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Posted

I submitted paperwork today to try to get on VA health & medical coverage. Since the eligibility is being relaxed (slightly) and our income is down from last year, the Rep. thinks there is a good shot of my getting on the system based on the numbers.

 

The question that neither the rep. nor the patient advocate I spoke with could answer was this: If I'm able to qualify and get on the VA system now, what happens if our income goes back up (especially if it goes up a lot)? Will the VA disqualify me from the system...ie.. will they kick me out because of it?????? They said they had never heard of it ever happening and didn't believe that they would. I said I sure would like to see that in writing some where! I know that the co-pays would change and I would gladly pay them, as long as I can still be covered.

 

My problem is I need absolute confirmation that would be the case. I could not give up my existing (expensive) health insurance coverage otherwise; Once I get off of it there won't be any getting back on and I have to have coverage. I'm still a couple of years out for social security (assuming it's still there, when I get there)

 

So, my Venturerider friends, if you know with some level of certainty, the answer, please let me know. If you know a reg. reference I can go to and look it up, that would be good, too! I've been looking, but no joy as yet. Thanks for any assist or info.

Posted

It your veteran of WWII, Korea, Vietnam, you may be entitled to more than you know. If you enlisted into the armed services before Bush senior took office you got a contract and full entitled to a lot of Va benefits. Yes you read right if they turn you down and your Vietnam vet and enlisted into the service! You just tell them thats not what the contract said when I joined the service.

Guest retusn
Posted

I applied this year and because of my income they thought I would be denied. The question is: Are you disabled for any reason from the military? Are you drawing VA compensation?

Because I am 10% service connected, my income did not matter. If I were you, I would file and let them tell you why you aren't entitled. Be persistant. Vets deserve to be treated with respect and not dumped on. Don't stop if they tell you no.

I'm sure that it not the answer you were looking for, but the system is not set up to give exact answers as each case is different.

Posted

You can go to your local VA hospital or clinic and get a copy of the latest VA benefits book. They are free and will explain in detail all the classification for VA care and how to qualify for them. Has alot of good info for dependents also.

Posted

I use the VA as my primary care. When I went back to the VA in 2001, I was between jobs and fell below the means max. Therefore, I qualified for zero amount copays. Later on, I exceeded the max and now pay the copays for visits and prescriptions. Now that I have company based insurance, the VA bills my insurance, just like any medical group. The difference is, if my insurance does not pay it all, the VA accepts what it pays.

One down side to this is the VA does not write prescriptions for outside phamacies and are somewhat limited it the drugs available and sometimes my copay is double what I could have gotten it for at Walmart without my insurance being used.

Now, I have no military related disabilities. I also live within three miles of a wonderful VA center that is also joined up with a close by Medical University.

As far as a excessive income, it is my understanding that if you want to skip the means test to see if you are entitled to zero deductables, you do not even have to state your income or aquired wealth.

RandyA

Posted

According to the forms, if you opt not to give financial data, you fall into priority group 8([G] I think it is) which is currently not eligible to access the system. (which really chaps me anyway, why does any veteran have to "qualify"? A DD-214 in hand should be sufficient.)

 

I'm waiting on a copy of my med records as we speak. when in hand the rep is going to go over them and see if there's anything there, coupled to current conditions that would enable me to go the disability route. If that works out, then the income thing is irrelevant as far as being able to access the system. It will affect copays, but as previously stated..that I can live with.

Posted

They've loosened up the eligibility req'ts some and there is (at least for this year) a "hardship" provision because of either job losses big income changes, etc. Worth checking into, even if there's no joy at the end!

Guest Oldsalt
Posted

First thing, get yourself down to a local American Legion, VFW rep and have them go over your information. These guys usually have an office right outside a military base (they often give presentations as part of a service member's mustering out group meeting). These folks know the system and they know the VA. It is all they do. Even if you do not think you have a service connected disability, talk to them. You may be surprised. Also, they have all the paper work forms and know how to work the system. Just one example: When I was meeting with the American Legion rep outside Fort Ord, he said "get a copy of your entire medical record and bring it back to me". I did, he went through it and much to my surprise he found all sorts of things that over my 24 year career qualified me for a service-connected disability (and that means you are a high priority at the VA). And this is the neat part...He said "You will have to turn in a copy of your military health record (mine was 2" thick) BUT MAKE SURE YOU MAKE A COPY FOR YOUSELF." And low and behold. the VA 'lost' my health record while they were making their determination. If I had not had that extra copy, it would have been a long battle to get another copy.

 

These guys know the straight poop. They are not the guys that hanga around the bar at their local Post. They have dedicated offices and all they do is work with folks who may be VA potential customers.

 

oldsalt

Posted

The service organizations are an excellent resource. Disabled American Vets (DAV) wasn't mentioned, but they are great too. Most of the VA centers where they do the disability determinations have service reps located in the same building. A lot of states also have veteran's service reps as well.

 

There are definately different "levels" based upon your eligibility. Just about anyone with military service and honorable discharge is in one of the categories. Those of us that are OIF or OEF vets are authorized care without income verification and copays for five years after returning from theater.

Posted

If you are a war vet and got a purple heart you get all free. If you are a Viet Nam vet and have diabetes you get disability even if you have nothing else wrong. When I applied for benefits my service rep reccomended that I use the American Legion as my rep as they are very active and have the largest base of members. I am 100% and it makes a diference. I still keep private insurance because if I have an emergency or if I am traveling I may end up in a private hospital or doctors and have to pay myself. If there was a hospital in my town I would drop it, but for an emergency I would have to travel a long way. If you cant get the answer you want call the VA office in Washington. It is listed on there website. Lyle

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