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Eliminating Medical Copayments for Eligible Veterans

When the Department of Veterans Affairs (VA) needed help canceling medical copayments for American Indian and Alaska Native veterans, the federal agency knew where to turn.

“Our team got a call from VA’s revenue operations leadership saying, ‘We need your help ASAP,’” said Ricky Patel, a Tria Federal director. “We formed a five-person team and got involved within a day.” 

With Tria’s support, VA implemented the Tribal Citizen Copayment Benefit in April 2023, enabling American Indian and Alaska Native veterans to receive an exemption from medical copayments. By early June 2024, VA had approved more than $3.5 million in copay exemptions for over 4,600 veterans. 

To create the benefit, Tria worked with the Central Plains Consolidated Patient Account Center to develop processes to efficiently review applications, verify the applicant’s tribal citizenship, and mail decision letters to veterans in a timely manner. For example, Tria created an 18-page step-by-step guide for reviewing applications and revamped the approval letter sent to veterans. 

“These new processes give VA a road map for handling future refunds that could be enacted for other specific veteran groups as more laws are passed,” said Alexis Idjagboro, a Tria staff consultant. “That’s the lasting impact of this project.” 

The benefit was created as a result of the Veterans Health Care and Benefits Improvement Act of 2020, which eliminated copayments for eligible American Indian and Alaska Native veterans accessing VA hospital care and most outpatient care. 

VA’s copay waiver gives these veterans another no-copay healthcare option outside of the Indian Health Service (IHS), whose facilities are located on reservations. 

“Getting VA treatment can be a more convenient option for many American Indian and Alaska Native veterans who don’t live on reservations and live closer to VA facilities,” Idjagboro said. 

To apply for the benefit, veterans must submit the VA Form 10-334 Tribal Documentation Form along with proof of tribal citizenship, which can be a copy of either their tribal membership ID card or documentation issued by a tribe on official letterhead.