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Anyone using the VA for medical benefits?
Old 02-10-2010, 07:48 AM   #1
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Anyone using the VA for medical benefits?

Our COBRA is running out soon and my husband (age 57) was approved for VA medical benefits. We're thinking of buying private insurance for me and he would exclusively use the VA. He has some high risk qualifiers (high blood pressure, high cholesterol, gout, etc) so have been quoted some very high prices (if we can get it) from BSBC - so far the only one we've tried. Is anyone using the VA - if so, what do you think of it? We have a clinic and hospital not far from where we live so that isn't an issue.
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Old 02-10-2010, 12:19 PM   #2
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My husband uses the VA for his medical needs, but we also have private insurance. We are really pleased with his care there, but it is my understanding that care varies widely from one VA medical center to another. It can take a long time to get appointments at some VAs, but we have not had any problems. However, we've only used the VA for general care for his chronic care conditions (including high blood pressure and high cholesterol). Each veteran receiving care has a rating which determines his priority. If your husband is at the bottom of the list, that could present a problem. In addition, it is my understanding that Iraqi and Afghanistan vets get priority over Vietnam vets sometimes. There may also be some income/asset limits that would impact you. The VA will probably not be where we go if something major (God forbid!) such as surgery or cancer should arise. It would probably be helpful if your husband met with a Veterans Service Officer near you. They can answer questions specifically about your situation and their services are free. Some vets do use the VA as their only medical provider and it works out fine for them. It is just different depending on each vets situation. Hope this helps.
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Old 02-10-2010, 12:34 PM   #3
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Please be aware that just because you may be a vet, it does not entitle to you to VA Clinic services, regardless of your current health.

Access to coverage is based upon your "priority group". See the following for defined levels of service:

Enrollment Priority Groups (View All) (VA Health Care Eligibility & Enrollment)

While I'm in priority group #3, I don't use services other than the annual flu shot (they seem to get faster access to the meds).
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Old 02-10-2010, 02:28 PM   #4
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My brother uses Portland VA. He is pleased with his care.
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Old 02-10-2010, 02:55 PM   #5
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Originally Posted by bhoferp View Post
....We are really pleased with his care there, but it is my understanding that care varies widely from one VA medical center to another......
I have two good friends that both use the VA for their medical needs because of health conditions and their financial conditions....plus neither can afford private health insurance because of pre-existing conditions.

One went to one VA hospital/clinic several times and was very unhappy with the facility and the staff each time, so he started going to another one (even though it was quite a bit farther away) and was thrilled with the facility and the staff and the treatment he received each time he went there.

The other friend went to that first hospital/clinic and was thrilled with everything about, and has not gone anywhere else.

So in either case, I don't know if it was the facility and staff, or the clients disposition and attitude, that marked the difference in opinions.
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Old 02-11-2010, 07:44 AM   #6
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Thanks for all the feedback. We've received his acceptance letter and they've enrolled him in Priority 5. We were a little surprised about the Priority rating (thought it would be more like 7 or 8 but sounds like 5 is better so we're not complaining). He has an appointment with his assigned primary physician in a couple weeks so guess we'll see how he likes it.

I am definitely nervous about depending on the VA as his sole insurance but after talking to the agent it sounds like getting private insurance for him (because of all his pre-existing conditions) will be tough and very expensive. Not to mention his meds - we have a high deductable plan now and its running $300 to $400 a month just for his pills.

Any more feedback or insight is appreciated!
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Old 02-11-2010, 10:38 AM   #7
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As with all health care systems the primary care physician is key to good care.
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Old 02-16-2010, 11:57 AM   #8
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Has the VA opened enrollment again? They stopped all enrollment several years back. I got in just under the deadline but do not use the VA for care as I have insurance. I would use it as backup should I lose my current policy.
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Old 02-16-2010, 12:37 PM   #9
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LOVE my VA healthcare! (have used Detroit, MI, Hampton, VA, East Orange and Lyons, NJ facilities) All my records are in ONE place for easy access by my primary care physician. I only use my BC/BS for gyn & chiropractor services when not on active military duty.

As others have stated - check with local facility for availability for his necessary services.
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Old 02-16-2010, 07:09 PM   #10
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I don't use the VA system because, as a retired military person, I have TRICARE. But in my capacity as the Service Officer for the local American Legion Post, I have helped several people apply for VA health benefits.

