Posted on Dec 20, 2014
Does VA health care priority group 5 have a co-pay for doctors appointments and tests at a VA clinic?
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When you are in priority group 5 is there a co-pay for doctors appointments and tests at a VA clinic?
Posted 10 y ago
Responses: 3
Idk but when I was new I did not know about travel pay. After your clinic appt or C&P you go to the travel office and they reimburse you per mile from your listed home. You must present your drivers license, VA I'd and for me receipts from the tollway. I went for years and did not know about travel. They use to give you the cash right at the window but so many ¥£€>%^% took advantage of it that now they mail it to me 10 business days later. It's a lot of money for you from PC to Gainesville. Where ever they send you go to the travel office after your appt. Every little bit help. It's overwhelming at first but I have had great medical cate at VA St.petersburg. I have been sent to Gainesville a few time and they were good too. Good luck dear and don't forget travel benefits. Wish someone told me that when I first started.
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SPC Leisel Luman
I don't drive because of my medical condition and meds. I don't ever expect to. For each appt I have to leave my house at 0530 and get home 11 hours later. Once I let my VA providers know they do a lot for me over the phone and try to combine appointment on the same day since I'm seen not only by my primary provider but two other specialty clinics. VABay pines St. Petersburg has gone over and beyond any medical providers on the civilian side. If you should happen to get a provider who does not listen to you or you feel are not addressing your health problem do what I did. I went to the Patient Advocate and stated I don't want to ever see this provider again. They switched me to another provider. Be proactive in your care. Best of luck to you
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Sgt Sherry Taylor-Bruce
I spoke to my senior claims examiner and she said because of my low income I won't have a co-pay for my doctors appointments or tests but I should expect an $8 co-pay for each of my meds. To that I say yea!
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Sgt Christopher Collins
I'm in Group 5 and have yet to pay any co-pays and only pay the co-pay for my meds.
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Maybe the copay went up since my claims examiner did her research. What would the grounds be for requesting the waiver? Is there an income level to maintain my priority level 5? The booklet said eligible for medicaid, I have No idea what that is since I have never applied for any government assistance other than unemployment when I lost my job in 2010.
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Sgt Sherry Taylor-Bruce Off the top of my head I think you will have co-pays for some things that you are being treated for that are NOT related to military service. I will do some further research and confirm. However, whatever happens in the area of co-pays, contact your local Veteran Service Organization (VFW, DAV, AL) Service Officer and discuss submitting a VA form 5655 and request a waiver for each co-pay. You can do this for each bill for services and co-pays the VA sends you - which means you can submit a waiver request every single month you receive a bill. The process takes up to 3 months for each waiver request.
I can provide further details, etc if you'd like - simply send a private message and request a private conversaton. However, please do NOT provide ANY personal information on this forum - for your own protection.
****** UPDATE ********
From a quick look at the VA co-pay rates, I believe you will not have any co-pays EXCEPT for medicines and/or long term care. I can't find the $8 co-pay you mention, but I do see a $9 co-pay for each month's worth of medicines - so if the VA mails you 3 months worth of medicine you will receive a bill for $27 in co-pay fees for each medicine/month/part of month
I can provide further details, etc if you'd like - simply send a private message and request a private conversaton. However, please do NOT provide ANY personal information on this forum - for your own protection.
****** UPDATE ********
From a quick look at the VA co-pay rates, I believe you will not have any co-pays EXCEPT for medicines and/or long term care. I can't find the $8 co-pay you mention, but I do see a $9 co-pay for each month's worth of medicines - so if the VA mails you 3 months worth of medicine you will receive a bill for $27 in co-pay fees for each medicine/month/part of month
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