06 Mar 2003
27 Mar 2003
10 May 2003
14 May 2003
04 Feb 2003
Plan of Action
- Medical Benefits
WAIS Document Retrieval[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of July 1, 2001]
From the U.S. Government Printing Office via GPO Access
TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS
PART 17--MEDICAL--Table of Contents
Sec. 17.38 Medical benefits package.
(a) Subject to paragraphs (b) and (c) of this section, the following
hospital and outpatient care constitutes the ``medical benefits
package'' (basic care and preventive care):
(1) Basic care.
(i) Outpatient medical, surgical, and mental healthcare, including
care for substance abuse.
(ii) Inpatient hospital, medical, surgical, and mental healthcare,
including care for substance abuse.
(iii) Prescription drugs, including over-the-counter drugs and
medical and surgical supplies available under the VA national formulary
(iv) Emergency care in VA facilities; and emergency care in non-VA
facilities in accordance with sharing contracts or if authorized by
Secs. 17.52(a)(3), 17.53, 17.54, 17.120-132.
(v) Bereavement counseling as authorized in Sec. 17.98.
(vi) Comprehensive rehabilitative services other than vocational
services provided under 38 U.S.C. chapter 31.
(vii) Consultation, professional counseling, training, and mental
health services for the members of the immediate family or legal
guardian of the veteran or the individual in whose household the veteran
certifies an intention to live, if needed to treat:
(A) The service-connected disability of a veteran; or
(B) The nonservice-connected disability of a veteran where these
services were first given during the veteran's hospitalization and
continuing them is essential to permit the veteran's release from
(viii) Durable medical equipment and prosthetic and orthotic
devices, including eyeglasses and hearing aids as authorized under
(ix) Home health services authorized under 38 U.S.C. 1717 and 1720C.
(x) Reconstructive (plastic) surgery required as a result of disease
or trauma, but not including cosmetic surgery that is not medically
(xi) Respite, hospice, and palliative care.
(xii) Payment of travel and travel expenses for veterans eligible
under Sec. 17.143 if authorized by that section.
(xiii) Pregnancy and delivery services, to the extent authorized by
(xiv) Completion of forms (e.g., Family Medical Leave forms, life
insurance applications, Department of Education forms for loan repayment
exemptions based on disability, non-VA disability program forms) by
healthcare professionals based on an examination or knowledge of the
veteran's condition, but not including the completion of forms for
examinations if a third party customarily will pay health care
practitioners for the examination but will not pay VA.
(2) Preventive care, as defined in 38 U.S.C. 1701(9), which
(i) Periodic medical exams.
(ii) Health education, including nutrition education.
(iii) Maintenance of drug-use profiles, drug monitoring, and drug
(iv) Mental health and substance abuse preventive services.
(v) Immunizations against infectious disease.
(vi) Prevention of musculoskeletal deformity or other gradually
developing disabilities of a metabolic or degenerative nature.
(vii) Genetic counseling concerning inheritance of genetically
(viii) Routine vision testing and eye-care services.
(ix) Periodic reexamination of members of high-risk groups for
selected diseases and for functional decline of sensory organs, and the
services to treat these diseases and functional declines.
(b) Provision of the ``medical benefits package''. Care referred to
in the ``medical benefits package'' will be provided to individuals only
if it is determined by appropriate healthcare professionals that the
care is needed to promote, preserve, or restore the health of the
individual and is in accord with generally accepted standards of medical
(1) Promote health. Care is deemed to promote health if the care
will enhance the quality of life or daily functional level of the
veteran, identify a predisposition for development of a condition or
early onset of disease which can be partly or totally ameliorated by
monitoring or early diagnosis and treatment, and prevent future disease.
(2) Preserve health. Care is deemed to preserve health if the care
will maintain the current quality of life or daily functional level of
the veteran, prevent the progression of disease, cure disease, or extend
(3) Restoring health. Care is deemed to restore health if the care
will restore the quality of life or daily functional level that has been
lost due to illness or injury.
(c) In addition to the care specifically excluded from the ``medical
benefits package'' under paragraphs (a) and (b) of this section, the
``medical benefits package'' does not include the following:
(1) Abortions and abortion counseling.
(2) In vitro fertilization.
(3) Drugs, biologicals, and medical devices not approved by the Food
and Drug Administration unless the treating medical facility is
conducting formal clinical trials under an Investigational Device
Exemption (IDE) or an Investigational New Drug (IND) application, or the
drugs, biologicals, or
medical devices are prescribed under a compassionate use exemption.
(4) Gender alterations.
(5) Hospital and outpatient care for a veteran who is either a
patient or inmate in an institution of another government agency if that
agency has a duty to give the care or services.
(6) Membership in spas and health clubs.
(Authority: 38 U.S.C. 101, 501, 1701, 1705, 1710, 1721, 1722)
[64 FR 54217, Oct. 6, 1999]
report any broken links, problems or suggestions for the site please contact -
the Web-Mistress: Racheal Goss