Getting emergency care at non-va facilities | veterans affairs

WHAT TO KNOW IF YOU GO TO A NON-VA FACILITY FOR EMERGENCY CARE THE FACILITY MUST BE AN EMERGENCY DEPARTMENT We can 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 WE MUST GET 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 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.