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VA for primary care-Are u crazy???
Old 07-29-2019, 02:30 PM   #1
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VA for primary care-Are u crazy???

One of the great ?s facing anyone who is lucky enough to retire early before they qualify for Medicare is what to do about health insurance.

Iím curious if anyone is a qualified Veteran without a disability rating that uses the VA for their primary health insurance?

I am a qualified Veteran, but currently have Connecticare for mine and my wifeís insurance. We pay our monthly premiums through our small business, but hopefully will retire in the next 5 years. This will put us both at 55 or 10 years shy of qualifying for Medicare. I am in good physical shape and exercise 5 times a week. Iím thinking of dropping my insurance now and using the VA exclusively, thus getting rid of at least 1 every increasing monthly expense.

Also, Is there any non veterans out there that is finding a way to bridge the gap from their early retirement to the time they can qualify for Medicare.

Thank You :-)
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Old 07-29-2019, 02:41 PM   #2
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My husband is a veteran but was not allowed to use the VA insurance when he retired. I had to put him on mine which is 1k/month.
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Old 07-29-2019, 03:18 PM   #3
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I use VA as a backup. I go in once a year for a checkup just to stay active in their system, and I've had many immunizations there (flu, pneumonia, shingles, etc.). Also a few other things like custom orthotics and an ultrasound scan. My interactions have all been excellent. The people there really try hard to give you the best care they can.

That said, they don't seem to have the resources that ordinary hospitals in the area have. When I said I felt a bit guilty taking up their time, they told me that their funding is based on how many "clients" they have registered to the facility. Since I'm on Medicare (with TFL supplement), I use civilian care primarily.

However, I know several people who consider VA their primary caregiver, including a couple of members right here on this forum. If they have any real complaints, they haven't shared them, so I think they're all happy with it.

However, there seems to be a huge difference depending on where you live. When my father was getting into his last days, he begged me to get him into a different VA center. He was in NYC and he said it was a living nightmare. I brought him to Ohio and he was delighted with his care. He was in their hands for his last six months, and my observation as well was that they took excellent care of him. So I would counsel anyone to ask around to gauge the quality of the VA care that is available to you locally.
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Old 07-29-2019, 03:32 PM   #4
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Using the VA healthcare works so much better if (1) the VA clinics and VA hospital in your area are not very far away. And (2) the quality of that VA system is acceptable.

Not every VA hospital and clinic is created equal. I think the common thread is seldom will you find a U.S. born physician working for the VA.

We're fortunate to have two fine VA Hospitals 90 and 120 minutes from us and our city's large enough to have a decent VA clinic locally--including a counseling unit.
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Old 07-29-2019, 03:54 PM   #5
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Yoheadden, DW and I are both retired Army, so can use VA but don’t. She is on Medicare and I am using Tri-Care prime. I only retired last Aug, so not a lot of experience with Tri-Care. One appointment for sprained wrist ( just wanted to confirm it wasn’t broken). Then later this week I’m in for physical. Seems to be all I need for medical, and I pay about $30 per month. In 2 years I’ll do Medicare and Kaiser. So, if you can do Tri-Care I would suggest checking that out.
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Old 07-29-2019, 04:08 PM   #6
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Also, Is there any non veterans out there that is finding a way to bridge the gap from their early retirement to the time they can qualify for Medicare.
We use ACA plans from the Marketplace.
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Old 07-29-2019, 04:35 PM   #7
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I am a disabled vet and use the VA for 100% of my medical care. That includes Vision and Pharmacy. $0 premium, $0 deductible.
Emergency care and even LTC is included.

I have VA dental insurance, through Delta Dental for my dental insurance. It works great.

The only difference between a disable Vet and non-disabled is the cost of the service, and priority. You may be surprised and you may be disabled and not know it. I got my disability rating 33+ years after I got out.

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Also, Is there any non veterans out there that is finding a way to bridge the gap from their early retirement to the time they can qualify for Medicare.
The DGF has MN Care. $0 premium, $0 deductible. It would not work if we were ever married, or ever had kids together.
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Old 07-29-2019, 04:57 PM   #8
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Retired at 33/34 and carried private insurance for 15 years (never used). For the last 15 years I have self insured (including two births). I carry PHI for each of my children at a cost of about $200/mth. Last year just before I turned 65 I got HI for myself at a cost of $1,000/yr as Intl insurers will not issue a policy after that age. I used it once so far to get a full medical. I qualify for Medicare now but can not use it except when I travel to the USA. But at least I no longer need to buy travel insurance!
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Old 07-30-2019, 04:45 AM   #9
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You may already know this so sorry if I'm repeating something you're perfectly familiar with. The VA Medical st stem operates on a priority system based on your degree of service-connected disability, if you have one. Obviously, the greater your disability, the higher your priority. If you have no disability, you're at the bottom and then there is an income/assets test. The lower your income/assets, the more readily you qualify for the low (non-service connected disability rating) priority.

Your access to a specific facility depends on how well resourced a particular medical center or clinic is. Someone may be a lower priority and have ready access to his/her local facility whereas someone of the same priority in another location may not.

There is an application process to get into the system and your priority is determined from that process. I used to be the Service Officer for an American Legion Post and I helped a few vets with the paper work. My experience is a bit dated so there may have been some changes. If you have any records related to continuing medical problems from your service (e.g., hearing loss if you were exposed to artillery, prostate cancer or diabetes if you served in-country in Vietnam - Agent Orange) you'll want to mention that in your application. The vets from the Vermont Legion Post where I was seemed to have pretty good access to the VA Medical Center in White River Junction and to the clinic in the Burlington area once they got into the system but I understand it's not the same everywhere. I don't personally use the VA system because I am on Medicare/Tricare.
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Old 07-30-2019, 05:16 AM   #10
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Dad was in their system on 10% disability from WWII.

