The Department of Veterans Affairs has made provisions for an emergency medical card for certain veterans. However, the veteran must be eligible for this service. This eligibility covers all special services, such as ambulance transportation and emergency medical expenses.
VA payment for ambulance transportation
For ambulance transport to be paid for by Veterans Affairs, the transport has to be pre-authorized. Payments can only be made without pre-authorization in certain emergency conditions or situations.
Two criteria must be met before approval, which include:
- A claimant must meet appropriate administrative eligibility
- A VA provider must determine the medical need for ambulance transport.
Note: this ambulance transport can only be paid for if the VA is already providing medical care for the veteran.
Pre-authorized ambulance record
For a veteran to access this transport, you must meet the administrative requirements.
- The veteran has a service-connected (SC) disability, or
- The veteran is currently receiving a VA pension, or
- The income of the previous year does not exceed the maximum VA pension rate, or
- The projected income in the travel year does not exceed the maximum VA pension, or
- The use of the ambulance is related to the care for the SC disability, or
- The use of the ambulance is for a Compensation and Pension exam, or
- The ambulance transport is related to VA transplant care, or
- The travel is to obtain a service dog, and
- There is documentation from a VA clinician that the use of ambulances (special mode transportation) is medically required.
Unauthorized ambulance transportation
Special transportation such as ambulance transportation must be pre-authorized by the VA unless it is about a medical emergency. In times of emergency, the veterans don’t need to contact the VA but they are encouraged to contact 911 or go to the nearest medical emergency room.
However, there are some criteria to be met for the VA to pay for these emergency services. The VA pays for emergency services if:
- The claimant meets administrative and medical travel eligibility criteria under the “pre-authorized ambulance transport”
- VA pays for emergency care in the community care facility under the no-service-connected (NSC) or SC authorities.
- VA is contacted within 72 hours of care at a community care facility and retroactively authorizes the community care for payment.
Documents required for emergency services
The following documents are required by the VA to consider a claim for payment of emergency care provided and associated ambulance transport:
- Documented request for VA payment of emergency transportation. This must be made available within 30 days of transport.
- Ambulance trip report documenting circumstances of medical events and care provided by the ambulance service.
- Invoice from ambulance service and community care provider.
- Community care facility records of care provided to the veteran. (These will be requested by the VA from the facility).
