Other Types of Care–Information for Providers
Beyond general and specialty care from community providers, VA also provides other types of care to eligible Veterans in their community in some circumstances, including:
- Home Health and Hospice Care
- Care through State Veterans Homes
- Foreign Medical Care
- In Vitro Fertilization
- Indian Health Services/Tribal Health Program
- Transplant Guidance
There are specific eligibility criteria and other policies that determine how Veterans can access these services. In most cases, these services require preauthorization unless the medical event is an emergency.
More information about these services can be found below. If you are interested in providing these services or treatment to Veterans, please contact VA through the contact information listed below for each service.
VA provides supportive medical services to help chronically ill or disabled eligible Veterans of any age remain in their home. These services are referred to as home health care and are considered extended care services prescribed by and under the direction of a VA physician.
VA provides several types of home health care including:
- Skilled home health care
- Home health aide services
- Homemaker services
- Palliative care
- Remote monitoring care
- Respite care
- Hospice care
For AN98 non-contracted skilled home health and hospice care payment methodology questions, contact the AN98 Support Group.
State Veterans Homes are facilities that provide eligible Veterans with nursing home, domiciliary, or adult day care. These facilities are owned and operated by state governments. Each state establishes eligibility and admission criteria for its homes, and some State Veterans Homes may admit non-Veteran spouses and gold star parents. VA’s State Home Program provides an economical alternative to constructing, maintaining, and operating facilities for the provision of care to eligible Veterans. VHA Office of Community Care (VHA OCC) provides payment on a per diem basis for Veterans who participate in the State Veterans Home Program.
VA participates in two grant-in-aid programs for states. State Veterans Homes may request up to 65 percent of the cost of construction or acquisition of state nursing homes or domiciliary or for renovations to existing state homes. VA also provides per diem payments to states for the care of eligible Veterans in state homes.
For more information on the Construction Grant Program, please visit the Office of Construction and Facilities Management.
Construction Grant Program
There are several policies and regulations that affect the State Home Per Diem Program (SHPD). To see a list of current regulations, laws, policies and handbooks relating to the program, please visit policy and regulations.
SHPD Policy and Regulations
VA’s Foreign Medical Program (FMP) is a health care benefits program for Veterans with VA-rated service-connected disabilities who are residing or traveling abroad. Through FMP, VA assumes payment responsibility for certain health care services, medication, and durable medical equipment necessary for treatment of a service-connected disability or condition associated with a service-connected disability.
VA adminsters FMP and is responsible for all aspects of the program including the Veterans’ registration process, verification of eligibility, authorization of benefits, and the processing and payment of claims.
All FMP claims should include the patient’s full name, VA Claim Number, mailing address, and the FMP Claim Cover Sheet (VA Form 10-7959f-2). Additional documentation may be necessary depending on the type of claim. For more information, please view the How to File a FMP Claim fact sheet.
Please note: To speed up claims processing, providers should submit claims in English. Claim information submitted in a language other than English will require translation and may delay processing of your claims.
If you are a community provider and have a question, please contact FMP at one of the phone numbers listed below:
- USA/Canada: 877-345-8179
- Australia: 1800 354 965
- Costa Rica: 0800-013-0759
- Germany: 0800 1800011
- Italy: 800 782655
- Japan: 00531-13-0871
- Mexico: (001) 877-345-8179
- Spain: 900 981 776
- UK: 0800-032 7425
Veterans with certain service-connected conditions that result in infertility may be eligible for in vitro fertilization (IVF), another form of assisted reproductive technology (ART), or other infertility services. VA may provide these services to Veterans if:
- The Veteran has a service-connected condition that causes infertility
- The Veteran is legally married
- Male spouses can produce sperm
- Female spouses have an intact uterus and ability to produce eggs
VA provides infertility treatment and services through Reproductive Endocrinology and Infertility (REI) community providers who are part of VA’s Patient-Centered Community Care (PC3) network. REI providers play an integral part in making sure Veterans get the infertility treatment they need.
If you are interested in providing treatment and services to Veterans, you must enroll in VA’s PC3 provider network through TriWest Healthcare Alliance, the Third-Party Administrator (TPA).
To register with TriWest as a PC3 provider, sign up on their website.
Join the TriWest provider network
To learn more about VA’s PC3 provider network, visit PC3.
PC3–Information for Providers
What does VA cover?
VA does not cover the costs associated with donor sperm, donor eggs, donor embryos, or gestational surrogacy. In addition, VA does not cover the cost of IVF related to donor sperm, donor eggs, donor embryos, or gestational surrogacy.
VA provides integrated care of acute and chronic diseases for which transplantation may be an option. Management of such advanced diseases (e.g., heart failure, cirrhosis) is coordinated among referring VA medical centers (VAMC), and regional referral VA medical centers, VA Transplant Centers (VATC), and/or community specialists as appropriate.
To learn more details about transplant guidance, read the VHA Office of Community Care Transplant Guide.