VA Northern California Health Care System
Billing & Insurance
Non-VA Emergency Billing Information
- If you must take the Veteran to Non-VA hospital (no VA hospital within 40 miles), inform Hospital ER Staff that Veteran is a patient of VA Northern California Health Care System.
- Hospital Staff must notify Purchased Care at (707) 562‐8430 of the Veteran’s arrival and condition.
CALL 911 if Veteran is experiencing a life-threatening medical emergency.
Complete ER paperwork and include the following billing address:
Department of VA Attn: 04/Community Care 201 Walnut Ave,
Mare Island, CA 94592
Notify Advice Nurse at (800) 382‐8387 of Veteran’s emergency as soon as possible.
Notify VANCHCS at (707) 562‐8430 as soon as possible and no later than 72 hours to avoid being responsible for Non-VA Emergency Charges.
*Note: Notification is not a guarantee of payment.
Copays and Charges Information
You may wish to review information for veterans about the new Medicare prescription drug benefits.
On January 1, 2006, Medicare prescription drug coverage (Medicare Part D) became available to everyone with Medicare Part A or B coverage. Veterans enrolled in the VA health care system may choose to enroll in Medicare Part D in addition to their VA benefits. The Medicare prescription drug coverage is wholly voluntary on the part of the participant. Each individual must decide whether to participate based on his or her own circumstances.
Private Health Insurance
Private health insurance coverage through a Veteran or Veteran's spouse is insurance provided by employer, Veteran or other non-federal source.
VA health care is not considered a health insurance plan.
VA is required to bill private health insurance providers for medical care, supplies and prescriptions provided for treatment of Veterans' nonservice-connected conditions. Generally, VA cannot bill Medicare, but can bill Medicare supplemental health insurance for covered services.
All Veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. Veterans are not responsible for paying any remaining balance of VA's insurance claim not paid or covered by their health insurance, and any payment received by VA may be used to offset "dollar for dollar" a Veteran's VA copay responsibility.
What's in it for me for providing health insurance information?
- You will not be responsible for any unpaid balance that the insurance carrier does not pay except for VA copay.
- Payments from your private health insurance carrier may allow us to offset part or all of your copay.
- Many private health insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.
Insurance Coverage and Eligibility for VA Health Care
Your insurance coverage or lack of insurance coverage does not determine your eligibility for treatment at a VA health care facility.
Risks of Giving Up Your Private Insurance
What should you do with your private health insurance if you are accepted into VA health care? You could save of money if you dropped the insurance, but there are some things you should consider.
- What about your non-Veteran family members?
- What would happen if you are disenrolled from VA's health care program?
- Do I still need Medicare Parts A and B if I receive my health care from VA?
- What would happen if you drop your Medicare Part B coverage?
VA does not normally provide care for family members of Veterans enrolled in VA's health care program. If you drop your private health insurance, they may have no health care coverage.
There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.
VA does not require a Veteran to have Medicare Part A or B to be enrolled in VA health care. However, a Veteran may want to consider their total health care needs before changing any insurance coverage.
If you cancel your Medicare Part B Coverage, you need to know that you cannot be reinstated until January of the following year, and you may be penalized for reinstatement.
For these reasons, VA encourages you to keep your private health insurance.