Chapter 3 – VA Health Benefits

VA Health Benefits are comprehensive and include all the necessary inpatient hospital care and outpatient services to promote, preserve, or restore health.
Preventive Care Services
         Health benefits include important preventive care services:
         Periodic medical exams (including gender-specific exams)
         Health education, including nutrition education
         Immunization against infectious disease
         Counseling on inheritance of genetically determined disease
Inpatient Care Services

         VA inpatient care includes a full spectrum of treatment services:
         Mental Health
         Acute care
Inpatient care also includes access to VA’s specialized care units:

         Intensive Care Units (medical, surgical, mental health, cardiac)
         Transplant Care Units
         Spinal Cord Injury Centers
         Traumatic Brain Injury Units
         PolyTrauma Centers
Ancillary Services
VA’s health care providers may employ ancillary services to help diagnose or treat medical conditions. These services include:
         Audiology (hearing)
         Blind and Vision Rehabilitation
         Chiropractic Services
         Diagnostic Laboratory
         Nutrition and Food Service
         Nuclear Medicine (imaging)
         Occupational Therapy
         Physical Therapy
         Prosthetics (artificial limbs, equipment, devices)
         Radiology (x-rays and imaging)
         Radiation Oncology (cancer care)
         Recreation and Creative Arts Therapies (music, art, dance and drama)
         Respiratory Therapy
         Social Work (housing, discharge planning, family support)
         Speech/Language Pathology (speech, language, voice, fluency, cognition, and swallowing)
         Traumatic Brain Injury
Specialty Care Services
Through VA’s specialty care services, there is access to expert knowledge that optimizes treatment in unique or complicated courses of care. Our specialty care providers focus on particular areas of care in which they have extensive training and education. VA medical and surgical specialty care services include:
         B ariatric surgery (weight loss surgery)
         Cardiology – Vascular (heart and blood circulation)
         Chaplain (spiritual support)
         Critical Care Specialty
         Diabetes and Endocrinology
         Geriatric Care
         Gynecology Care
         Infectious Disease
         Nephrology (kidney)
         Neurology (nerves)
         Mental Health
         Oncology (cancer)
         Optometry & Ophthalmology (eye care)
         Orthopedic Surgery
         Pacemaker (heart)
         Pain Management
         Podiatry (feet)
         Prosthetic and Orthotic (amputee care and custom orthotics)
         Pulmonary (lungs)
         Robotic-Assisted Surgery
         Spinal Cord Injury
         Transplant Surgery (heart, lung, liver, etc.)
         Vascular Surgery
         Women’s Care
Mental Health Care
VA provides specialty inpatient and outpatient mental health services at its medical centers and community-based outpatient clinics (in addition, readjustment counseling services may be available at Vet Centers across the nation).

Our goal is to support recovery and enable Veterans who experience mental health problems to live meaningful lives in their communities and to achieve their full potential.
VA provides cost-free (no VA copayments) military sexual trauma counseling and referral. This includes appropriate care and services to overcome psychological trauma resulting from a physical assault or battery of a sexual nature or from sexual harassment that occurred while the Veteran was on active duty or was on Active Duty for Training (ADUTRA).
Mental health services are available in specialty clinics, primary care clinics, nursing homes, and residential care facilities. Specialized programs, such as mental health intensive case management, day centers, work programs and psychosocial rehabilitation are provided for those with serious mental health problems. The list of services and programs that Mental Health supports include:
         Inpatient Care
         Residential Care
         Outpatient Mental Health Care
         Homeless Programs
         Programs for Incarcerated Veterans
         Specialized PTSD Services
         Military Sexual Trauma
         Psychosocial Rehabilitation & Recovery Service
         Substance Use Disorders
         Suicide Programs
         Violence Prevention
         Evidence Based Psychotherapy Programs
         Mental Health Disaster Response/Post Deployment Activities
Veterans Crisis Line (available to all Veterans regardless of enrollment status)
         Pick up the phone and call for immediate help if you notice any of these signs:
         Thinking about hurting or killing yourself or others
         Experiencing an emotional crisis
         Hopelessness, feeling like there’s no way out
         Talking or writing about death, dying, or suicide
         Engaging in self-destructive behavior, such as drug abuse
The number for the Veterans Crisis Line is 1-800-273-TALK (8255) Press 1 for Veterans and someone who can help you will answer right away.
Additional Warning Signs
         Anxiety, agitation, sleeplessness, mood swings
         Feeling like there is no reason to live
         Extended periods of anger or rage
         Engaging in risky activities without thinking
         Increasing alcohol or drug abuse
         Withdrawing from family and friends
Homeless Services
VA provides specialized homeless services at its medical centers and through community-based partners with a goal that no Veteran will have to become or remain homeless.
If you are homeless or at risk of becoming homeless pick up the phone and call for help. The number for the National Call Center for Homeless Veterans is 1-877-424-3838. The call center will connect you with the closest VA medical center to best address your specific needs.
Women’s Health
VA is committed to meeting women Veterans’ unique needs by delivering the highest quality health care in a setting that ensures privacy, dignity, and sensitivity. VA facilities offer a variety of services, including:
Women’s gender-specific health care (menopause evaluation and symptom management, osteoporosis, incontinence, birth control, breast and gynecological care, maternity and limited infertility services)
         Screening and disease prevention programs (for example, mammograms, bone density screening, and cervica cancer screening)
Routine gynecologic services are available at VA facilities and include:
         Human Papilloma Virus (HPV) vaccinations
         Pelvic exams, ultrasounds
         Birth control counseling and management (medical and surgical)
         Pre-pregnancy care
         Treatment and prevention of sexually transmitted infections
A provider can assist with routine exams, diagnosis, and management of:
         Pelvic/abdominal pain
         Abnormal vaginal bleeding
         Vaginal symptoms (dryness/infections)
         Breast and other women’s cancers
         Abnormal cervical screening results
         Infertility evaluation, including intrauterine insemination (IUI). VA is not authorized to provide or cover the cost of in-vitro fertilization (IVF)
         Sexual dysfunction
Transplant Services

