Non-VA Emergency Care: VA's 72-Hour Rule and Who Pays

Do I need VA's permission to go to a non-VA emergency room?

No. If you think your life or health is in danger, call 911 or go to the nearest emergency room. VA's emergency care page is clear on this. The paperwork comes after.

What is the 72-hour rule?

VA should be told within 72 hours of when the emergency care starts. Under 38 CFR 17.4020(c), when VA gets notice in time and approves the care, VA can authorize it after the fact as Community Care. The care has to be from an eligible provider and part of VA's benefits package.

As of August 10, 2026, the rule says notice can go to the nearest VA facility or through VA's centralized notification process.

Who can notify VA, and how?

VA prefers that the hospital do it, but you or someone acting for you can too. Notice has to identify you and the hospital or provider.

• Online: VA's emergency care reporting portal at emergencycarereporting.communitycare.va.gov, used mainly by providers.
• Phone: VA's emergency care notification line, 844-724-7842.

If you're not sure the hospital notified VA, ask the hospital's billing or case management office, or call VA yourself.

Does notice mean VA will pay?

Not by itself. Notification and payment are separate. VA still decides whether to authorize the care.

If VA isn't notified within 72 hours, VA says the claim isn't automatically denied. It's reviewed under the rules for emergency care VA didn't authorize:

• Service-connected care, under 38 U.S.C. 1728. For example, the emergency was for a service-connected condition or a condition that made one worse, you're rated permanently and totally disabled, or you needed the care to return to a VA vocational rehabilitation program.
• Non-service-connected care, under 38 U.S.C. 1725. You generally need to be enrolled, have had VA or in-network care in the 24 months before, have gotten care at a hospital emergency department or similar public facility, and have no other way for a third party to pay.

These rules have more conditions, which is why prompt notice helps.

What if I have other insurance?

If your other insurance doesn't fully cover the emergency, VA may cover certain amounts you owe. VA says it can't reimburse copays charged by your other insurance, and it can't pay costs that come from missing your insurer's deadlines or skipping its appeals.

Keep VA and the hospital updated on your insurance, and let your insurer process its part first.

What if the hospital doesn't bill VA, or I already paid?

You can file a claim yourself. VA's reimbursement page says to send:

• VA Form 10-320, the Veteran Reimbursement Claim Form;
• a bill or receipt showing the amount as paid; and
• an itemized list of the services and dates.

Mail it to VHA Office of Veterans Community Care, Payment Operations, PO Box 320394, Flowood, MS 39232.

Deadlines range from 90 days to 2 years depending on the type of claim. VA recommends filing within 90 days of the date of service.

What about ambulances?

VA's provider guidance says ambulance claims go directly to VA within 30 days and need the trip report. If you get an ambulance bill, call VA's Community Care contact center at 877-881-7618.

What about emergencies outside the U.S.?

VA only pays for emergency care abroad through the Foreign Medical Program, and only for service-connected conditions.

What if it's a mental health crisis?

VA covers emergency suicide crisis care at no cost, even without enrollment, for eligible Veterans. See Free Emergency Suicide Crisis Care. If you need help right now, call 988 and press 1.

What should I do after an emergency visit?

1. Tell the hospital you're a Veteran.
2. Ask them to notify VA within 72 hours, or do it yourself.
3. Keep your discharge papers, itemized bill, and any insurance explanation of benefits.
4. If you get a bill, call 877-881-7618 before paying it.
5. Ask your VA team to set up follow-up care. Ongoing care after you're stable usually needs a regular referral.