Mental Health Copay Exemptions for Eligible Veterans

The Department of Veterans Affairs (VA) is committed to ensuring that veterans have access to essential mental health care services. To support this commitment, eligible veterans may be entitled to a valuable benefit—a copay exemption for their first three outpatient mental health or substance use disorder visits in a calendar year. The visits must be between June 27, 2023, and December 29, 2027. This exemption can significantly lower healthcare costs and make vital mental health care more accessible.

Understanding the Eligibility Criteria

To qualify for the copay exemptions, veterans must be enrolled in VA healthcare and have existing copays for outpatient mental health and substance use disorder services. The VA will review copays to determine their eligibility for exemption and will reimburse any eligible copays that have already been paid.

Covered Services

Under the copay exemptions, eligible veterans won’t have to pay the first three copays for outpatient mental health or substance use disorder visits with qualified providers at a VA facility or in the VA community care network. These providers encompass qualified outpatient mental health care professionals who offer essential services without requiring an overnight stay.

Important Considerations

It’s important to note that while these exemptions cover initial visits, veterans are still responsible for medication copays, inpatient care, and other applicable charges related to their healthcare needs.

Securing Your Copay Exemption

Eligible veterans don’t need to undertake any specific actions or provide additional documentation to secure this exemption. They can simply proceed with their scheduled outpatient mental health or substance use disorder appointments as usual.

If you require clarification on your copays or assistance with managing them, you can contact the phone number provided on your patient statement. You may explore options such as setting up a repayment plan or requesting a waiver from the VA.

Find out how to request financial hardship assistance

In conclusion, these valuable exemptions are set forth by the VA with an aim of ensuring that essential mental health care is financially accessible for eligible veterans. By waiving initial visit copays within specified timeframes at both VA facilities and within community care networks, these measures demonstrate a commitment towards supporting veteran well-being through easier access of critical services.

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