Information on Veterans' Ability To Defray the Cost of Their Inpatient Care

HRD-85-63: Published: May 3, 1985. Publicly Released: May 3, 1985.

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GAO reviewed the Veterans Administration's (VA) comprehensive reform of eligibility criteria for medical care which will include an income-based test for veterans with no service-connected disabilities. GAO determined the extent to which veterans under age 65 who received inpatient care had incomes that permitted them to pay for that care.

GAO found that: (1) veterans with service-connected disabilities were afforded the highest priority and were eligible to receive free inpatient and outpatient care for treatment of such disabilities; and (2) veterans can obtain inpatient care for non-service disabilities if they are at least 65 years old or are unable to defray the costs of necessary hospital care. The Administrator of Veterans Affairs is required to accept statements under oath of applicants that are unable to defray medical expenses as sufficient evidence of inability to pay. GAO used three different means tests to determine how much of their income veterans could have spent on health care, including: (1) limiting amounts veterans would have been expected to pay for care to the difference between their incomes and the poverty income level; (2) substituting VA pension levels for the national poverty income guidelines; and (3) considering veterans' incomes, family sizes, and estimated costs of medical care. Using the poverty-based means test, GAO found that VA provided care to veterans under age 65 with no service-connected disabilities whose income exceeded twice the poverty level.

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