Fritz, well of course you will lose coverage for emergencies (and everything else) if you choose to give up your VA coverage. They are not going to provide service if you dis-enroll. I could dis-enroll, take the Exchange coverage with my wife and re-enroll back in VA coverage if the situation made it more attractive at a later date. Due to my priority 3 status I don’t think they will ever bar me from being able to get coverage. But although there are limitations in the VA system and some concerns about emergency care given outside their system, I think I will work within their system since I have no co-pays with them. Will still be a lot of co-pays and other cost with the Exchange coverage that I don’t have with VA Health Care. Nothing is perfect but I am very happy with the ACA at this point as it makes it possible to get insurance for my spouse, and this will allow me to retire a little early.
ACA and VA Care
- Thread starter Buck2520
- Start date
We purchased a high(est) deductible policy as back-up for VA care in case of emergencies (don't trust that we'll be reimbursed and it could get expensive quickly) and we signed up for VA care as back-up for our high deductible policy. I guess we can continue with this strategy if the rates are acceptable (i,e, we are paying no more than we are now) and we forego the subsidy. We will balance the lack of subsidy with protection again possibly having to pay the high deductible for one or both for multiple years. I guess our decision will be made when prices are posted some day on the exchange for Florida.
I misread as a re-enrolling limitations (given item #1 is listed as starting over and being subject to current regs) and not as what you lose when leaving the VA (disenrolling). As for disenrolling in the VA to go on the ACA exchanges - it somewhat works out that my doing this would be at no additional out of pocket cost (it costs the same for one as it does for two. Enrolling my wife will improve her coverage and reduce her price, but if I join her - the costs are the same. It would also eliminate my personal requirement of purchasing outside emergency VA coverage, which currently costs me $4k annually (I've never used it and it has a $5k deductible). It would be a significant cost if I were to have to utilize that policy ($5k upfront out of pocket and 80/20 for an additional $3k before the bleeding stops). That $4k annual cost would pay for a lot of deductibles and/or out of pocket co-pays for either of us on the ACA exchange, or possibly upgrade us to a different plan level. Another worry is if BCBS chooses to eliminate my current outside policy with the implementation of the ACA exchange, and I have to buy a different policy. My cost increases are based on my joining at 59. I've checked pricing and it would be higher to acquire another policy now at 62 all things being equal. These are just things that I'll need to evaluate, but the financials do point to ACA exchange scenario. I have ongoing issues that would cost out of pocket where the VA covers them, but can't determine direction until I see the ACA actual policy costs with the subsidy.
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ivinsfan
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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- Feb 19, 2007
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I wanted to do an update for those of you in the VA system.
As I mentioned in some previous posts on this thread, VA did an emergency admit for my husband who has VA care. They signed off on paperwork that said they would be responsible for all of the bills related to that admission.
The update is that after about 90 days the VA has submitted all the bills from the admission directly to Blue Cross. Even though the care was provided at another hospital the bills are going in under the VA claim.
This will not affect our out of pocket costs in any way, as my husband needed a surgery to correct the original problem. We elected to have that done under our Blue Cross policy so that we could hurry things along and pick which doctor we wanted to use.
So, we have already met our out-of-pocket max for the year. VA is an approved Blue Cross provider so they will have to accept the amount they are paid from Blue Cross as a final payment.
Now, if we hadn't met our max out of pocket, I don't know what VA might do or not do in regards to collecting any more payment, such as the original out of pocket. I would think that we would only have been liable for the standard co-pays but I don't have a certain answer for that.
I just wanted to provide this additional info for those of you wondering what the VA covers and doesn't cover.
As I mentioned in some previous posts on this thread, VA did an emergency admit for my husband who has VA care. They signed off on paperwork that said they would be responsible for all of the bills related to that admission.
The update is that after about 90 days the VA has submitted all the bills from the admission directly to Blue Cross. Even though the care was provided at another hospital the bills are going in under the VA claim.
This will not affect our out of pocket costs in any way, as my husband needed a surgery to correct the original problem. We elected to have that done under our Blue Cross policy so that we could hurry things along and pick which doctor we wanted to use.
So, we have already met our out-of-pocket max for the year. VA is an approved Blue Cross provider so they will have to accept the amount they are paid from Blue Cross as a final payment.
Now, if we hadn't met our max out of pocket, I don't know what VA might do or not do in regards to collecting any more payment, such as the original out of pocket. I would think that we would only have been liable for the standard co-pays but I don't have a certain answer for that.
I just wanted to provide this additional info for those of you wondering what the VA covers and doesn't cover.
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mickeyd
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Thanks for the suggestion braumeister. I think I'll take advantage of the opportunity.
