Request an annual statement of all payments made to the VA. Obtain your statement account number. Discuss the posting of a prior payment to your VA records. Due to COVID-19 the VA has been unable to mail bills to Veterans for copays, and a consolidated bill will be mailed in the future. However, Veterans can still check balances and make payments using one of three options: 1. Call 1-888-827-4817.
VAPORHCS wants to keep you abreast of this upcoming change that was part of the nation's relief response to the COVID-19 pandemic so you can plan accordingly. There are many options and resources for Veterans in the brief article below.
(Updated November 6, 2020; see FAQs below)
Veterans should be aware and plan accordingly that the current suspension of VA collection actions and extension of terms of previous repayment agreements is scheduled to end December 31, 2020.
VA stopped sending monthly billing statements for medical care debt starting April 6, 2020. This change followed the President’s April 2 announcement that was part of the nation's relief response to the COVID-19 pandemic. In addition, all actions on debts owed to VA in the form of copayments under the jurisdiction of the U.S. Department of Treasury were suspended.
With the conclusion of the mandated deferral, VA plans to begin billing Veterans in January 2021 for those postponed copays.
In January, Veterans should receive a patient statement that includes new copay charges for any care or prescriptions from April 6, 2020, through December 31, 2020, and any unpaid copays from before April 2020.
Veterans are not required to make payments until after December, but they can make them now if they want.
How do I pay my VA copay bill?
Veterans can pay their bill in any of these 4 ways:
Online
Pay directly from your bank account or by debit or credit card on the secure Pay.gov website.
By phone
Call the VA at 888-827-4817. Be sure to have your account number ready.
By mail
Send your payment stub, along with a check or money order made payable to 'VA,' to the address below. Be sure to include your account number on the check or money order.
Department of Veterans Affairs
PO Box 3978
Portland, OR 97208-3978
In person
Visit your nearest VA medical center and ask for the “agent cashier's office.” Bring your payment stub, along with a check or money order made payable to “VA.” Be sure to include your account number on the check or money order.
The agent cashier can look up your billing information; just bring a photo ID card.
Agent cashier's office, Bldg. 100, 3rd floor (open M-F, 8 a.m.-4 p.m.)
3710 Southwest US Veterans Hospital Road
Portland, OR 97239-2964
Click THIS LINK for other details and answers about…
Pay My Va Bill Online
- how to dispute your copay charges;
- and how to request financial hardship assistance.
Frequently Asked Questions
(As of Novmber 6, 2020)
Why are Veteranscurrentlynot receiving monthlypatientstatements from the Department of Veterans Affairs (VA)?
Due to thepotentialimpactCOVID-19may haveonVeterans’financial well-being,VAis notprinting and mailingpatient statements for health-care-associated costs from April 6, 2020, through December31, 2020. This means Veterans will not receive a monthly bill for any copaysincurredduring this time. VA will not be adding late charges or interest toaccountsor take any collection action onmedical caredebt until after December31, 2020.
When will theprinting andmailing of statements resume?
Patientstatements are expected to resumemail delivery in January 2021. Thosepatientstatements will includeunpaidchargesincurredprior to April 2020 and charges for services and medications received from April 2020 through December31, 2020.
How can Veterans find their current balances?
Veterans can obtain balances by calling 866-400-1238 or their local VA medical center’srevenue office.In November 2020, Veterans will receive a letter citing a current balance owed on accounts, with information on how payments may be voluntarily made.An outgoing call campaign will commenceonNovember6, 2020and will includeOffice of Community CareRevenue Operations staff callingVeterans with a greater than $2,000copayment balance.
What happens in January 2021 when statements resume? Will Veterans be required to pay the full statement balance?
In January 2021, Veterans will have the option to pay theircharges in full or arrange a payment plan to make smaller monthly payments. VA continues to consider Veterans who experienced changes to income and are struggling to make copayments due to COVID-19. Financial Hardshiparrangementscan also be requested at this timeor earlier.
How do Veterans make payments on their accounts if they are not receiving monthlypatientstatements?
Veterans can make payments to accounts during this time.Veterans or other payers must have theiraccount number.
- An account balancecanbe obtained by:
- Calling866-400-1238
- Callingthelocal VA medical center’sfacilityrevenue office
- ConsultingtheNovemberletter containing theiraccountbalance andadditionaldetails on the halt inpatientstatementprinting and mailing(Appendix A)
- Methods by which a Veteran can pay on a balance
- www.pay.gov
- Callinga VA medical center facility revenue office
- By mail:
Department of Veterans Affairs
PO Box 3978
Portland, OR 97208-3978
- By phone at 888-827-4817
What debt relief options are available to Veterans?
