HEALTH CARE

What is the average payout for the PACT Act? Who is eligible? Requirements for compensation

The Department of Veterans Affairs expanded VA benefits under the PACT Act, which helps care for veterans exposed to burn pits and other toxic substances.

Two years ago, President Joe Biden signed into law the PACT ACT, which expands benefits and services for veterans who were exposed to toxic substances such as Agent Orange and burn pits. The White House has announced that since the enactment of the legislation, a significant number of veterans have benefited from the bipartisan measure.

According to the announcement of the Biden administration, one million claims by veterans and survivors have been approved, amounting to $5.7 billion. This comes out to an average payout of $5,700 per claim.

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The Department of Veterans Affairs announced earlier this year that veterans and survivors can apply anytime for PACT Act benefits. Under this law all veterans who were exposed to toxins during their service no longer need to first apply for VA benefits before they can enroll in the VA health care program.

The VA is encouraging veterans to apply so they can have access to low- or no-cost VA health care. “Even if you don’t think you need this care today, you might need it tomorrow, or the next day, or 30 years from now. All you have to do is enroll; then you have access for life,” explains Veterans Affairs.

Expanded health care eligibility for veterans: Who is eligible?

The Pact Act greatly expanded and extended eligibility for VA health care by adding more presumptive conditions for exposure to toxins during military service. Veterans that were deployed as well as those who were not will be eligible based on their military service records.

According to the Department of Veterans Affairs the three general eligibility requirements are toxic exposure, serving in a combat zone or a toxic exposure risk activity (TERA), regardless of their geographic location.

The VA lists the following:

  • Air pollutants (burn pits, sand, dust, particulates, oil well fires, sulfur fires)
  • Chemicals (pesticides, herbicides, depleted uranium with embedded shrapnel, contaminated water)
  • Occupational hazards (asbestos, industrial solvents, lead, paints including chemical agent resistant coating, firefighting foams)
  • Radiation (nuclear weapons handling, maintenance and detonation, radioactive material, calibration and measurement sources, X-rays, radiation from military occupational exposure)
  • Warfare agents (nerve agents, chemical and biological weapons)

The VA states that the above is not a comprehensive list and additional military exposure categories can be viewed on the VA Public Health website.

There is no deadline or expiration date, “this expansion of care is here to stay,” says the VA, meaning veterans can apply at any time. However, the agency encourages veterans to apply as soon as possible “so they have access to care when they need it.”

If you have additional questions you can visit www.va.gov/PACT or call 1-800-MyVA411.

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How much will veterans have to pay for VA health care under the Pact Act?

One of the reasons the VA is encouraging veterans to enroll in the VA health care program is its affordability. “All VA health care is low- or no-cost for Veterans,” states the VA. “But with this expansion of care, we are dramatically expanding the amount of care that we will deliver for free.

“Specifically, Veterans who enroll under this expanded health care eligibility do not owe copayments for treatment for any condition that may be related to their qualifying service.”

While it is still a “work in progress” the VA is “working urgently to implement these copayment changes.” It is also proactively reviewing priority groups already enrolled to see if they are eligible for the reduced payments.

The agency advises that they will work with those who think that they were wrongly charged copayments. If it is determined that there was an erroneous copayment, the VA will give a refund. But you will need to inform the VA to start the process.

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