VETERAN FULL MED BENEFITS TX AND RX COPAY EXMT (53)    HEALTH BENEFIT PLAN (25.11)

Name Value
NAME VETERAN FULL MED BENEFITS TX AND RX COPAY EXMT
PLAN CODE 213
SHORT DESCRIPTION
FM
LONG DESCRIPTION
All enrolled Veterans have a comprehensive medical benefits package, 
(CL), Military Sexual Trauma (MST), Toxic Exposure Risk Activity 
(TERA), or their status as an Indian.  Veterans assigned this VHAP meet 
one of the following conditions:
   .  Determined to be 50% or greater SC
   .  Determined to be 10% to 40% Compensable SC*
   .  Received a Medal of Honor (MOH)
   .  Received a Purple Heart (PH)**
   .  Has been a Prisoner of War (POW)
   .  Determined to be Catastrophically Disabled (CD)
   .  Determined to be Unemployable due to SC conditions
which VA administers through an annual patient enrollment system. Veterans
   .  In receipt of Aid & Attendance (A&A)
   .  In receipt of Housebound (HB)
   .  In receipt of a VA Pension
   .  Discharge Due to Disability**
   .  Military Disability Retirement**
   .  Receive Medicaid**
   .  Non-Service Connected (NSC)***
 
 *They are exempt from copay for medications related to their SC rated 
condition, but they must complete a Pharmacy Copay Exemption Test and the 
who meet Veteran status for VA healthcare benefits and are not subject to
outcome is Rx Copay Exempt to be exempt from NSC medication copays.
 
 **They must complete a Pharmacy Copay Exemption Test and the outcome is Rx 
Copay Exempt to be exempt from NSC medication copays.
 
 ***NSC Veterans who are subject to Means Testing; the outcome of the Means 
Test is MT Copay Exempt and Rx Exemption status is Exempt.
 
For eligible individuals, under Veterans Comprehensive Prevention, Access 
to Care, and Treatment Act of 2020 (COMPACT), Section 201, VA will 
copay for their inpatient, outpatient services nor medications. Veterans
furnish, reimburse, pay for emergent suicide care, make referrals, as 
appropriate, for care following the period of emergent suicide care. 
Eligible individuals are Veterans who served in the active military 
service, and meet the minimum duty service requirement according to 38 USC
5303A.
 
For eligible individuals, under Dr. Kate Hendricks Thomas Supporting 
Expanded Review for Veterans in Combat Environments (SERVICE) Act, VA 
will furnish clinically appropriate breast cancer risk assessment for 
care. Eligible individuals are Veterans who served in the active military 
are exempt from copayments for inpatient, outpatient services and 
service, and meet the minimum duty service requirement according to 38 USC
5303A.
medications related to their Service Connected (SC) related disability 
and special authority factor(s) - Agent Orange Exposure (AO), Southwest
Asia Conditions (SWA), Ionizing Radiation (IR), Nose Throat Radium (NTR),
Shipboard Hazard and Defense (SHAD), Combat Veteran (CV), Camp Lejeune 
COVERAGE CODE FB01001