Beneficiary Travel from Guam

Guam has an on-island clinic and an on-island Navy inpatient partner, which is why its travel problem looks smaller than American Samoa's and is in fact worse on the one number that matters. Among veterans in the territories enrolled in VA health care in fiscal 2022, VA officials told the Government Accountability Office that fifty-nine percent of enrolled veterans in Guam were not eligible for travel benefits. That is the highest figure among the Pacific territories, against fifty-six percent in the Northern Mariana Islands and thirty-five percent in American Samoa. VA officials in Guam explained why: the majority of veterans at the Guam clinic who were ineligible were so because their service-connected conditions were rated under thirty percent and they were seeking treatment for a non-service-connected condition. That explanation is the practical lesson. The under-thirty route into beneficiary travel exists only when the care you are travelling for is related to your service-connected disability. Veterans going to a specialist for something unrelated fall outside it, and on Guam that is the common case. The cost when it applies: GAO recorded VA's estimate that a round-trip flight between Guam and Hawaii cost more than $3,200 in January 2023. The eligibility routes are federal, at 38 U.S.C. § 111 and 38 C.F.R. part 70. A service-connected rating of thirty percent or more; travel for care related to a service-connected disability where the rating is under thirty; receipt of VA pension; annual income below the set rate with the other conditions met; vision impairment, spinal cord injury or disorder, or double or multiple amputations with travel for care through a VA special disability rehabilitation programme. Travel to a compensation and pension examination and travel to obtain a service dog are also covered, and certain caregivers may be eligible. Reimbursement is generally for round-trip costs tied to a scheduled appointment, with an exception for emergency care. Only thirty-nine veterans living in Guam received VA pension in fiscal 2023, so the pension route is technically open and rarely used. The income route is worth asking about rather than assuming. Two things specific to Guam make this less painful than the raw percentage suggests. U.S. Naval Hospital Guam is on island and takes VA specialty referrals under a Defense Department sharing agreement, which removes the flight entirely for some care. And 10 GCA § 67111 directs the Guam Office of Veterans Affairs to provide non-emergency transportation for eligible veterans to and from medical appointments and pharmacies, which covers the on-island leg that beneficiary travel would otherwise reimburse at a mileage rate. GAO noted that the Secretary has statutory authority to prescribe additional regulations extending travel payments to people not otherwise covered and has not used it for the territories.