Debt relief options are always available to Veterans. They include:
- Set up a repayment plan
- Request a waiver, write off or compromise of your debt
- Request a VA Hardship Determination
To learn more, please visithttps://www.va.gov/health-care/pay-copay-bill/financial-hardship/
Copayments
Medical Debt Relief
American Rescue Plan: Copayment Cancellations and Refunds
Due to the passage of the American Rescue Plan in March 2021, copayments for medical care and prescriptions provided by the Veterans Health Administration (VHA) during the period of April 6, 2020 through September 30, 2021 will be canceled. All copayments paid to VA for medical care and prescriptions during the period of April 6, 2020 to present will be refunded.
Please review the COVID-19 Medical Debt Relief page for answers to some common questions.
COVID-19 Medical Debt Relief FAQs
Enrolled Veterans will be assessed copayments for care or services (including urgent care) based on their eligibility and/or income on file in the VA health care system. For care or services furnished through the Veterans Community Care Program, the same copayment requirements will apply. Copayment rates are listed below.
For information on how to pay your bill or copayment, visit our Billing and Payments page.
Billing and Payments
Veteran Copayments— Published October 6, 2017
You can explore your eligibility for VA health care benefits using the online Health Benefits Explorer or by contacting the VA Call Center.
VA Call Center: 877-222-VETS (8387)
Monday through Friday, 8:00 a.m. – 8:00 p.m. ET
Urgent Care (Community Care)
Veterans may be charged a copayment for urgent care that is different from other VA medical copayments.
- Copayments depend on the Veteran’s assigned priority group and the number of times an urgent care provider is visited in a calendar year.
- Copayment charges are billed separately by VA as part of VA’s billing process. There is no limit to the number of times a Veteran can go to an urgent care provider. For more information, visit the OCC Urgent Care page.
OCC Urgent Care page
| Veteran Priority Groups | Copayment Amount |
|---|---|
| 1-5 |
|
| 6 | If related to a condition covered by a special authority:
If not related to a condition covered by a special authority: $30 per visit |
| 7-8 | $30 per visit |
| 1-8 | $0 copay for visit consisting of only a flu shot |
Outpatient Care
Outpatient care is defined as primary or specialty care that does not require an overnight stay. Copayments for outpatient care are listed in the table.
NOTE: Veterans who have a service-connected rating of 10% or higher are not required to pay a copayment for outpatient medical care.
| Examples of Outpatient Care | Copay |
|---|---|
| Primary Care Services | $15 per visit |
| Specialty Care Services: Services such as outpatient surgery, dermatology, audiology, optometry, cardiology and specialty tests like MRI or CAT scan. | $50 per visit |
Inpatient Care
Inpatient care occurs when a patient’s condition requires admission to a hospital. There are two inpatient copayment rates: the full rate and the reduced rate. Veterans living in high cost areas may qualify for a reduced inpatient copayment rate. Copayment rates for an inpatient hospital stay are listed in the table below.
NOTE: Veterans who have a service-connected disability rating of 10% or higher are not required to pay a copayment for inpatient medical care.
| Veteran Priority Groups | Copay (2021) | Period of Service/Care |
|---|---|---|
| Priority Group 7 Veterans Veterans with gross household incomes below the geographically-adjusted VA income limits for their resident location and who agree to pay copayments. | $296.80 | First 90 days of care during a 365-day period |
| $148.40 | Each additional 90 days of care during a 365-day period | |
| $2 | Per day charge | |
| Priority Group 8 Veterans Veterans with gross household incomes above the geographically-adjusted VA income limits for their resident location, who agree to pay copayments, and meet other specific enrollment and service-connected eligibility criteria. | $1,484 | First 90 days of care during a 365-day period |
| $742 | Each additional 90 days of care during a 365-day period | |
| $10 | Per day charge |
Medications
Medication copayments are required for each prescription, including each 30-day (or less) supply of maintenance medications prescribed on an outpatient basis for nonservice-connected conditions. This copayment may change annually.
Medication copayments are also charged for all over-the-counter (OTC) medications (like aspirin, cough syrup, and vitamins) that are dispensed from a VA pharmacy. You may want to consider purchasing over-the-counter medications on your own.
