Copay exemptions for American Indian and Alaska Native Veterans
Beginning April 4, 2023, eligible American Indian and Alaska Native Veterans no longer have to pay a copay for VA health care services and urgent care. And we’ll review copays we received for covered services on or after January 5, 2022. Keep reading on this page to find out if you’re eligible for a copay exemption.
Services covered by copay exemptions
If you’re eligible for these copay exemptions, we won’t bill you for future copays for these services:
- Hospital care
- Certain health care services, such as outpatient prescription medicines
- Urgent care visits
We’ll also review any copays you paid for covered services on or after January 5, 2022. We’ll reimburse you for eligible copays.
Note: You’ll still have to pay copays for domiciliary care, institutional respite care, institutional geriatric evaluation, and nursing home care.
Eligibility for copay exemptions
You may be eligible for a copay exemption if you meet these 3 requirements:
- You’re an American Indian or Alaska Native Veteran, and
- You provide us a copy of an official tribal document that shows you meet the eligibility requirements of the Indian Health Care Improvement Act, and
- You submit a completed Tribal Documentation Form (VA Form 10-334)
Learn more about eligibility from the Indian Health Care Improvement Act
Your tribal document must show that at least one of these descriptions from the Indian Health Care Improvement Act is true for you:
- You’re a member—or the first- or second-degree descendant of a member—of a tribe, band, or other organized group of Indians (Note: These groups include those terminated since 1940 and those recognized now or in the future by the state you live in. And this definition applies whether or not you live on or near a reservation), or
- You’re an Eskimo or Aleut or other Alaska Native, or
- You’re considered by the Secretary of the U.S. Department of the Interior to be an Indian for any purpose, or
- You’re determined to be an Indian under U.S. Department of Health and Human Services (HHS) regulations, or
- You meet any of these descriptions and you live in an urban center (Note: An urban center is a community that the Secretary of HHS has determined has a large enough urban Indian population with unmet health needs to warrant assistance under title V of the Indian Health Care Improvement Act.)
Note: On VA.gov, we strive to use terms that communities use to describe themselves. For legal reasons, we must use terms from the original Indian Health Care Improvement Act of 1976, as well as subsequent legislation, in the descriptions listed here.
How to get a copay exemption
You’ll need to provide these documents to get an exemption:
- A copy of an official tribal document that shows you’re eligible for an exemption, and
- A completed Tribal Documentation Form (VA Form 10-334)
Get VA Form 10-334 to download
Documents we accept to show eligibility
These are examples of documents that show your eligibility to get an exemption:
- A tribal enrollment or a membership ID card
- Tribal Census documentation
- A certificate of Indian blood from the Bureau of Indian Affairs
- A document on official tribal letterhead that shows you’re a member of that federally recognized tribe
Review the full list of documents we accept
You can submit any one of the documents listed here to show your eligibility to get an exemption.
Note: On VA.gov, we strive to use terms that communities use to describe themselves. For legal reasons, we must use terms from the original Indian Health Care Improvement Act of 1976, as well as subsequent legislation, in the descriptions listed here.
Here are the documents we accept:
- A tribal enrollment or a membership ID card
- Tribal Census documentation
- A certificate of Indian blood from the Bureau of Indian Affairs
- A document on official tribal letterhead that shows you’re a member of that federally recognized tribe
- An official Department of Interior (DOI) document that shows you’re a member of a federally recognized tribe or that the DOI considers you an Indian for any purpose
- An official Department of Health and Human Services (HHS) document that shows that HHS considers you to be an Indian for purposes of eligibility for Indian health care services, including as a California Indian, Eskimo, Aleut, or other Alaska Native
- Another type of official tribal document that shows you live in an urban center and meet at least one of the other descriptions for eligibility
How to provide your documents to us
Send your completed VA Form 10-334 and a copy of your official tribal document to this address:
VHA Tribal Documentation
PO Box 5100
Janesville, WI 53547-5100
Note: Don’t send us your original documents. Be sure to send us copies only. If you need to request copies of your documents or VA Form 10-334, please contact your local VA medical center or clinic.
What to do if you’re not yet enrolled in VA health care
You can apply now. Be sure to check “American Indian or Alaska Native” for the question that asks for your race, ethnicity, or origin.
What to expect after you provide your documents
After we receive your completed form and tribal documents, we’ll determine if you’re eligible for a copay exemption. We’ll notify you to tell you if you’re eligible.
If you’re eligible, we’ll also reimburse you for any copays you paid for covered services on or after January 5, 2022.
What if I have questions?
Call us at 800-698-2411 (TTY: 711). We’re here 24/7.