If the need arises, transplant services are available. Primary Care Teams coordinate these requests.
Dental Services
Eligibility for VA dental benefits is based on specific guidelines and differs significantly from eligibility requirements for other types of medical care.
You are eligible for outpatient dental treatment if you meet one of the following criteria:

VA providers order medications and medical supplies as needed. Specific information about VA Pharmacy benefits can be found in Chapter 7.
Health Promotion and Disease Prevention

Health promotion and disease prevention services are obtained from Primary Care Providers. These services include immunizations to prevent disease, screening tests to detect disease at an early stage, and behavioral counseling to avoid or reduce risk factors for disease. There are also health education programs available to help develop healthy living skills and manage health problems.
Healthy Living

There has been a lot of research in recent years on the best ways to take care of yourself and stay healthy. We encourage you to make healthy living behaviors part of your daily life.
Check out the following websites for resources that are available to you:
My HealtheVet Healthy Living Centers
Program website
Men: Stay Healthy at Any Age
Women: Stay Healthy at Any Age
What are VA’s Health Registries?
VA maintains health registries related to environmental and occupational exposures of US Veterans during military service, including Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF), Gulf War, Vietnam, World War II, and atomic test activities. These registries include a free specialized and comprehensive health examination provided by a VA Environmental Health (EH) clinician.
Visit the Environmental Agents Service (EAS) website , where you will also find links to newsletters covering related topics:
Agent Orange Review
Operations Iraqi Freedom/Enduring Freedom Review
Gulf War Review
Ionizing Radiation Review
Another resource is VA’s toll-free special health issues helpline, 1-800-349-8383
Toxic Embedded Fragments
VA and the Department of Defense established the Depleted Uranium (DU) Follow-up Program at the Baltimore VA Medical Center to screen and monitor Veterans for health problems associated with exposure to depleted uranium. The DU Follow-up Program involves:
Detailed physical exams
Clinical tests of organ systems function
Recommendations for treatment, including surgical removal of embedded fragments
Details on the DU Follow-up Program can be obtained from the Environmental Health Coordinator at the nearest VA health care facility. Another resource is VA’s toll-free special health issues helpline,1-800-749-8387

