Veterans Affairs Facilities
Most Veterans Affairs (VA) facilities are network providers, but check with your regional contractor before making an appointment. >>Find a VA facility near you
When and how you get care at a VA facility depends on your military status and your health care needs.
Active Duty/Guard and Reserve Members
In the following scenarios, you can get limited health care services at VA facilities.
- You can get emergency care without a referral or authorization.
- Call your primary care manager (PCM) or regional contractor within the first 24 hours or next business day so the care can be authorized.
Urgent and Routine Care
- You can get urgent and routine care if you have a valid referral and authorization from your PCM or regional contractor.
- The VA may see you without a referral, but to follow TRICARE’s rules, you must have a referral to get care from any provider other than your PCM.
Separated and Retired Service Members
Separated and retired service members may qualify for VA benefits upon separation or retirement.
If You Separate
If you separate or "get out" before you retire, you qualify for transitional coverage but will eventually lose all TRICARE benefits. After TRICARE coverage is lost, you can get care through the VA when you qualify.
If You Retire
If you retire and qualify for VA benefits, you can use your TRICARE and VA benefits together. You will see the VA for service-connected conditions and use TRICARE for everything else.
Beneficiaries Using TRICARE For Life
VA facilities, even if they are in the TRICARE network, are not Medicare-authorized providers.
- Medicare can't pay for care at a government facility.
- When you use TRICARE For Life to get care for a non-service-connected condition from a VA facility, the VA can't bill Medicare.
- TRICARE can pay only up to 20% of the TRICARE allowable chargeThe maximum amount TRICARE pays for each procedure or service. This is tied by law to Medicare's allowable charges.. You're responsible for the remaining balance.
You should get care for your service-connected disability at a VA facility, but for all other care, consider all of your options, including using a Medicare-certified provider. When using Medicare providers, you typically have no out-of-pocket costs for services covered by both Medicare and TRICARE. If you use your TRICARE For Life benefit at a VA facility and have no other VA benefit to cover those costs, you'll be required to pay the remaining balance after TRICARE pays its 20% of the TRICARE-allowable charge.
Talk to your VA facility about your VA options, including how VA claims are processed if you are entitled to Medicare or have other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance.".
Last Updated 1/19/2018