Catastrophic Disabilities And Copay Exemption

Washington, DC—Thanks to a new law passed in May, the Caregiver and Veterans Omnibus Health Services Act of 2010, veterans who are determined by the Department of Veterans Affairs (VA) to be “catastrophically disabled” qualify for an exemption from inpatient, outpatient and prescription copays. However, they may still be subject to copayments for extended care (long-term care) services.
 
“Paralyzed Veterans of America applauds this new law that exempts our veterans with severe disabilities from copays for doctor visits and prescription medications. These folks have already paid through their service,” said Gene A. Crayton, national president of Paralyzed Veterans of America. “Many veterans who suffer from catastrophically disabling injuries are already struggling to carry out the activities of daily living, so anything that can be done to help make their lives, and their caregivers’ lives, more manageable should be done.”

A catastrophically disabled determination may be authorized when a VA clinician determines that there is sufficient medical documentation without the need for further evaluation. Veterans may also request a catastrophically disabled evaluation by contacting the enrollment coordinator at their local VA health-care facility. It is VA policy to provide veterans with catastrophic disabilities an evaluation within 30 days of the request. There is no charge for this examination. Veterans who believe they may qualify for catastrophic disability status are encouraged to apply for enrollment or, if already enrolled, to request an evaluation through their primary care team or their local enrollment coordinator.
  
VA is also currently reviewing copayments made by veterans with catastrophic disabilities for inpatient care, outpatient care, and prescriptions received on or after May 5, 2010, when the law was signed into effect. VA has indicated that copayment charges will be cancelled, or if veterans have previously paid, refunds will be issued. For more information, veterans should contact the enrollment coordinator at their VA Medical Center: call 1-877-222-VETS (8387); or visit www.va.gov/healtheligibility.