§1781 — Title 38 Veterans' Benefits | U.S. Code

Summary

The Secretary must provide medical care for certain spouses, children, survivors, and some designated caregivers of veterans. This includes spouses or children of veterans with a permanent total service-connected disability; surviving spouses or children of veterans who died from a service-connected disability or who had a permanent total service-connected disability when they died; surviving spouses or children of people who died on active duty in the line of duty (not due to their own misconduct); and a person named as a primary personal-care provider who has no health-plan coverage. The care is given in the same way and with the same limits as health care for dependents of active-duty and retired military under chapter 55 (CHAMPUS). To do this, the VA will either work with the Department of Defense and pay it back for costs, or buy suitable health plans under rules the VA sets. A child aged 18 to 23 who is eligible and is in a full-time approved school program stays eligible if they get a disabling illness or injury while enrolled or during breaks, until the earliest of six months after the disability ends, two years after it starts, or the child’s 23rd birthday. If someone is eligible for Medicare Part A, they can get care here only if they are also enrolled in Medicare Part B, except people who were 65 by June 5, 2001 and not enrolled in Part B on that date. When both this program and Medicare or another insurer could pay for the same care, the VA pays the amount by which the care costs exceed Medicare payments plus other third-party payments, but not more than the amount that would be paid under the CHAMPUS-style rules. “Medicare program” means the federal health insurance under Title XVIII. “Third party” means other insurers or payers. When the VA pays for care under these rules, that payment is final and the patient owes nothing more.

Title 38, §1781

Veterans' Benefits — Source: USLM XML via OLRC

(a)The Secretary is authorized to provide medical care, in accordance with the provisions of subsection (b) of this section, for—

(1)the spouse or child of a veteran who has a total disability, permanent in nature, resulting from a service-connected disability,

(2)the surviving spouse or child of a veteran who (A) died as a result of a service-connected disability, or (B) at the time of death had a total disability permanent in nature, resulting from a service-connected disability,

(3)the surviving spouse or child of a person who died in the active military, naval, air, or space service in the line of duty and not due to such person’s own misconduct, and

(4)an individual designated as a primary provider of personal care services under section 1720G(a)(7)(A) of this title who is not entitled to care or services under a health-plan contract (as defined in section 1725(h) of this title),

(b)In order to accomplish the purposes of subsection (a) of this section, the Secretary shall provide for medical care in the same or similar manner and subject to the same or similar limitations as medical care is furnished to certain dependents and survivors of active duty and retired members of the Armed Forces under chapter 55 of title 10 (CHAMPUS), by—

(1)entering into an agreement with the Secretary of Defense under which that Secretary shall include coverage for such medical care under the contract, or contracts, that Secretary enters into to carry out such chapter 55, and under which the Secretary of Veterans Affairs shall fully reimburse the Secretary of Defense for all costs and expenditures made for the purposes of affording the medical care authorized pursuant to this section; or

(2)contracting in accordance with such regulations as the Secretary shall prescribe for such insurance, medical service, or health plans as the Secretary deems appropriate.

(c)For the purposes of this section, a child between the ages of eighteen and twenty-three (1) who is eligible for benefits under subsection (a) of this section, (2) who is pursuing a full-time course of instruction at an educational institution approved under chapter 36 of this title, and (3) who, while pursuing such course of instruction, incurs a disabling illness or injury (including a disabling illness or injury incurred between terms, semesters, or quarters or during a vacation or holiday period) which is not the result of such child’s own willful misconduct and which results in such child’s inability to continue or resume such child’s chosen program of education at an approved educational institution shall remain eligible for benefits under this section until the end of the six-month period beginning on the date the disability is removed, the end of the two-year period beginning on the date of the onset of the disability, or the twenty-third birthday of the child, whichever occurs first.

(d)(1)(A)An individual otherwise eligible for medical care under this section who is also entitled to hospital insurance benefits under part A of the medicare program is eligible for medical care under this section only if the individual is also enrolled in the supplementary medical insurance program under part B of the medicare program.

(B)The limitation in subparagraph (A) does not apply to an individual who—

(i)has attained 65 years of age as of June 5, 2001; and

(ii)is not enrolled in the supplementary medical insurance program under part B of the medicare program as of that date.

(2)Subject to paragraph (3), if an individual described in paragraph (1) receives medical care for which payment may be made under both this section and the medicare program, the amount payable for such medical care under this section shall be the amount by which (A) the costs for such medical care exceed (B) the sum of—

(i)the amount payable for such medical care under the medicare program; and

(ii)the total amount paid or payable for such medical care by third party payers other than the medicare program.

(3)The amount payable under this subsection for medical care may not exceed the total amount that would be paid under subsection (b) if payment for such medical care were made solely under subsection (b).

