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Copay Rates
Copay Rates
Outpatient Services
Basic Care Services |
$15 / visit |
Services provided by a primary care clinician |
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Specialty Care Services |
$50 / visit |
Services provided by a clinical specialist such as surgeon, radiologist, audiologist, optometrist, cardiologist, and specialty tests such as magnetic resonance imagery (MRI), computerized axial tomography (CAT) scan, and nuclear medicine studies |
Inpatient Services
There are two inpatient copay rates, the full rate and the reduced rate.
Priority Group 7 and certain other Veterans are responsible for paying 20 percent of VA’s inpatient copay rate. |
| • Inpatient Copay for the first 90 days of care during a 365-day period |
$231.20 |
| • Inpatient Copay for each additional 90 days of care during a 365-day period |
$115.60 |
| • Daily Charge |
$2/day |
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Priority Group 8 and certain other Veterans are responsible for VA’s full inpatient copay rate. |
| • Inpatient Copay for the first 90 days of care during a 365-day period |
$1,156 |
| • Inpatient Copay for each additional 90 days of care during a 365-day period |
$578 |
| • Daily Charge |
$10/day |
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| Veterans living in high cost areas may qualify for a reduced inpatient copay rate. For more information contact VA toll-free at 877-222-VETS (8387). |
Medications
Veterans in Priority Groups 2-6, for each 30-day or less supply of medication for treatment of nonservice-connected condition
(Veterans in Priority Groups 2 through 6 are limited to $960 annual cap) |
$8 |
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Veterans in Priority Groups 7-8, for each 30-day or less supply of medication for treatment of nonservice-connected condition
(Veterans in Priority Groups 7-8 do not qualify for medication copay annual cap) |
$9 |
Veterans in Priority Group 1 do not pay for medications
For information call
1-877-222-VETS (8387) between the hours of
8:00 AM and 8:00 PM ET Monday - Friday
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