Under the Veterans Administration's Fee Program (also called Fee Basis or non-VA care), the VA may authorize veterans
to receive care at a non-VA health-care facility when the needed services are not "feasibly available" at the
Albuquerque VA Medical Center or when the veteran is unable to travel the distance to the VA health-care facility
because of illness or if a veteran is catastrophically disabled.
Fee-based services can cover virtually anything a veteran needs as long as it is related to a service-connected
condition. It also can pay for nonservice-connected care under special conditions.
Non-VA care must be authorized by the Albuquerque VA Medical Center fee-based office in advance. Veterans enrolled in
the VA health system first need to talk to their VA provider to see if fee-based care is an option for their medical
Veterans not enrolled in the VA health system and needing care for a service-connected condition should contact the
Albuquerque VA Medical Center Fee Office for assistance. Veterans also can obtain services not covered in the
benefits package through private health-care providers at their own expense.
The use of Fee Basis to provide Non-VA care to veterans is governed by federal laws containing strict eligibility
criteria and other policies specifying when and why it can be used. A preauthorization for treatment in the community
is required to use Fee Basis care - unless the medical event is an emergency. Emergency events may be reimbursed on
behalf of the veteran in certain cases. Fee Basis care is not an entitlement program or a permanent treatment option.
Important things to remember about the Fee Basis program:
If a veteran is eligible for VA medical care, the VA hospital or clinic will provide it as the first option.
A preauthorization for treatment in the community is required to use Fee Basis care, unless the medical event is an
Non-VA care must be authorized by the Albuquerque VA Medical Center in advance. Veterans enrolled in the VA health
system first need to talk to their VA primary-care provider to see if fee-based care is an option for their medical
Fee Basis care is not an entitlement program. The VA may consider Fee Basis care in the veteran's community.
The Durango VA Clinic cannot approve fee-based services. Those services can be approved only by the Albuquerque VA
Medical Center fee-based program office. Call the office at (800) 465-8262.
For specific VA eligibility details, call the VA Health Care Benefits Service Center at (877) 222-8387.
Richard Schleeter is the veterans service officer for the La Plata County Veterans Service Office. He can be reached
at 759-0117 or firstname.lastname@example.org.