2023 VA Health Care Copay Rates

Urgent care copay rates

(Care for minor illnesses and injuries)

There’s no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, both of these must be true:

• You must be enrolled in the VA health care system, and
• You must have received care from us within the past 24 months (2 years)

If you’re only getting a flu shot at your visit, you won’t have to pay any copays, no matter your priority group.

Learn more about urgent care benefits

Note: Special authorities include conditions related to combat service and exposures (like Agent Orange, active duty at Camp Lejeune, ionizing radiation, Project Shipboard Hazard and Defense (SHAD/Project 112), Southwest Asia Conditions) as well as military sexual trauma, and presumptions applicable to certain Veterans with psychosis and other mental illness.

Outpatient care copay rates

(Primary or specialty care that doesn’t require an overnight stay)

If you have a service-connected disability rating of 10% or higher

You won’t need to pay a copay for outpatient care.

If you don’t have a service-connected disability rating of 10% or higher

You may need to pay a copay for outpatient care for conditions not related to your military service, at the rates listed below.

Note: You won’t need to pay any copays for X-rays, lab tests, or preventive tests and services like health screenings or immunizations.

Inpatient care copay rates

(Care that requires you to stay one or more days in a hospital)

If you have a service-connected disability rating of 10% or higher

You won’t need to pay a copay for inpatient care.

If you’re in priority group 7 or 8

You’ll pay either our full copay rate or reduced copay rate. If you live in a high-cost area, you may qualify for a reduced inpatient copay rate no matter what priority group you’re in. To find out if you qualify for a reduced inpatient copay rate, call us toll-free at 877-222-8387 (TTY: 711). We’re here Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

Note: You may be in priority group 7 and qualify for these rates if you don’t meet eligibility requirements for priority groups 1 through 6, but you have a gross household income below our income limits for where you live and you agree to pay copays.

Review the current VA national income limits

Note: You may be in priority group 8 and qualify for these rates if you don’t meet eligibility requirements for priority groups 1 through 6, and you have a gross household income above our income limits for where you live, agree to pay copays, and meet other specific enrollment and service-connected eligibility criteria.

Learn more about priority groups

Medication copay rates

If you’re in priority group 1

You won’t pay a copay for any medications.

Note: You may be in priority group 1 if we’ve rated your service-connected disability at 50% or more disabling, if we’ve determined that you can’t work because of your service-connected disability (called unemployable), or if you’ve received the Medal of Honor.

Learn more about priority groups

If you’re in priority groups 2 through 8

You may pay a copay for these types of medications:

• Medications your health care provider prescribes to treat non-service-connected conditions, and
• Over-the-counter medications (like aspirin, cough syrup, or vitamins) that you get from a VA pharmacy. You may want to consider buying your over-the-counter medications on your own.

Note: The costs for any medications you receive while staying in a VA or other approved hospital or health facility are covered by your inpatient care copay.

The amount you’ll pay for these medications will depend on the “tier” of the medication and the amount of medication you’re getting, which we determine by days of supply. Once you’ve been charged $700 in medication copays within a calendar year (January 1 to December 31), you won’t have to pay any more that year—even if you still get more medications. This is called a copay cap.

Learn more about long-term care options

Services that don’t require a copay

You won’t need to pay a copay for any of the services listed here, no matter what your disability rating is or what priority group you’re in.

Past rates

Review health care copay rates for past years.

2022 rates (effective January 1, 2022)
2021 rates (effective January 1, 2021)
2020 rates (effective January 1, 2020)