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Spina Bifida Health Care Benefits Program (SBHCBP)

 

icon spine with medical crossThe Department of Veterans Affairs (VA) provides monetary allowances, vocational training and rehabilitation and VA-financed health care benefits to certain Korea and Vietnam Veterans' birth children who have been diagnosed with spina bifida (SB). If you are the birth child of a Vietnam Veteran and you have been diagnosed with spina bifida, you may already be receiving monetary allowances, vocational training or rehabilitation due to your condition. For the purpose of the VA SB Health Care Benefits Program, spina bifida is defined as all forms or manifestations of spina bifida (except spina bifida occulta).

The Veterans Health Administration Office of Community Care (VHA OCC) in Denver, Colo., manages the SB Health Care Benefits Program, including authorization of benefits and the subsequent processing and payment of health care claims after a determination of eligibility has been made by the Denver VA Regional Office (VARO).


How to Apply

To qualify, you must be diagnosed with spina bifida as the VA defines it — basically, all forms or manifestations of SB (except spina bifida occulta).

Once the Denver VARO determines eligibility, Spina Bifida awardees (or guardians) are contacted by the Veterans Health Administration Office of Community Care and registered for health care benefits. The VHA OCC will then send beneficiaries detailed information addressing covered and noncovered services and supplies, preauthorization requirements, and claim filing instructions.

You can contact the Denver VA Regional Office for detailed application information, Monday through Friday from 8 a.m. to 3 p.m., Mountain Standard Time (MST), except Wednesday, 8 a.m. to 11:30 p.m., MST.

Denver VA Regional Office Contacts

Phone: 303-914-2900 (NOT toll free)
Colorado residents can call 800-827-1000

Fax: 303-914-5903

Email: BDEFECTS.VBADEN@va.gov

Mail:
VA Regional Office
Veterans Service Center (339/21)
PO Box 25126
Denver CO 80225

Pharmacy Benefits

Meds by Mail: Meds by Mail is a voluntary service that provides a safe, easy and cost-free way for eligible CHAMPVA and Spina Bifida beneficiaries to receive non-urgent maintenance medications delivered right to your door.

OptumRx Retail Pharmacy Network: OptumRx electronically processes pharmacy claims nationwide, including Puerto Rico, Guam, and the Virgin Islands. Beneficiaries are serviced through a network of over 82,000 retail pharmacies.

Pharmacy Benefits

How to File a Claim for SB Health Care Benefits

View SB Claims Information for detailed information on how to submit various types of claims for the VA Spina Bifida Health Care Benefits Program. Health care providers can obtain more information about the program and how to file claims on SB Health Care Benefits Program–Information for Providers.

SB Claims InformationSB Health Care Benefits Program–Information for Providers

SB Health Care Benefits Program and the Affordable Care Act

The Affordable Care Act (ACA) is a health care law that was created to expand access to affordable health care coverage for all Americans, lower costs, and improve quality and care coordination. Under the health care law, people will have health coverage that meets a minimum standard (called "minimum essential coverage"). If you are enrolled in the Spina Bifida Health Care Benefits Program, you do not need to take additional steps to meet the health care law coverage standards. The ACA does not change Spina Bifida benefits or out-of-pocket costs.

Fact Sheet: SBHCBP and the Affordable Care Act|Hoja de Datos en Español

Fact Sheet: SBHCBP and the ACA–Frequently Asked Questions|Hoja de Datos en Español

For additional information, view the ACA information on the VA website or call our customer service center:

VA, Affordable Care Act and You
https://www.va.gov/health/aca/

VHA OCC Customer Service Center
800-820-1756

Contacts

General information: 888-820-1756

Eligibility application: 303-914-2900
Colorado residents ONLY: 800-827-1000

Preauthorization fax: 303-331-7807

Mailing address:
VHA Office of Community Care
Spina Bifida Health Care Benefits Program
PO Box 469065
Denver CO 80246-9065

Email: Inquiry Routing & Information System (IRIS) or spina.inq@va.gov

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