Dad had two surgeries, one an emergency for bowel obstruction, that went fine.

However, Dad had many other surgeries out of the system (orthopedic) that we were all glad were not through the VA because the process was so much more smooth outside of the VA.

He used VA as an adjunct to his private insurance. He got drug coverage and hearing aid coverage, for example.

The experience was always a bit difficult. He had to have a doctor's visit for the drugs, and she was some east European that could barely speak English. He just gutted through it for the medicine.

The hearing aids were a 6 month waiting process. But they worked, and he was glad to have them. When he broke them once, I went there and stood in line, only to have an envelope given to me. I put the pieces in an envelope, and dropped it in a box as directed. 2 weeks later, brand new aids came in the mail. The process worked, but was very sterile.

I'm not going to outright "dis" the VA like some will. His care was generally good, just difficult to obtain. You need patience, and may have to put up with some crap. His emergency surgery was the finest around. Saved his life. Perhaps this is where medicine in general is going. Actually, it already is, even in the private sector. "Generally put up with crap, but you'll be OK in a true emergency."

P.S. Dad's VA hospital complex was one of the better ones. It matters.
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Old 07-31-2019, 02:49 PM   #11
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The VA covers the most expensive medications for a close relative who is a kidney transplant recipient...that otherwise would have cost them thousands annually.

OTOH my Dad had his gallbladder out via the VA...18" long scar...looks like they had to open him up enough in order to fish around for it.
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Old 07-31-2019, 04:57 PM   #12
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When I was working, I also had a private insurance through my employer. The VA would send their bill to my insurance, and I would get the EOB. They went like the rest of them, except no payment from me.

Charge $1,000
Allowed $750
Max Deductible not met yet
Patient responsibility $750.

I never had to pay any "Patient responsibility" amounts, however my max deductible got $750 closer to being met. It was pretty good. I figured that if I needed something from the private section, it would not have cost too much in terms of my expense as my deductible was closer to being met.
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Old 08-12-2019, 12:19 AM   #13
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Been using VA for all medical care for five years.Three more to go before Medicare. Generally have found it to be pretty good. Like others said, depends on your local facility. Biggest problem is itís portability if you are not in your local home area. Also big questions about ER care outside the VA system. Yes they are supposed to cover but there are many problems. Bureaucracy in VA is crazy. Hard to count on them for all health care issues. If you close to a good VA Hospital and donít travel much they should be fine. New policy for Urgent Care should also help as long as there is a participating location where you need one. So far there are many geographical areas with no participating provider. My thoughts, overall, VA care pretty good, portability and ease of use, not so good.
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Old 08-12-2019, 05:21 AM   #14
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Yoheadden, DW and I are both retired Army, so can use VA but donít. She is on Medicare and I am using Tri-Care prime. I only retired last Aug, so not a lot of experience with Tri-Care. One appointment for sprained wrist ( just wanted to confirm it wasnít broken). Then later this week Iím in for physical. Seems to be all I need for medical, and I pay about $30 per month. In 2 years Iíll do Medicare and Kaiser. So, if you can do Tri-Care I would suggest checking that out.
We have been using Tri-Care for 2+ years. Modest deductibles, co-pays, and zero premiums. Very pleased with the coverage. We're not near a military facility, so we just see in-network providers. Tri-Care was a big part of our 60-65 retirement strategy and it's working great.

I'm a veteran of 30 years, and could probably qualify for some level of service related disability. But I tend to shun bureaucracy in all its forms...
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Old 08-12-2019, 06:50 AM   #15
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Biggest problem is it’s portability if you are not in your local home area. Also big questions about ER care outside the VA system. Yes they are supposed to cover but there are many problems.
I am planning on going to the nearest emergency care hospital, wherever the ambulance take me, if I need it. The VA has to cover you like any other insurance plan. That is the law. The VA must still abide by the law, that is why a service connected Vet gets 100% healthcare rather than just for service connected issues (like previously)

You have to meet the VA's qualifications (i.e. be eligible), and let them know right away. If you have outside insurance, you may have to pay a deductible, if you do not, it's 100% free.

Most VA hospitals do not cover true emergency care anyway, you would be sent to a nearby hospital if you had a true emergency like a heart attack. I know in Minneapolis, MN, they do not handle heart care.

You can also get a traveling referral, if you know you are traveling and may have an issue.

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In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

https://www.healthcare.gov/using-mar...mergency-care/
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Old 10-18-2019, 03:04 AM   #16
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I use VA as a backup. I go in once a year for a checkup just to stay active in their system, and I've had many immunizations there (flu, pneumonia, shingles, etc.).





I wonder what the minimum treatment is to be considered active in the system.


would a simple flu shot do it?
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Old 10-18-2019, 04:42 AM   #17
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I wonder what the minimum treatment is to be considered active in the system.


would a simple flu shot do it?


I worked for the VA as part of my bridge career. Visiting once a year is considered active treatment. And the area where you go gets $2500 allocation for your yearly visit. I do not use the VA for my primary care and for me it would be 3rd in line for my preference given my particular options.
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Old 10-18-2019, 07:17 AM   #18
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I wonder what the minimum treatment is to be considered active in the system.

would a simple flu shot do it?
It may be, although you can go to Walgreens too. Walgreens uploads the records to the VA system. That is the same as getting the shot from the VA, would that count?

Why not just go for an annual physical and bloodwork? Then you know you are covered.


And if they find something that the medicare/medicaid doctor did not, you can feel better.
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Old 10-18-2019, 12:45 PM   #19
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For a close relative VA covers what would otherwise be very expensive meds related to their kidney transplant, so they get even routine care (e.g flu shot) there as well.
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