Many State governments operate veterans homes and hospitals. These institutions are
generally open only to veterans and certain dependents of veterans, and include domiciliary,
hospital, infirmary, and/or nursing home type facilities. These institutions are financed
primarily from State funds; in addition, most receive nominal per diem payments from
the VA for domiciliary, hospital, or nursing home type care for each veteran who would
also qualify for admission to a VA hospital or domiciliary.
Where such a participating institution charges its residents and patients to the extent
of their ability to pay, or seeks payment from available sources other than Medicare,
benefits are payable for covered items and services furnished to Medicare beneficiaries.
However, if it is the policy of the institution to admit and treat a veteran without
charge simply because he is a veteran, or because he has a service-connected condition,
payment is precluded under title XVIII.
Per diem amounts paid by the VA to State veterans homes on behalf of patients who
are otherwise eligible for care in a VA facility may be credited towards any deductible,
coinsurance, or noncovered amounts required to be paid by the patient. However, if
a State veterans home collects amounts from the VA in excess of the applicable deductible
and coinsurance, the Medicare payment is reduced to the extent of such excess.