterans can receive complete dental care if they are receiving disability
compensation at the 100-percent rate for service-connected conditions or are eligible
to receive it by reason of unemployability.
(f) Nonservice-connected dental conditions that are determined by VA to be associated
with an aggravated, service-connected medical problem can be treated.
(g) Disabled veterans participating in a vocational rehabilitation program will be
treated.
(h) Veterans can be treated for nonservice-connected dental conditions or disabilities
when treatment was begun while in a VA medical center, when it is professionally
determined to be reasonably necessary to complete such dental treatment on an
outpatient basis.
(i) Veterans scheduled for admission to inpatient services or who are receiving
medical services can be provided outpatient dental care if the dental condition is
professionally determined to be complicating a medical condition currently under
treatment by VA.

Nonservice-connected veterans who are authorized outpatient dental care may be billed
the applicable copayment if their income exceeds the maximum threshold.

Persian Gulf, Agent Orange and lonizing Radiation

Registry Examination Programs
Under the auspices of VA's Persian Gulf, Agent Orange and lonizing Radiation
Registries, veterans who served in the Persian Gulf War or who claim exposure to Agent
Orange or atomic radiation are provided with free, comprehensive medical examinations,
including base-line laboratory tests and other tests determined necessary by an
examining physician to determine current health status. Results of the examinations,
which include completion of a questionnaire about the veteran's military service and
exposure history, are entered into special, computerized programs maintained by VA.
These data bases assist VA in analyzing the types of health conditions being reported
by veterans. Registry participants are advised of the results of their examinations by
personal consultation. Each registry serves as an outreach mechanism which assists VA
in providing participants with significant information of concern to them. Veterans
wishing to participate should contact the nearest VA health-care facility to request
an examination. Appointments generally can be arranged within two to three weeks.

Agent Orange, Nuclear Radiation and Environmental
Contamination Treatment
VA provides priority treatment to any Vietnam-Era veteran who, while serving in
Vietnam, may have been exposed to dioxin or to a toxic substance in a herbicide or
defoliant used for military purposes. Priority health-care services are available for
any veteran exposed to ionizing radiation from the detonation of a nuclear device in
connection with nuclear tests or with the American occupation of Hiroshima and
Nagasaki, Japan, during the period beginning Sept. 11, 1945, and ending July 1, 1946.
Treatment was authorized through June 30, 1994, for veterans exposed to Agent Orange
or nuclear radiation. VA also provides priority treatment to any Persian Gulf veteran
who requires treatment for a condition medically determined to be possibly related to
service in the Persian Gulf area.

Beneficiary Travel

Payment or reimbursement for travel costs to receive VA medical care, called
beneficiary travel payment, may be made to the following:
(a) Veterans whose service-connected disabilities are rated at 30 percent or more.
(b) Veterans who are traveling in connection with treatment of a service-connected
condition.
(c) Veterans who are in receipt of VA pension.
(d) Veterans traveling in connection with a compensation and pension examination.
(e) Veterans whose income is less than or equal to the maximum base VA pension rate.
(f) Veterans whose medical condition requires use of a special mode of transportation,
if the veteran is unable to defray the costs and travel is pre-authorized— unless the
medical condition is a medical emergency.

Travel is subject to a deductible of $3 for each one-way trip—with an $18 per month
cap. Two exceptions to this rule are travel for a compensation and pension examination
and travel by special modes of transportation.

Counseling for Persian Gulf Veterans

Marital and family counseling is provided to veterans of the Persian Gulf War and
their spouses and children. The counseling is provided at VA medical centers and Vet
Centers.

Counseling for Sexual Trauma

Counseling may be furnished to a woman veteran to overcome psychological trauma which,
in the judgment of a mental health professional employed by VA, resulted from physical
assault of a sexual nature, battery of a sexual nature, or sexual harassment which
occurred while serving on active duty.

Alcohol and Drug Dependence Treatment

Veterans without service-connected disabilities whose incomes exceed the threshold for
free medical care may be authorized treatment for alcohol and drug dependence only if
the veteran agrees to pay the applicable copayment. After hospitalization for alcohol
or drug treatment, veterans may be eligible for outpatient care or may be authorized
to continue treatment or rehabilitation at VA expense in private facilities such as
halfway houses.

Prosthetic Services

Veterans may apply for prosthetic services to treat any condition when receiving
hospital, domiciliary or nursing-home care in a VA facility. Veterans who meet the
basic requirements for outpatient medical treatment may be provided needed prosthetic
services:
(1) For a service-connected disability or adjunct condition.
(2) For any medical condition for a veteran with a service-connected disability rated
at 50 percent or more or for a veteran receiving compensation as a result of treatment
in a VA facility.
(3) For a disability for which a veteran was discharged or released from active
service.
(4) For a veteran participating in a rehabilitation program under 38 USC Chapter 31.
(5) As part of outpatient care to complete treatment of a disability for which
hospital, nursing home or domiciliary care was provided.
(6) For a veteran in receipt of increased pension or allowance based on needing aid
and attendance or being permanently housebound.
(7) For a veteran of World War I or the Mexican Border period.
(8) For a former prisoner of war.

Blind Aids and Services

Veterans are eligible to receive VA aids for the blind if their blindness is a
service-connected disability, if they are entitled to compensation from VA for any
service-connected disability or if they are eligible for VA medical services. Veterans
with corrected vision of 20/200 or less in the better eye or field defect of 20
degrees or less are considered to be blind. Blind veterans need not be receiving
compensation or pension to be eligible for admission to a VA blind rehabilitation
center or clinic, or to receive services at a VA medical center. Benefits include:
(a) A total health and benefits review by a VA Visual Impairment Services Team (VIST).

