Getting emergency care at non-va facilities | veterans affairs

Getting emergency care at non-va facilities | veterans affairs


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If you think your life or health is in danger, call 911 or go to the nearest emergency department. You don’t need to check with us first. But if you go to a non-VA facility—even one that’s


in our community care network—you must follow certain rules so that we can cover the cost of your care. Keep reading on this page to learn what you need to know if you go to a non-VA


facility for emergency care. EMERGENCY CARE ELIGIBILITY REQUIREMENTS ELIGIBILITY FOR EMERGENCY MENTAL HEALTH CARE In most cases, we will provide or cover the cost of your emergency mental


health care and up to 90 days of related services—even if you’re not enrolled in VA health care. If a health care provider or a trained crisis responder determines you’re at risk of


immediate self-harm, we can provide or cover the cost of your care if you meet at least one of these requirements: * You were sexually assaulted, battered, or harassed while serving in the


Armed Forces, OR * You served on active duty for more than 24 months and didn’t get a dishonorable discharge, OR  * You served more than 100 days under a combat exclusion or in support of a


contingency operation (including as a member of the Reserve) and didn’t get a dishonorable discharge. You meet this requirement if you served directly or if you operated an unmanned aerial


vehicle from another location. If you go to a non-VA emergency department for help, tell the staff you’re a Veteran. Ask them to contact us right away. ELIGIBILITY FOR ALL OTHER EMERGENCY


CARE GENERAL ELIGIBILITY REQUIREMENTS By law, we can only cover the cost of your care at a non-VA emergency department if you meet all of these requirements: * You’re enrolled in VA health


care or you have a qualifying exemption from enrollment, AND * A VA health care facility or other federal facility that could provide the needed care wasn’t “feasibly available” (meaning it


was too far away for you to get there fast enough to get the emergency care you needed), AND * A person with an average knowledge of health and medicine (called a “prudent layperson”) would


reasonably believe that a delay in seeking care would have put your life or health in danger, AND * You meet our other requirements based on your specific situation—including the time limit


for us to receive your claim. Keep reading to learn more about requirements for different situations. NOTE: We only cover non-VA emergency care until we can safely transfer you to a VA or


other federal facility. The only time this rule doesn’t apply is if the community provider contacts us and we can’t accept your transfer. MORE EMERGENCY CARE COVERAGE REQUIREMENTS In


addition to the general eligibility requirements, you must also meet these other requirements based on your specific situation.