If You Have Health Insurance 

The military hospital or clinic where you received your care will file medical claims on your behalf. Once your insurance company pays your claims, you’ll get a bill for:

• Copays 
• Coinsurance
• Deductibles 
• Nominal fees
• Non-covered services

If you believe paying this bill will cause you financial difficulty, you may apply for the discount program.

If You Don’t Have Health Insurance  

You’ll get a bill from the military hospital or clinic where you received care.  If you believe paying this bill will cause you financial difficulty, you may apply to the waiver and payment program.

Eligibility for a discount is based on your household income in relation to the Federal Poverty Guidelines. You may be eligible for a sliding fee discount or a catastrophic fee discount if your household income is at:

• 100% or below of FPG: You may receive a full discount.
• 101 – 400% of FPG: You may only be responsible for a nominal fee payable in installments up to 72 months interest free. Nominal fees are published annually.
• 401 – 600% of FPG: You may receive a reduced bill payable in installments up to 72 months interest free. This reduced bill is determined by taking 5% of your monthly income multiplied by 36 months.

If you’re approved for a discounted medical bill, you can:

• Repay your balance in full, or
• Repay through installment payments of 12, 24, 36, 48, 60, or 72 months (maximum allowed). The minimum monthly payment amount allowed is $25. For installment payment eligibility, you must sign the Voluntary Repayment Agreement on the Request for Medical Debt Discount, Military Health System Modified Payment and Waiver Program (DD Form 3201).  

1. Complete and sign Request for Medical Debt Discount, Military Health System Modified Payment and Waiver Program (DD Form 3201)
2. Complete and sign Third Party Collection Program/Medical Services Account/Other Health Insurance (DD Form 2569). You must complete this form even if you don't have health insurance.
3. Gather required documents. You'll need:

• Recent federal tax returns. If you didn’t file a federal tax return for the preceding year, you must attest that you didn’t file an income tax statement on the application.
• Two most recent pay stubs
  • If you don’t have any verifiable income, you must certify this on the application
  • If you’ve certified to having no verifiable income and don’t have either a tax return or pay stubs, you can validate your income by submitting:
    • Last two bank statements (savings and/or checking accounts)
    • Disability check stubs
    • An income verification letter signed by your employer
• Copy of your medical bill

Mail your complete application to:
DHA Debt Adjudication Office/UBO
3130 General Hudnell Dr., Suite 416
San Antonio, TX 78226-4417

You'll get a written notification of a decision within about 30 days.

If you get a discounted bill and still face difficulty, you may apply for a waiver of your remaining medical debt. A waiver may be partial or full.

Waivers are based on an assessment conducted by the competent medical authority at the facility you received care. This assessment is based on how your care enhanced the knowledge, skills, and abilities of the healthcare provider team.

For approved waivers of $600 or more, you'll get a Cancellation of Debt (IRS Form 1099-C) form which may have tax implications for you (please consult a tax professional).

The IRS Form 1099-C will reflect the waived amount after the discount is applied (not your original billed amount).