VA EXTENDED CARE SERVICES COPAY EXEMPT (76)    HEALTH BENEFIT PLAN (25.11)

Name Value
NAME VA EXTENDED CARE SERVICES COPAY EXEMPT
PLAN CODE 285
SHORT DESCRIPTION
Ref ECS Ex
LONG DESCRIPTION
Veterans Enrolled in VA Health Care System are exempt from extended care 
   .  Care authorized under 38 U.S.C. 1710(e) for Vietnam-era herbicide-
      exposed Veterans, radiation-exposed Veterans, Persian Gulf War 
      Veterans, post-Persian Gulf War combat-exposed Veterans, or Camp 
      Lejeune Veterans pursuant to Section 17.400.
   .  Care for treatment of sexual trauma as authorized under 38 U.S.C. 
      1720D.
   .  Care or services authorized under 38 U.S.C. 1720E for certain 
      Veterans regarding cancer of the head or neck.
   .  A Veteran who VA determines to be catastrophically disabled, as 
      defined in 38 CFR 17.36(e), is exempt from copayments for adult day 
copayments if they have one of the following:
      health care, non-institutional respite care, and non-institutional 
      geriatric care.
   .  A Veteran receiving care for psychosis or a mental illness other than 
      psychosis pursuant to Section 17.109.
   .  A Veteran who was awarded the Medal of Honor.
   .  Receiving hospice care as part of extended care services
 
These Veterans do not have mandatory eligibility for nursing home care and 
may be provided needed nursing home care on a space and resources available 
basis.
   .  A Veteran with a compensable service-connected disability.
 
These Veterans do not pay copayments for extended care services provided by 
VA (directly or paid for by VA), and do not complete VA Form 10-10EC.
   .  A Veteran whose annual income (determined under 38 U.S.C. 1503) is 
      less than the amount in effect under 38 U.S.C. 1521(b).
   .  Care for a Veteran's non-compensable zero percent service-connected 
      disability.
   .  An episode of extended care services that began on or before November 
      30, 1999.
COVERAGE CODE EC01002