Home Health Care
Home Health Care includes VA’s Skilled Home Health Care Services (SHHC) and Homemaker and Home Health Aid Services (H/HHA).
Skilled Home Health Care (SHHC) Services
SHHC services are in-home services provided by specially trained personnel, including nurses, physical therapists, occupational therapists, speech therapists, and social workers. Care includes clinical assessment, treatment planning, treatment provision, health status monitoring, patient and family education, reassessment, referral, and follow-up.
Homemaker/Home Health Aide (H/HHA) Services
H/HHA services are personal care and related support services that enable frail or disabled Veterans to live at home.
Family Caregivers Program
VA’s Family Caregivers Program provides support and assistance to caregivers of post 9/11 Veterans and Service Members being medically discharged. Eligible primary Family Caregivers can receive a stipend, training, mental health services, travel and lodging reimbursement, and access to health insurance if they are not already under a health care plan. More information can be obtained from a Caregiver Support Coordinator at the nearest VA health care facility, by visiting, or by calling 1-877-222-VETS (8387).
Geriatrics and Extended Care Services
The mission of VA’s Geriatrics and Extended Care is to advance quality care for aging and chronically-ill Veterans in the most efficient manner. Through research, education and evaluation of new clinical models, we have developed innovative and effective long-term care programs.
Geriatric Evaluation
VA provides assessments and care plan recommendations for the complex problems of aging.
Hospice Services
The primary goal of Hospice services is to provide comfort rather than cure for those with an advanced disease that is life-limiting. VA’s interdisciplinary team of professionals and volunteers focuses on relief of suffering and maintenance of functional capacity as long as possible. Through integrated management of the physical, psychological, social and spiritual needs of the patient, these programs also give support to the patient’s family or other caregivers, which includes bereavement counseling following the death of the patient.
Respite Care Program
Respite Care is a program that provides short-term services to give the caregiver of a chronically-ill or disabled Veteran a period of relief from the demands of daily care.
Respite Care services may include a short stay by the Veteran in a VA Community Living Center (formerly known as a VA nursing home) or hospital; a short stay in a community nursing home; in-home services provided by a personal care aide; or services provided in an adult day health facility in the community.
Respite care is generally limited to 30 days per year.
Domiciliary Care
VA offers two distinct types of Domiciliary Care: short-term rehabilitation and long-term health maintenance care. This program also provides a clinically appropriate level of care for homeless Veterans whose health care needs are not severe enough to require more intensive levels of treatment.
Adult Day Health Care
Adult Day Health Care is an outpatient day program consisting of health maintenance, rehabilitative services, socialization, and caregiver support. Veterans receiving Adult Day Health Care are often frail, elderly and functionally impaired. Adult Day Health Care includes key program elements to address health needs, physical and cognitive functions and social support. The emphasis is on helping participants and their caregivers develop the knowledge and skills necessary to manage care at home.
Nursing Home Placement
Placement in nursing homes, when clinically indicated, may be available either through VA’s Community Living Centers (CLC) or contract nursing homes. The mission of the VA Community Living Centers (VACLC) program (formerly known as VA Nursing Home Care Units) is to provide compassionate care to Veterans with chronic stable conditions — those who suffer from dementia, who require rehabilitation or short-term specialized services (such as respite or intravenous therapy), or who need comfort and care at the end of life. VA nursing home care will be provided to Veterans who:
Require nursing home care for a Service-connected disability;
Are rated 60 percent Service-connected and unemployable and requires nursing home care for any condition;
Have a combined Service-connected percentage of 70 percent or more and requires nursing home care for any condition.
Otherwise, Veterans may be placed, if clinically indicated, based on space availability.
State Veterans Homes
The term “State Home” refers to a VA-recognized home established by a state, primarily for Veterans disabled by age or disease, whose disabilities render them incapable of earning a living. A State Home includes facilities for domiciliary and/or nursing home care. A State Home may also provide care to a Veteran’s spouse or to a parent who has suffered the loss of a son or daughter in service. Eligibility for State Home placement varies by state.
Medically Related Travel, Lodging, and Per Diem
Mileage Reimbursement
Reimbursement of 41.5 cents per mile may be received, subject to applicable deductibles, for travel related to obtaining VA health care services, if the Veteran is:
         Service-connected 30% or more
         Receiving a VA Pension
         Traveling for treatment of a Service-connected condition
         Traveling for a scheduled Compensation and Pension exam (exempt from deductible requirements)
         Reporting income below the maximum annual VA pension rate
Specialized Transportation (Ambulances, Wheelchair Vans)
VA may arrange or provide reimbursement for specialized transportation related to obtaining VA health care services if eligible for mileage reimbursement (based on the above five criteria) and:
The medical condition requires an ambulance or a specially equipped van as determined by a VA clinician; or
The travel is pre-authorized (authorization is not required for emergencies if a delay would be hazardous to life or health)
Lodging and Per Diem
VA may provide payment of the actual cost for meals, lodging, or both — not to exceed 50 percent of the amount allowed for government employees — is reimbursed when it is determined that an overnight stay is required for travel
related to obtaining VA health care services. Factors VA may consider in making that determination include, but are not limited to:
         The distance you must travel;
         The time of day when VA scheduled your appointment;
         The weather, traffic, or other conditions affecting your travel; or
         The medical condition and its impact on ability to travel
Fisher Houses
The Fisher House Foundation, a non-profit organization, was created in 1990 by Zachary and Elizabeth Fisher. Fisher Houses are designed for use by family members of hospitalized Veterans. However, Veterans undergoing outpatient treatment who do not live within commuting distance of the VHA facility may also be accommodated at Fisher  Houses.

