Billing & Insurance
While many Veterans qualify for free health care services based on a VA compensable service-connected condition or other qualifying factor, most Veterans are asked to complete an annual financial assessment, to determine if they qualify for free services. Veterans whose income exceed the established VA Income Thresholds as well as those who choose not to complete the financial assessment must agree to pay required copays to become eligible for VA health care services.
The Fee Basis VA program allows Veterans to be seen by a community provider. The Fee Basis program or Non-VA Care is health care provided outside VA. NVCC Office coordinates services and payments for Veterans receiving non-VA care for emergent and non-emergent medical care.
For more information call 1-800-396-7929.
Claims for Non-VA Emergency Care
Veterans need to make sure any bills for non-VA emergency care of non-service connected conditions are submitted to the VA Medical Center’s NVCC Office within 90 days. For emergency care of service connected conditions, there is a two-year limit to submit any bills.
Non-VA Care
P.O. Box 14830
Albany, NY 12212
Private Health Insurance
Private health insurance coverage through a Veteran or Veteran's spouse is insurance provided by employer, Veteran or other non-federal source.
VA health care is not considered a health insurance plan.
VA is required to bill private health insurance providers for medical care, supplies and prescriptions provided for treatment of Veterans' nonservice-connected conditions. Generally, VA cannot bill Medicare, but can bill Medicare supplemental health insurance for covered services.
All Veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. Veterans are not responsible for paying any remaining balance of VA's insurance claim not paid or covered by their health insurance, and any payment received by VA may be used to offset "dollar for dollar" a Veteran's VA copay responsibility.
What's in it for me for providing health insurance information?
- You will not be responsible for any unpaid balance that the insurance carrier does not pay except for VA copay.
- Payments from your private health insurance carrier may allow us to offset part or all of your copay.
- Many private health insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.
Insurance Coverage and Eligibility for VA Health Care
Your insurance coverage or lack of insurance coverage does not determine your eligibility for treatment at a VA health care facility.
Risks of Giving Up Your Private Insurance
What should you do with your private health insurance if you are accepted into VA health care? You could save of money if you dropped the insurance, but there are some things you should consider.
- What about your non-Veteran family members?
- What would happen if you are disenrolled from VA's health care program?
- Do I still need Medicare Parts A and B if I receive my health care from VA?
- What would happen if you drop your Medicare Part B coverage?
VA does not normally provide care for family members of Veterans enrolled in VA's health care program. If you drop your private health insurance, they may have no health care coverage.
There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.
VA does not require a Veteran to have Medicare Part A or B to be enrolled in VA health care. However, a Veteran may want to consider their total health care needs before changing any insurance coverage.
If you cancel your Medicare Part B Coverage, you need to know that you cannot be reinstated until January of the following year, and you may be penalized for reinstatement.
For these reasons, VA encourages you to keep your private health insurance.
