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Getting Emergency Care At Non-VA Facilities

Tbird
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Always check on VA.gov for the latest.

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 the VA's community care network—you must follow certain rules so that the VA 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.

What to know if you go to a non-VA facility for emergency care

The facility must be an EMERGENCY DEPARTMENT

VA will only cover the cost of emergency care at an emergency department. An emergency department is a facility that has the staff and equipment to provide emergency care (like a hospital or free-standing emergency department).

Urgent care facilities don’t qualify as emergency departments. If you’re not sure what type of facility you should go to, we can help.

Learn more about choosing between emergency and urgent care

The VA must be notified of your care within 72 hours

Ask the provider to notify us right away in either of these ways:

We must get the notification within 72 hours of when your emergency care starts. We prefer that the provider notify us. But if they don’t, you or someone acting on your behalf can notify us instead.

We can only cover emergency care when you meet certain requirements

Keep reading to learn more about eligibility requirements for emergency mental health care and other types of 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 the VA's 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.

What to do if you’re charged for emergency care

If you get a bill for emergency care at a non-VA facility and you think we should cover the cost, we can help. Call us at 877-881-7618 (TTY: 711). We’re here Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

We’ll go over the charges with you and help figure out who should cover the cost of your care. We can also help resolve billing issues with community providers.

Find out how to file a claim for reimbursement of non-VA medical expenses.


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Tbird
 

Founder HadIt.com Veteran To Veteran LLC - Founded Jan 20, 1997

 

HadIt.com Veteran To Veteran | Community Forum | RallyPoint | FaceBook | LinkedIn | About Me

 

Time Dedicated to HadIt.com Veterans and my brothers and sisters: 65,700 - 109,500 Hours Over Thirty Years

 

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I am writing my memoirs and would love it if you could help a shipmate out and look at it.

I've had a few challenges, perhaps the same as you. I relate them here to demonstrate that we can learn, overcome, and find purpose in life.

The stories can be harrowing to read; they were challenging to live. Remember that each story taught me something I would need once I found my purpose, and my purpose was and is HadIt.com Veterans.

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