LVMAC Tidbits

Understanding Travel Reimbursement for VHA Health Care

We have had a number of inquiries regarding VA travel reimbursement.  The information sheet provided below should answer most questions.

1.  PURPOSE:    To explain travel reimbursement for VHA health care as it applies to veterans and their families.

2.  ELIGIBILTY FOR TRAVEL REIMBURSEMENT*:

 –   Veterans rated 30% or more SC for travel relating to any condition
–   Veterans rated less than 30% for travel relating to their SC condition
–   Veterans receiving VA pension benefits for all conditions
–   Veterans with annual income below the maximum applicable annual rate of pension for all conditions
–   Veterans who can present clear evidence that they are unable to defray the cost of travel
–   Veterans traveling in relation to a Compensation and Pension (C&P) Examination
–   Certain veterans in certain emergency situations
–   Certain non-veterans when related to care of a veteran (attendants & donors)

3.  REIMBURSEMENT RATE FOR VETERANS (Before Deductible):  Effective November 17, 2008 VA reimburses 41.5 cents per mile for ALL veteran travel, including C&P exams and when VA has determined that a deficiency [in]  lab, EKG, x-ray etc. exists in relation to a C&P exam (“Convenience of the Government”).

4.  DEDUCTIBLE:  Effective January 9, 2009 the Beneficiary Travel deductible was reduced to $3.00 per one way trip; $6.00 for a round trip; with a maximum deductible of $18.00 per calendar month, regardless of whether or not the condition being treated is service-connected.

Notes:
–  The $18.00 is the total monthly deductible amount for travel to all VA facilities.
–  Regardless of the deductible amount withheld per trip, deductible requirements end after 6 one- way (3     round) trips in a calendar month.
–  When multiple VA facilities are used, each facility must inquire of the others to determine if the deductible has been met.

Exemptions:
–  Veterans traveling in conjunction with a C&P examination,
–  Non veteran donors
–  Veterans requiring a special mode of transportation such as an ambulance or wheel chair van
–  Deductible  would cause a severe financial hardship (see “Waivers” and 38 CFR § 70.31(c))

5.  TOLLS AND PARKING:  Reimbursement for these and/or other accessories of travel may be provided upon presentation of an appropriate receipt. Reimbursement is based on a case-by-case basis and the individual needs and condition of the beneficiary.

6.  MEALS AND LODGING:  VA may provide reimbursement for the actual cost up to 50% of the government employee rate for meals and/or lodging, when appropriate. The need for such costs should be determined on a case-by-case basis and based upon the veteran’s medical condition, distance required to travel, and any other extenuating circumstances. Such items should be requested and authorized in advance of travel. Reimbursement should not be provided solely because the veteran chooses to stop or take a less direct route to the VA facility.

7.  REIMBURSEMENT OF ATTENDANTS: VA has the authority to pay for transportation and associated incidental costs (lodging, food, etc.) at VA expense of certain non-veterans.  This includes when it is clinically determined by a VA provider that due to the veteran’s mental or physical condition that an attendant is required when transporting the veteran.

8.  REDUCED FARE REQUESTS: Printed reduced-fare requests for use by eligible beneficiaries and their attendants when traveling at their own expense to or from any VA facility or VA-authorized facility for authorized VA health care are available from any VA medical facility. Beneficiaries may use these request forms to ask transportation providers, such as bus companies, for a reduced fare. Whether to grant a reduced fare is determined by the transportation provider.

9.  APPLICATION:  A claimant may apply for beneficiary travel orally or in writing but must provide VA the receipt for each expense other than for mileage. Submit the information to the Chief of the Business Office or other designee at the VA medical facility responsible for the medical care or services being provided and for which travel is required.  Some facilities, like Wilkes-Barre VAMC, will reimburse on the spot for local travel.  Others, like the Allentown Clinic and Lyons VAMC, will forward a check.

–  Without a Special Mode of Transportation: Apply within 30 calendar days after completing travel.
–  With a Special Mode of Transportation:  Apply but obtain approval from VA prior to the travel.  No time limit specified.
–  Emergency treatment:  If there has been an emergency treatment and the claimant applies for payment of Beneficiary Travel (without prior approval) within 30 calendar days after the travel is completed, the application will be considered timely submitted.
–  Eligible within 30 days of travel: If a person becomes eligible for Beneficiary Travel after the travel takes place, payment may be made if the person applies for travel benefits within 30 days of the date when the person became eligible for travel benefits.

ADDITIONAL DETAILS:  Primary sources were:

–  http://www.va.gov/healtheligibility/library/faqs/benetravelfaq.asp#eligible
–  38USC111
–  38CFR70.31
–  http://www.va.gov/healtheligibility/Library/pubs/BeneficiaryTravel/BeneficiaryTravel.pdf

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Footnotes:  * Other federal employees and former allies may be reimbursed if an arrangement for service  has been made.

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As of 5 September 2011