NOTE: There is an annual medication copayment cap of $700 for Veterans in Priority Groups 2 through 8. Guitar pro mod. The medication copayment cap goes by calendar year (January 1 – December 31).
Veterans who have a service-connected rating of 40% or less, and whose income is at or below the applicable national income thresholds may wish to complete a medication copayment exemption test.
VA National Income LimitsVA Financial Assessment information
| Veteran Priority Groups | Copay | |||
|---|---|---|---|---|
| Priority Group 1 Veterans Veterans with VA-rated service-connected disabilities 50% or more disabling or Veterans determined by VA to be unemployable due to service-connected conditions or Medal of Honor recipients. | No copayment | |||
| Priority Group 2-8 Veterans Required to pay for each 30-day or less supply of medication for treatment of nonservice-connected condition (unless otherwise exempt). Limited to $700 annual cap. IMPORTANT: Some Veterans may qualify for reduced or no-cost prescriptions based on special eligibility factors. | Prescription Drug Tier | Days of Supply | ||
| 1‑30 | 31‑60 | 61‑90 | ||
| Tier 1: Preferred generics | $5 | $10 | $15 | |
| Tier 2: Non-preferred generics and some OTC medications | $8 | $16 | $24 | |
| Tier 3: Brand-name | $11 | $22 | $33 | |
Additional information on tiered medication copays can be found on the VA Pharmacy Benefits Management Services website.
Geriatrics and Extended Care
Copayments for health care for older Veterans are based on three levels of care—inpatient, outpatient, and domiciliary (see below). Copayment rates will vary from Veteran to Veteran depending upon financial information submitted on VA Form 10-10EC, Application for Extended Care Services.
NOTE: Copayments for long-term care services start on the 22nd day of care during any 12-month period. There is no copayment requirement for the first 21 days.
| Inpatient Care | Copay |
|---|---|
| Community Living Centers (formerly known as nursing homes) VA Community Living Centers are long-term care services provided to Veterans who need a skilled environment for short-term and long-term stays. | Up to $97/day |
| Respite Care Respite Care is a service that pays for someone to come to a Veteran's home or for a Veteran to go to a program while your family caregiver takes a break. Respite Care services may be available up to 30 days each calendar year. | Up to $97/day |
| Geriatric Evaluation A multidisciplinary team consisting of a doctor, nurse, and several other health providers conduct an evaluation to promote, preserve, or restore a Veteran’s health. The information gained from the Geriatric Evaluation helps you and your family decide what type of services and support would best meet your needs and preferences. | Up to $97/day |
| Outpatient Senior Care | Copay |
| Adult Day Health Care Adult Day Health Care is a program Veterans can go to during the day for social activities, peer support, companionship, and recreation. Adult Day Health Care is for Veterans who need skilled services, case management, and assistance with activities of daily living (e.g., bathing and getting dressed); instrumental activities of daily living (e.g., fixing meals and taking medicines); and/or are isolated or your caregiver is experiencing burden. Adult Day Health Care can provide respite care for your family caregiver and can also help you and your caregiver gain skills to manage your care at home. | Up to $15/day |
| Respite Care Respite Care is a service that pays for someone to come to a Veteran's home or for a Veteran to go to a program while your family caregiver takes a break. Respite Care services may be available up to 30 days each calendar year. | Up to $15/day |
| Geriatric Evaluation A multidisciplinary team consisting of a doctor, nurse, and several other health providers conduct an evaluation to promote, preserve, or restore a Veteran’s health. The information gained from the Geriatric Evaluation helps you and your family decide what type of services and support would best meet your needs and preferences. | Up to $15/day |
| Domiciliary Care for Homeless Veterans | Copay |
| Short-Term Rehabilitation and Long-Term Health Maintenance Care VA offers two types of Domiciliary Care: short-term rehabilitation and long-term health maintenance care. This program provides clinically appropriate levels of care for homeless Veterans whose health care needs are not severe enough to require more intensive levels of treatment. | Up to $5/day |
Resources
Va Monthly Copay Statements
877-222-VETS (8387)
Monday – Friday
8 a.m. – 8 p.m. EST
VA Geriatrics and Extended Care Resources
Does The Va Charge A Copay
• VA Geriatrics and Extended Care
• VA Community Living Centers
• Respite Care
• Adult Day Health Care
• Domiciliary Care for Homeless Veterans Program