(4)In this subsection:

(A)The term “medicare program” means the program of health insurance administered by the Secretary of Health and Human Services under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).

(B)The term “third party” has the meaning given that term in section 1729(i)(3) of this title.

(e)Payment by the Secretary under this section on behalf of a covered beneficiary for medical care shall constitute payment in full and extinguish any liability on the part of the beneficiary for that care.

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Social Security Act, referred to in subsec. (d)(4)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Act is classified generally to subchapter XVIII (§ 1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Prior Provisions

A prior section 1781 was renumbered section 3681 of this title.

Amendments

2022—Subsec. (a)(4). Pub. L. 117–328 substituted “section 1725(h)” for “section 1725(f)”. 2021—Subsec. (a)(3). Pub. L. 116–283 substituted “air, or space service” for “or air service”. 2015—Subsec. (a)(4). Pub. L. 114–58 substituted “title),” for “title);”. 2010—Subsec. (a)(4). Pub. L. 111–163, § 102, added par. (4). Subsec. (e). Pub. L. 111–163, § 503, added subsec. (e). 2002—Pub. L. 107–135, § 208(c)(1), (2), renumbered section 1713 of this title as this section. Subsec. (b). Pub. L. 107–135, § 208(c)(3), inserted at end “A dependent or survivor receiving care under the preceding sentence shall be eligible for the same medical services as a veteran, including services under section 1782 and 1783 of this title.” Subsec. (d)(1)(B)(i). Pub. L. 107–330, § 308(g)(8)(A), substituted “as of June 5, 2001” for “as of the date of the enactment of the Veterans’ Survivor Benefits Improvements Act of 2001”. Subsec. (d)(4). Pub. L. 107–330, § 308(g)(8)(B), substituted “subsection” for “paragraph” in introductory provisions. 2001—Subsec. (d). Pub. L. 107–14 amended subsec. (d) generally. Prior to amendment, subsec. (d) read as follows: “Notwithstanding section 1086(d)(1) of title 10 or any other provision of law, any spouse, surviving spouse, or child who, after losing eligibility for medical care under this section by virtue of becoming entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.), has exhausted any such benefits shall become eligible for medical care under this section and shall not thereafter lose such eligibility under this section by virtue of becoming again eligible for such hospital insurance benefits.” 1991—Pub. L. 102–83, § 5(a), renumbered section 613 of this title as this section. Subsec. (a). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions. Subsec. (b). Pub. L. 102–83, § 4(b)(2)(B), substituted “that Secretary” for second and third references to “the Secretary” and “the Secretary of Defense” for last reference to “the Secretary” in par. (1). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing in introductory and concluding provisions and in par. (2). Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in concluding provisions. Subsec. (d). Pub. L. 102–190 substituted “section 1086(d)(1)” for “the second sentence of section 1086(c)”. 1982—Subsec. (d). Pub. L. 97–251 added subsec. (d). 1981—Subsec. (b). Pub. L. 97–72 substituted “equipped to provide the care and treatment” for “particularly equipped to provide the most effective care and treatment” in provisions following par. (2). 1979—Subsec. (a). Pub. L. 96–151, § 205(a)(1), in cl. (1) substituted reference to spouse for reference to wife, in cl. (2) substituted reference to surviving spouse for reference to widow, and added cl. (3). Subsec. (c). Pub. L. 96–151, § 205(a)(2), added subsec. (c). 1976—Subsec. (a)(2). Pub. L. 94–581, § 104, designated existing provisions as cl. (A) and added cl. (B). Subsec. (b)(1). Pub. L. 94–581, § 210(a)(4)(A), substituted “the Secretary enters” for “he enters”. Subsec. (b)(2). Pub. L. 94–581, § 210(a)(4)(B), substituted “the Administrator” for “he” in two places.

Statutory Notes and Related Subsidiaries

Effective Date

of 1982 Amendment Pub. L. 97–251, § 5(b), Sept. 8, 1982, 96 Stat. 716, provided that: “The amendment made by subsection (a) [amending this section] shall take effect on October 1, 1982.”

Effective Date

of 1979 Amendment Pub. L. 96–151, title II, § 205(b), Dec. 20, 1979, 93 Stat. 1095, provided that: “The

Amendments

made by subsection (a) [amending this section] shall take effect with respect to fiscal year 1980 only to such extent and for such amounts as may be specifically provided for such purpose in appropriation Acts.”

Effective Date

of 1976 AmendmentAmendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date

Section effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as an

Effective Date

of 1973 Amendment note under section 1701 of this title.

§1781 Medical care for survivors and dependents of certain veterans

Summary

Title 38, §1781

Notes & Related Subsidiaries

Editorial Notes

References in Text

Prior Provisions

Amendments

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Amendments

Effective Date

Effective Date

Effective Date

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