Medical Equipment/Prosthetic Items and Aids
VA Prosthetic & Sensory Aids Service (PSAS) furnishes properly prescribed prosthetic equipment, sensory aids and other devices to eligible Veterans. Regardless of cost, PSAS’ purpose is to provide the most appropriate medically  prescribed technology to a Veteran in a timely manner. Prosthetics serves as the case manager for the equipment
needs of disabled Veterans.

Does VA Provide Eyeglasses?
Service-connected Veterans receiving compensation, former Prisoners of War, Purple Heart Recipients, or Veterans in receipt of VA’s Aid and Attendance or Housebound benefits and receiving VA care or services, are provided eyeglasses based on clinical need.
Otherwise, VA provides eyeglasses only in special circumstances. However, Veterans otherwise receiving VA care or services may be eligible because of medically compelling reasons, as determined by a VA eye care practitioner. These circumstances may include vision impairment that results from:

 Diseases or medical conditions for which you are receiving VA care, or which result from treatment of such conditions;
A significant functional or cognitive impairment that causes problems with activities of daily living, not including normally occurring vision loss; or
Vision impairment severe enough to interfere with your ability to actively participate in your health care

Does VA Provide Hearing Aids?
Service-connected Veterans receiving compensation, former Prisoners of War, Purple Heart Recipients, or Veterans in receipt of VA’s Aid and Attendance or Housebound benefits and receiving VA care or services, are provided hearingaids based on clinical need.
Otherwise, VA provides hearing aids only in special circumstances. However, Veterans otherwise receiving VA care or services may be eligible because of medically compelling reasons, as determined by a VA audiologist. These
circumstances may include hearing impairment that results from:
Diseases or medical conditions for which you are receiving VA care, or which result from treatment of such conditions;

A significant functional or cognitive impairment that causes problems with activities of daily living, not including normally occurring hearing loss; or
Hearing impairment severe enough to interfere with your ability to actively participate in your health care
0% Service-connected hearing impairment disabilities that meet certain medical criteria
Automobile Adaptive Equipment Program
VA’s Automobile Adaptive Equipment program provides equipment and training to enter, exit, or operate a motor vehicle for Service-connected Veterans whose Primary Care Provider decides that it is necessary to drive safely and
comply with State licensing laws. Please note that only certain Service-connected conditions qualify. Veterans may also be eligible for financial assistance, in the form of a grant, to purchase a new or used automobile (or other
Automobile Access Equipment
If you are Nonservice-connected, VA may provide automobile access equipment (for example, items such as power ifts, power door openers, turning seats) if you need assistance to enter or exit a motor vehicle. You may be eligible, as determined by your VA Primary Care Provider. For more information, contact the Prosthetic Representative at the local VA health care facility.
Home Improvement and Structural Alteration (HISA) Grants
A Home Improvement and Structural Alteration Grant may be awarded for improvements or structural alterations needed to access home or essential bathroom facilities.
Clothing Allowance Benefit
Service-connected Veterans who must wear a prescribed device that causes their clothing to wear or tear, or if clothing is damaged due to use of a topical ointment, may receive an annual clothing allowance payment. For more information, contact the Prosthetic Representative at the local VA health care facility.
Dependents’ Health Care
Dependents may qualify for VA’s Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). They must not have eligibility under TRICARE and must be dependents of a:

Veteran who has been rated by VA as having a service-connected total and permanent disability.

Veteran who died from VA rated service-connected condition(s), or who, at the time of death, was rated permanently and totally disabled from a VA rated Service-connected condition(s).

Veteran who died on active duty and in the line of duty (not due to misconduct).
For more information, call 1-800-733-8387 or go to
Spina Bifida/Children of Women Vietnam Veterans
VA provides monetary allowances, vocational training and rehabilitation, and VA-financed health care benefits to certain Korean and Vietnam Veterans’ birth children who have been diagnosed with spina bifida. For the purpose of this program, spina bifida is defined as all forms or manifestations of spina bifida (except spina bifida occulta). For more information, call 1-888-820-1756 or go to
Medical Benefits Package Exclusions
The following health care services are not included in the VA Medical Benefits Package:
         Abortions and abortion counseling
         Cosmetic surgery, except where determined by VA to be medically necessary
         Gender alteration
         Health club or spa membership
         In-vitro fertilization

Drugs, biological, and medical devices not approved by the Food and Drug Administration, unless part of formal clinical trial under an approved research program or when prescribed under a compassionate use exemption

Inpatient hospital or outpatient care for a Veteran who is either a patient or inmate in an institution of another government agency, if that agency has a legal obligation to provide the care or services