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Dental Emergency

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I had to recently pay $1000.00 for a root canal at the U of Mi Hospital. I still owe $300.00. Can I get reimbursed for any of that cost? I go to the VA now for my dental.


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Write a letter to request it.

If you were within the donut hole between the effective date and the decision, Maybe you can do it.


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  • HadIt.com Elder




VA Payment for Emergency Care Provided by a Community Hospital http://www.visn2.va.gov/vet/vsc/emergcare.asp

We encourage you to call your VA medical center first for care.

However, if you should need emergency care for a medical or mental health condition and there is no VA medical center close to you - call 911 or go to the nearest community hospital that has an emergency room.

When you are admitted to a community hospital for emergency care a family, friend or hospital staff needs to contact VA within 72 hours of your admission to provide VA information about your emergency care.

In limited circumstances, VA may authorize payment for care provided in a non-VA facility.

VA policy states that payment for outpatient and inpatient emergency care services provided by a community hospital may be paid if the following criteria are met:

The emergency treatment was for a Service-Connected (SC) disability or

The emergency treatment was for a Non- Service Connected (NSC) disability and you have no other health care insurance coverage (Millennium Health Care and Benefits Act) and

Treatment was for an emergent condition and

A VA facility was not available to you and

The claim is filed timely and

All VA forms are completed, signed and returned to VA upon request

*VA's Millennium Health Care and Benefi ts Act provides a safety net to veterans enrolled in VA health care for emergency care for a non Service Connected condition and who have no other means of health insurance coverage for the emergency services provided.

Emergency care provided outside the United States may be paid by VA if the emergency care is related to a service-connected condition.

For more information on care provided by a community emergency room call the Network 2 Fee Processing Center at 1-800-396-7929 or visit www.va.gov/hac/hacmain.asp

For more information on care outside the United States contact VA Health Administration Center at (877) 345-8179 or go to www.va.gov/hac/hacmain/.asp

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I think that outside of any emergency situation this is the hill you will have to climb as it is a requirement of Title 38 (not CFR 38):

(<_< In a medical emergency. Care and services not previously authorized were rendered in a medical emergency of such nature that delay would have been hazardous to life or health, and

Check out Title 38 section 17:120 and see if it helps you.

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The chance is slim but you should try.

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If you were in the dounut hole you can get the VA to pay for dental care. I did it. It took 6 months for them to pay but they paid most of it. If you had a severe toothacke on a day when no VA dentist was available and you had to use your own doctor to fix a tooth you should be able to get reimbursement. You would have to try to get VA care first if you are eligible. You would need to get a statement from the dentist saying your care was an emergency. The VA will try not to pay and may insist on records from the dentist to prove emergency or to even show you had care if you are in the dougnut hole.

The situation I am in now is that the VA refused to do an implant and I got my own dentist to do it. Can I get these jerks to pay since the VA claims it was not a medical necessity.

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  • In Memoriam

I was not service connected and went to VA dental, in Los Angeles, about 5 years ago. I told VA dental that I had pain; then the VA dental found the problem doing a root-canal.

I have never been turned down by VA dental in a dental emergency.

Even after I moved to Arkansas, before my service connection about 2 years ago, the VA dental fixed a tooth that had cracked down the middle causing pain. While I was there they fixed 3 other teeth in the same sitting.

This could make it hard to recomp expenses.

There seems to be a world of difference between VAMC and VA dental department, every where that I have gone to.

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