Veterans Health Benefits Handbook Only by Center Sample Provided ...

Veterans Health

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Table of Contents

Chapter 1: Welcome............................................................................................................................. 1 Overview of VA's Nationwide Health Care System.............................................................................. 1 Overview of VA's Medical Benefits Package ....................................................................................... 2 VA Provides Health Services at Facilities Across the Nation............................................................... 3 What Do I Need to Know About Primary Care? .................................................................................. 3 Your Primary Care Provider and Team Information ............................................................................. 4 Your Eligibility Information ................................................................................................................... 4 Health Benefits Are Different for Each Veteran -- Including You ........................................................ 4

r Chapter 2: Your Eligibility.................................................................................................................... 7 ly e Your Priority Group .............................................................................................................................. 7 t Your Eligibilities ................................................................................................................................... 7 n n Your Benefits At A Glance.................................................................................................................... 8 O y e Enrollment Priority Groups .................................................................................................................. 8 le b C Chapter 3: Your VA Health Benefits .................................................................................................. 11 p d y Preventive Care Services .................................................................................................................. 11 m ide ilit Inpatient Care Services ..................................................................................................................... 11

Ancillary Services .............................................................................................................................. 12

a v ib Specialty Care Services .................................................................................................................... 12

Mental Health Care ........................................................................................................................... 14

S ro lig Transplant Services........................................................................................................................... 15

Dental Services ................................................................................................................................. 15

P E Pharmacy .......................................................................................................................................... 15 h Health Promotion and Disease Prevention ....................................................................................... 15 lt What are VA's Health Registries?...................................................................................................... 16 a Home Health Care............................................................................................................................. 17 e Geriatrics and Extended Care Services ............................................................................................ 17 H Medically Related Travel, Lodging, and Per Diem ............................................................................ 19

Medical Equipment/ Prosthetic Items and Aids ................................................................................. 20

VA Automobile Adaptive Equipment Program......................................................................................... 20

Home Improvement and Structural Alteration (HISA) Grants ............................................................ 20 Clothing Allowance Benefit ................................................................................................................ 21 Dependents' Health Care .................................................................................................................. 21 Spina Bifida/Children of Women Vietnam Veterans .......................................................................... 21

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Veterans Health Benefits Handbook

Medical Benefits Package Exclusions ............................................................................................... 21 Chapter 4: Getting Started with VA Health Care.............................................................................. 23

Your First Appointment ...................................................................................................................... 23 How Do I Get my Veterans Identification Card? ................................................................................ 23 What if my VIC is Lost or Destroyed? ............................................................................................... 23 Is my VIC Like a Credit Card? ........................................................................................................... 23 How Can My HealtheVet Improve the Quality of my Care? .............................................................. 24 My HealtheVet: Registration and Authentication ............................................................................... 24 Why Should I Keep a Personal Health Journal? ............................................................................... 24 How Do I Keep my Information Up To Date?..................................................................................... 25

r If You Move, Your VA Health Care Services Move with You .............................................................. 25 ly te Chapter 5: Accessing Your VA Health Care Services ..................................................................... 27

Your Primary VA Health Care Facility ................................................................................................ 27

n n Important Facility Phone Numbers .................................................................................................... 27 O y e Scheduling and Canceling Appointments.......................................................................................... 27 le b C Emergency Care ............................................................................................................................... 28 p d y Urgent and After-Hours Care (Evenings, Nights, Weekends, Federal Holidays) .............................. 29 m ide ilit What if I Require a Hospital Admission? ........................................................................................... 29

Extended-Care Admission ................................................................................................................. 29

a v ib Social Work Services......................................................................................................................... 29 S ro lig Interpreter Services ........................................................................................................................... 30

Chapter 6: Coordination of Care....................................................................................................... 31

P E How Does VA Coordinate Care if I am Traveling or Living at a Temporary Address? ....................... 31

What About Coordination of Care with Providers Outside the VA Network (Co-managed/Dual

h Care)?.......................................................................................................................................... 31 lt Coordination of Care Among VA Facilities......................................................................................... 32 a What if my VA Provider and Private Provider Disagree?................................................................... 32 e Chapter 7: Your Pharmacy Services................................................................................................. 33 H What is VA's Prescription Benefit? .................................................................................................... 33

VA's Drug Formulary ......................................................................................................................... 33

VA Understanding Your Medication ........................................................................................................ 35

Filling Your Prescriptions ................................................................................................................... 36 Chapter 8: Your Patient Rights and Responsibilities ..................................................................... 41

Respect and Nondiscrimination......................................................................................................... 41 Obtaining and Transferring Your Health Records .............................................................................. 42

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Table of Contents

Keeping Health Information Private and Secure ............................................................................... 42 Partnering in Care ............................................................................................................................. 43 Concerns, Complaints, and Compliments ......................................................................................... 44 Patient Advocate ............................................................................................................................... 44 Keeping Your Information Up-To-Date............................................................................................... 44 Family Involvement in Your Health Care ........................................................................................... 44 What If I am an Inpatient or a Community Living Center Resident? ................................................. 45 Advance Directives: What are They and Why are They Important?.................................................. 46 Chapter 9: VA Copayments and Insurance ...................................................................................... 49 Overview of Copayments .................................................................................................................. 49

r Insurance and Other Third Party Payments: Why Does VA Bill Insurance Companies? .................. 49 ly e Retroactive Award of Service-Connection or VA Pension Benefit ..................................................... 50 t Chapter 10: Care Outside the VA System: What VA Covers........................................................... 51 n n Pre-authorized Non-VA Care ............................................................................................................. 51 O y e Emergency Care ............................................................................................................................... 52 le b C What if I am Living or Traveling in a Foreign Country ....................................................................... 52 p d y Chapter 11: Appeals........................................................................................................................... 55 m ide ilit Administrative Appeals ...................................................................................................................... 55

Clinical Appeals ................................................................................................................................. 56

a v ib Health Care Ethics Consultation ....................................................................................................... 56

Chapter 12: Vet Centers..................................................................................................................... 57

S ro lig Introduction to Vet Centers................................................................................................................ 57

What Services Do Vet Centers Provide?........................................................................................... 57

P E How Do I Gain Access to Vet Center Services?................................................................................ 58 h Chapter 13: VA Health Care and Medicare ....................................................................................... 59 VA Healt Glossary: Commonly Used Terms A-Z .............................................................................................61

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