About this form

Please use this form to pay your medical care and prescription copayments billed on your monthly statement (form 0246) for services provided by a VA medical center or clinic.

You will need:

• Your VA account number
• Amount due

Tips:

• Where do I find my VA Account Number? Your VA account number and amount due will be listed on the Veteran Patient Statement.
• If you do not have a statement available, you can also log into My HealtheVet to obtain this information.
• Your username and password for My HealtheVet cannot be used on Pay.gov, but you can pay as a guest and do not need to register.
• Questions about your VA co-payment bill? Please contact VA's First Contact Center at the number on your billing statement or click here to find your VA health facility.

Accepted Payment Methods:

• Bank account (ACH)
• Debit or credit card