(b) Adjustment to blindness training.
(c) Home improvements and structural alterations to homes (HISA Program).
(d) Specially adapted housing and adaptations.
(e) Low-vision aids and training in their use.
(f) Approved electronic and mechanical aids for the blind, and their necessary repair
and replacement.
(g) Guide dogs, including the expense of training the veteran to use the dog and the
cost of the dog's medical care.
(h) Talking books, tapes and Braille literature, provided from the Library of
Congress.

Readjustment Counseling

Veterans who served on active duty during the Vietnam Era or served in the war or
conflict zones of Lebanon, Grenada, Panama or the Persian Gulf theaters during periods
of hostilities or war are entitled to counseling to assist in readjusting to civilian
life.

Counseling is provided at Vet Centers of the VA's Readjustment Counseling Service to
help veterans resolve war-related psychological difficulties and to help them achieve
a successful post-war readjustment to civilian life. Assistance includes group,
individual and family counseling, community outreach and education. Vet Center staff
help veterans find services from VA and non-VA sources if needed. One common
readjustment problem is post-traumatic stress disorder, or PTSD.

This refers to such symptoms as nightmares, intrusive recollections or memories,
flashbacks, anxiety or sudden reactions after exposure to traumatic conditions.
Readjustment difficulties may affect functioning in school, family or work. Counseling
also is provided veterans for difficulties due to sexual assault or harassment while
on active duty.

The location of the nearest Vet Center usually can be found in the U.S. Government
section of the phone book under Department of Veterans Affairs. All Vet Centers are
listed in the back of this booklet. In areas which are distant from Vet Centers or VA
medical facilities, veterans may obtain readjustment counseling from private sector
counselors, psychologists, social workers or other professionals who are on contract
with VA. To locate a contract provider, contact the nearest Vet Center.

Income Verification Matching

Income of veterans receiving VA medical care based on income is verified with records
maintained by the Internal Revenue Service and the Social Security Administration.
Service-connected veterans are not subject to the verification even when evaluated or
treated for a nonservice-connected condition. The purpose of the verification is to
ensure proper VA medical care is administered to eligible veterans.

Home Improvements and Structural Alterations

The Home Improvements and Structural Alterations (HISA) program helps pay for home
improvements necessary to assume continuation of treatment or provide access to the
home and essential lavatory and sanitary facilities. For alterations, VA will pay up
to $4,100 for veterans being treated for a service-connected disability, and up to
$1,200 for the nonservice-connected disability of a veteran receiving post-hospital
care or a veteran rated 50 percent or more disabled.

Medical Care for Merchant Seamen

Those Merchant Marine seamen whose World War II service qualifies them for veterans'
benefits must present their DD-214 discharge certificate when applying for medical
care benefits at VA medical centers. VA regional offices can provide information on
obtaining a certificate.

Medical Care for Allied Veterans

VA is authorized to provide reciprocal medical care to veterans of nations allied or
associated with the United States during World War I or World War II. Such treatment
is available at any VA medical facility but must be authorized and reimbursed by the
foreign government. VA also is authorized to provide hospitalization, outpatient and
domiciliary care to former members of the armed forces of the governments of
Czechoslovakia or Poland who participated during World Wars I and II in armed conflict
against an enemy of the United States, if they have been citizens of the United States
for at least 10 years. Benefits are the same as those provided to U.S. veterans.

Medical Care for Dependents and
Survivors (CHAMPVA)

The VA Civilian Health and Medical Program, known as CHAMPVA, shares the cost of
medical services and supplies obtained by eligible dependents and survivors of certain
veterans. The following are eligible for CHAMPVA benefits, provided they are not
eligible for medical care under CHAMPUS (Civilian Health and Medical Program of the
Uniformed Services) or Medicare, Part A, as a result of reaching age 65:

(a) The spouse or child of a veteran who has a permanent and total service-connected
disability.
(b) The surviving spouse or child of a veteran who died as a result of a
service-connected condition; or who at the time of death was permanently and totally
disabled from a service-connected condition.
(c) The surviving spouse or child of a person who died while on active military
service in the line of duty.

Beneficiaries age 65 or older who lose eligibility for CHAMPVA by becoming potentially
eligible for Medicare, Part A, or who qualify for Medicare, Part A, benefits on the
basis of a disability may re-establish CHAMPVA eligibility by submitting documentation
from the Social Security Administration certifying their nonentitlement to or
exhaustion of Medicare, Part A, benefits. Persons under age 65 who are enrolled in
both Medicare Parts A and B may become eligible for CHAMPVA as a secondary payer to
Medicare. Apply to the CHAMPVA Center, 4500 Cherry Creek Drive South, Denver, CO
80222, or call 1-800-733-8387.

Homeless Veterans

A number of VA benefits assist eligible homeless veterans, including disability
compensation, pension, education and burial benefits. Homeless veterans also are
provided special assistance through many program initiatives.

VA also continues to expand its health and rehabilitation programs for homeless
veterans. Homeless Chronically Mentally Ill Veterans programs at 50 sites provide
comprehensive medical, psychological and rehabilitation treatment programs through
case management and community-based residential care. Domiciliary Care for Homeless
Veterans programs at 31 sites provide active residential rehabilitation services. VA
has a growing number of Compensated Work Therapy/Therapeutic Residence group homes;
special day-time, drop-in centers; and Comprehensive Homeless Centers.

VA has joined with the Department of Housing and Urban Development, the Social
Security Administration, veterans service organizations, and community nonprofit
homeless service providers in special partnerships that help VA provide comprehensive
care for homeless veterans. For information, contact the nearest VA regional office or
medical center.