The deal is:
- if you have "service connected disability" you get a higher priority.
- if you have a "presumptive condition" as a result of in-country Vietnam service, you get care for that condition. (These conditions include prostate cancer, diabetes and a number of other diseases.) The presumption is that if you were in Vietnam - even for one day that you can document - you were exposed to Agent Orange which has been linked to these diseases. Service on Navy ships off the coast does not count - only in country.
- Even if you have neither of the above situations, if you are a vet with an income below about $25K/year, you may qualify. (The exact amount varies by location and depends also on the assets you have. The value of your house and car are not included in determining your assets.)

I have heard nothing but good about the VA Center in White River Junction, VT. When I was on active duty and used to visit the Center in Togus, Maine, I heard the same thing. But I've heard that other locations do not get the same raves.

Bottom line: if you think you may be eligible, call the local American Legion or VFW Post and ask to be put in touch with the Service Officer. He/she can help you determine whether or not you might qualify. Other than filling out a form and collecting a few records from your service years, it's not that hard to apply. The worst they can say is NO, but they might say YES. Even if you just use the VA for prescriptions, it might be worth it.
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Old 02-16-2010, 07:46 PM   #11
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Friar,

Certain Blue Water Vietnam vets are now covered (presumptive) - here's a couple good link that explains it well

Certain “Blue Water” Navy Vietnam Veterans Now Eligible For Agent Orange Presumptive Service-Connected Compensation Benefits

http://www.bluewaternavy.org/CP%20Bu...Jan%202010.pdf

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Old 02-16-2010, 09:12 PM   #12
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Friar,

Certain Blue Water Vietnam vets are now covered (presumptive) - here's a couple good link that explains it well

Certain “Blue Water” Navy Vietnam Veterans Now Eligible For Agent Orange Presumptive Service-Connected Compensation Benefits

http://www.bluewaternavy.org/CP%20Bu...Jan%202010.pdf

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Fireup,

Thanks very much for the info; I was not aware of these exceptions to the general rule about Navy ships not being eligible.
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Old 02-20-2010, 01:48 AM   #13
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My DH tried to get VA care to fill in the time between age 62 and medicare. He was in the navy for 5 years during Vietnam. He was turned down and got no help at all. And he had no preexisting conditions. I was very disappointed since he did serve his country. Somehow that doesn't seem right!
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Old 02-20-2010, 11:24 AM   #14
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A vet myself, I am happy that I am not in a high priority VA category. Give it to those guys who really need it, and please give them the best of care.

It never occurred to me to look into it.
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Old 02-20-2010, 11:28 AM   #15
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What Ed said...
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Old 02-20-2010, 01:29 PM   #16
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Originally Posted by Ed_The_Gypsy View Post
A vet myself, I am happy that I am not in a high priority VA category. Give it to those guys who really need it, and please give them the best of care.
It never occurred to me to look into it.
It's worth registering with your local VA, since their funding depends on the number of registered veterans in their area.

But I'm not going to go down there and whine about a new disability evaluation for my busted-up knees when there are guys less than half my age returning from combat zones without legs.
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Old 02-20-2010, 02:39 PM   #17
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A good friend of mine recently was deemed eligible for VA benefits, don't know his priority level. He has been unemployed for almost two years and has gone from making a 6 figure+ salary as senior software engineer to applying for all kinds of jobs from Postal worker to BART driver, and of course IT stuff. Recently he is going to school to be an auto mechanic. I told him right now there is some 55 year old auto worker in Detroit being trained to be a computer guy and in California they are doing the opposite.

The VA advised him to keep his private insurance, to cover emergency expenses which aren't covered by the VA. The nearest VA facility is a bit of a drive, but it is in Palo Alto California so I kinda of assume it is good. Considering that he is paying $1300/month for health insurance due to some serious pre-existing conditions I advised him to consider dropping his insurance.

It seems me that main risk financial risk he faces is being taken to a local hospital for emergency care and then getting stuck with a big bill. Are their other issues that he may face on relying on just VA care?
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Old 02-21-2010, 06:39 AM   #18
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Thanks everyone for the feedback. clifp, your friend's situation sounds similar to my husband who has been out of work for a few years now. Not having private insurance for an emergency situation is really scary. For instance if he got in an auto accident and they ambulanced him to the nearest hospital. My husband seems to think that may be covered but I don't believe it. Getting private insurance will be so expensive (if we can get it) because of all his preexisting conditions so I'm not sure what we'll do. He has his first appointment with a primary care Dr on Tuesday - maybe we'll get a better feel for how it will all go after that.
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