VA Medical Expenses
Reimbursement details explained.
Question: I’m a veteran with a T-6 complete spinal-cord injury (SCI) and receiving Department of Veterans Affairs (VA) Improved Pension with a spouse and two children.
It seems that each year we have more and more medical expenses for which we’re not reimbursed. Does the VA allow us to claim these medical expenses?
Answer: Let’s begin with the first question. Yes.
A veteran receiving VA Improved Pension may submit a medical expense report (VA Form 21P-8416) each year to claim any unreimbursed medical expense he or she, or his or her family members, had incurred during that annual period up to the allowable pension rate for the veteran for that calendar year.
The form addresses any related transportation expenses in subsections for medical purposes (mileage, parking and tolls or actual fares for Med car, taxi, ambulance, buses, etc.).
This year, in an effort to eliminate the red tape for veterans, the VA discontinued the use of Eligibility Verification Reports being required annually as a form of reporting. However, it’s still a valuable tool to report any changes in income, dependency and claiming unreimbursed medical expenses for the veteran and family members.
Unreimbursed medical expenses that exceed 5% of reported annual pension benefits can be deducted under the basic authority cited in Title 38 United State Code (U.S.C)1503 (a)(14))and implementing regulation in Title 38 Code of Federal Regulations (C.F.R) 3.262(1).
This includes those medical expenses a veteran pays for him/herself, spouse or child during the calendar year. If the veteran has an insurance policy, any and all insurance deductibles (private, social security, etc.) paid by the veteran or his or her family members can be claimed. Transportation expenses or mileage can also be claimed.
Keep in Mind
No deductions are allowed for expenses the veteran hasn’t yet paid or has been reimbursed for under an insurance policy.
In other words, deductible out-of-pocket medical-related expenses must be paid by the veteran and family members. If you’re not sure about the particular expense, or the expense will be one time, provide a complete description of the purpose of the payment.
Remember, always keep the receipts at least three years for all reimbursed medical expenses, in case you’re asked to verify expenses by the VA.
If the veteran receives Aid and Attendance/Housebound rates from the VA, all fees paid are deductible as long as the caregiver/agency provided some medical care or nursing services.
When managing the caregiver payment, a receipt book may be ideal to record the payments for caregiver-related services. The caregiver doesn’t have to be a licensed professional. All reasonable fees paid to the individual for the veteran’s personal care and maintenance of his/her immediate environment may be allowed.
This includes such services as cooking and housecleaning. However, services beyond the scope of personal care of the veteran’s immediate environment may not be allowed.
Nursing Home Fees
Medical expenses for nursing home fees are deductible if a responsible official of the nursing home certifies the disabled person is a patient (as opposed to a resident) of the nursing home.
A medical expense deduction can be allowed for unreimbursed nursing home fees even though the nursing home may not be state licensed to provide skilled or intermediate care.
This assists in providing needed care to those who have difficulty traveling to a VA health care facility.
However, this copayment exemption was effective after May 6, 2012. This only applies to in-home video telehealth services.
For more information, visit benefits.va.gov/benefits or contact your local National Service.
VA Medical Expenses
(Register or login to add comments.)