New mental health copayment exemptions

Includes substance use disorder care

By VHA Communications

On June 7, 2024

Your mental health is important to you and a priority for us. Section 193A of the Cleland-Dole Act enhances access to care and lowers out-of-pocket costs for outpatient mental health and substance use disorder (SUD) care.

If you owe copays for your VA outpatient mental health and SUD visits, this benefit makes the soonest and best care better by canceling and refunding the first three copays in each calendar year between June 27, 2023, and Dec. 29, 2027.

Am I eligible?

  • You must be enrolled in VA health care and owe copayments for VA outpatient mental health and substance use disorder (SUD) visits.
  • The visits must be with a qualified outpatient mental health provider at a VA facility or through VA’s Community Care Network (CCN).
  • The visits must occur in each calendar year between June 27, 2023, and Dec. 29, 2027 (when the benefit ends).

What do I have to do?

  • Attend your appointments; we’ll do the rest.
  • We’ll review the copays we received on or after June 27, 2023, and issue a cancellation or refund by direct deposit or check for eligible copays already made to VA.  

What is covered?

The copay exemption applies to the first three outpatient mental health and substance use disorder (SUD) visits in each calendar year between June 27, 2023, and Dec. 29. 2027. You’ll still be responsible for medication and other care copays.

What if I have questions?  

Call the number on your patient statement; our staff is ready to help. If you need help with your copays, you can ask for a payment plan or a waiver.

Learn more about outpatient mental health copay exemptions.

This piece was republished from VA News.

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