Health care
VA Health Care in the U.S. Virgin Islands
Two outpatient clinics, two Vet Centers, no VA medical center and no community-based outpatient clinic. Seventy-six percent of enrolled veterans here did not qualify for federal travel pay, the worst rate in any territory.
Also called: VA Caribbean, St. Croix, St. Thomas, outpatient clinic, Vet Center, San Juan, beneficiary travel, enrollment.
For: Veteran or service member.
Where it applies
Written for the jurisdictions listed here.
- U.S. Virgin IslandsTerritory
The Virgin Islands has the thinnest VA health footprint of any Caribbean or Atlantic jurisdiction in this catalog, and the numbers explain why the territory's own medical travel reimbursement matters so much.
The Government Accountability Office counted, for the U.S. Virgin Islands in its 2024 review of VA in the territories: zero VA medical centers, zero community-based outpatient clinics, two other outpatient clinics and two Vet Centers and outstations. Puerto Rico, in the same VA Caribbean Healthcare System, has one medical center, five community-based outpatient clinics, three other clinics and three Vet Centers.
Everything above outpatient level runs through San Juan. The VA Caribbean Healthcare System, centred on the San Juan VA Medical Center, served an estimated 61,000 enrolled veterans across ten outpatient clinics in Puerto Rico and the Virgin Islands. Unlike the Pacific, the Caribbean system has an inpatient hospital of its own, so a Virgin Islands referral goes to a VA facility rather than to a Defense Department partner.
The travel gap is the worst in the territories. Among veterans enrolled in VA health care in fiscal 2022, VA officials told GAO that seventy-six percent of enrolled veterans in the U.S. Virgin Islands were not eligible for travel benefits, against fifty-nine percent in Guam, fifty-six in the Northern Mariana Islands, fifty-one in Puerto Rico and thirty-five in American Samoa. VA Caribbean officials explained that the ineligible veterans were generally either seeking care for conditions that were not service connected, or did not meet income eligibility requirements.
Three quarters of enrolled veterans here cannot get VA to pay for the flight to their appointment. That is the reason the Office of Veterans Affairs runs its own medical travel reimbursement, paying one hundred percent of the flight precisely for non-service-connected appointments within the VA Caribbean network, and it has its own entry. GAO recorded the arrangement: an official from the USVI veterans office told GAO that the office will reimburse veterans for health care-related travel when VA will not.
The federal routes remain what they are everywhere: a service-connected rating of thirty percent or more; travel for care related to a service-connected disability where the rating is under thirty; VA pension; income below the set rate with the other conditions met; or specified severe disabilities with travel through a VA special disability rehabilitation programme. Travel to a compensation and pension examination and to obtain a service dog is also covered.
Claims and examinations. Compensation and pension examinations for veterans living in Puerto Rico or the U.S. Virgin Islands can be conducted at the San Juan VA medical center or through VBA-contracted examiners. Average days to process a disability claim requiring a medical examination, for veterans living in the U.S. Virgin Islands, were 364 in fiscal 2020, 326 in 2021, 211 in 2022 and 214 in 2023, against VA's stated goal of 125 days or fewer.
Scale. VA's population model estimated 3,833 veterans living in the U.S. Virgin Islands in fiscal 2020, 3,725 in 2021 and 3,625 in 2022. In fiscal 2023, 1,150 veterans living in the territory received disability compensation, 34 received pension, 63 received education benefits and 21 used the home loan guaranty. GAO flagged that it could not confirm the accuracy of VA's territorial population estimates, so treat those as working figures.
Enrollment is ordinary federal VA health care enrollment. There is no Virgin Islands application and no local eligibility rule. The territory's own free emergency ambulance service for all veterans residing here is separate and has its own entry.
Thresholds
| Gate | Rule |
|---|---|
| Ordinary VA health care enrollment | Eligibility and priority group follow the usual federal rules. A service-connected rating changes priority and copays rather than opening or closing the door. |
| Thirty percent or more qualifies for federal beneficiary travel | A service-connected rating of thirty percent or more is the general route to beneficiary travel under 38 U.S.C. § 111. Recorded as a note rather than a gate because the statute has routes below thirty and because the territory\u2019s own reimbursement covers the gap. |
| The territory pays where VA does not | GAO recorded that the USVI Office of Veterans Affairs reimburses veterans for health care-related travel when VA will not. Seventy-six percent of the territory\u2019s VA-enrolled veterans were ineligible for federal travel benefits in fiscal 2022, the highest proportion of any territory. |
| No VA medical center and no community-based outpatient clinic | GAO counted zero VA medical centers, zero community-based outpatient clinics, two other outpatient clinics and two Vet Centers in the territory. Care above outpatient level runs through the San Juan VA Medical Center, which has its own inpatient hospital. |
Sources
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Disclaimer
VetTOC is not affiliated with the U.S. Department of Veterans Affairs or the Department of Defense. Information is for reference only and is not an eligibility determination. Verify with VA, the relevant state or territory, or an accredited VSO.