Should I apply for VA Healthcare even if I have good private Insurance?

2019-02-12T23:55:51-05:00

I have decent Health Insurance through my company. Should I also apply for VA Healthcare? As far as I know I qualify on several counts including 1) I receive monthly disability payments from the VA and 2) I was discharged medically with a service connected disability.

So, any benefit in signing up for VA Healthcare? My service connected disability has,over the last 30 years, caused me to pick up many rather disastrous medical conditions.

Response by Capt Daniel Goodman made Feb 13 at 2019 12:18 AM

2019-02-13T00:18:14-05:00

Trust me, been there, done that (BTDT)...need you ask? I had pneumonia with cardiac stuff, that was eventually linked nonmometarily by VA to my other VA stuff...we had to get !e out of one private hospital as Medicare did a quality care (QC) review, and said to get out or pay something like $10K a day...thank God we had a VA by us, I'd been clinical before my disability, one of the ER attendjngs said going home would've been dangerous as well as stupid, she said drive over, my wife and I got out of the private one, VA took me nearly 2 wks more, no problem, trust me register for it all, all the VA websites eBenefits, VONAPP (less well known) myHealrheVet (the VA patient site), and also if you're ever 100% upgraded, service disabled vet insurance (S-DVI), not spSGLI or VGLI, those are different S-DVI gives VA 100% $10K coverage free from Congress, then up to $30K more taken out of tour monthly VA disability allotment...also, if you're VA 100% ever, get CHAMPVA, [login to see] , the VA analogues to TRICARE (the used to be CHAMPUS, hence the na!e similarity), we got six and half yrs back benefits on my wife, it's for spouse and minor kids, or adult kids up to a certain age, just rememner, if you have any other insurance besides MEDICARE and CHAMPVA, Congress only provided for electronic rollover from MEDICARE to CHAMPVA directly, any other intervening policies as secondaries negate the electronic rollover, so all CHAMPVA claims for my wife need to go in manually on a HCFA 1500 form to Denver, CO, getting forward repays on copays is doable, hough arduous, we needed to have me send, I kid thee not, 10000 pages of stuff on my wife to Denver for CHAMPVA to figure out what we were owed, we got it, though getting the 10000 pages took forever, plus, we had to send all of it by USPS Express Mail, the HCFA 1500 forms go to PO Box in Denver, they need to be very clearly marked how much copay is given, we're told we don't need to give it, I locate bills, so we give it, then try to get it back, Hus far only one clinical office sent it back to us, I've gotta get on getting the rest, just trust me, get your VA, I assure you, you'll thank me for telling you to do it, if you need help ever look at http://www.vetadvocates.org, if you wanna upgrade at all, or try for it, NOVA aside from vet groups and law school vet law clinics, is the top of the VA disability law food chain, we paid $500 for our consult, did exactly what we were told, the attorney got what he was entitled to like a fifth or something, we transferred it to him from a vet group, my thing was way too complex for them, though they're good people, our guy had 3 yrs prior active and 35-40 yrs VA disability law experience, he even got us pro bono help for free from another law firm he knew partners at, we found out real quick there was a real reason God invented attorneys, honest, lemme know your thoughts, I'd be eager to hear more, no rush, whenever convenient, OK?

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Response by CSM Richard StCyr made Feb 13 at 2019 12:41 PM

2019-02-13T12:41:51-05:00

I would apply for the VA healthcare if you have earned it and are entitled to it. You can loose your company healthcare and be sucking wind. If you have the VA you will have something to fall back on.

Response by LtCol Robert Quinter made Feb 13 at 2019 10:36 PM

2019-02-13T22:36:39-05:00

If you are eligible, take it and file the fact you have the civilian plan available. The VA may file against your civil insurance and you'll be paying your way while getting to see clinicians that are familiar with you military related problems.
Another consideration, if you are eligible for total free care from the VA, your employer might give you additional pay in lieu of medical insurance.

Response by 1SG Private RallyPoint Member made Feb 14 at 2019 10:40 AM

2019-02-14T10:40:18-05:00

If you believe you have developed medical conditions secondary to service connected disabilities you should consider filing a claim for those immediately.

Response by LCpl Berry Johnson Jr. made Feb 14 at 2019 8:45 PM

2019-02-14T20:45:27-05:00

You've earned them, go for it!

Response by Maj Private RallyPoint Member made Oct 25 at 2023 8:49 PM

2023-10-25T20:49:36-04:00

I have a great employer plan. But it has deductibles and limits. AT 50% disability, I don't use my employer plan except to cover my wife. Definitely worth it! Great Doctors too!

Response by PO3 C M made Oct 26 at 2023 10:30 AM

2023-10-26T10:30:53-04:00

I have both private health insurance through my work and thru the VA. The VA doesn't offer dental services (I don't qualify) so I keep my private insurance as the cost covers my dental and I also find it easier to access chiropractic with my company insurance. Those are really the two services I use under my company insurance. The rest of my health needs I typically go through the VA. The VA submits claims to my company insurance helping offset their costs and this also goes toward meeting my deductible for my private insurance. I qualify for free health care at the VA, except for medication co-pays not related to my injury (I'm 10% service connected). The money that the VA receives from my private insurance in turn helps the VA to cover costs to provide healthcare to other veterans.

Response by SPC Dennis Horton made Oct 26 at 2023 2:35 PM

2023-10-26T14:35:37-04:00

I was honorably discharged after 4 years of active service and to the best of my knowledge have no medical issues directly or indirectly relate to my service. Are there benefits that I should be aware of?

Response by Lucy Postolov made Oct 26 at 2023 6:06 PM

2023-10-26T18:06:39-04:00

Speaking strictly as a CCN provider (Acupuncture) I think you should apply for VA benefits as you
are entitled to FREE acupuncture with a community care provider.

Response by SGT Stephanie Southworth made Oct 26 at 2023 6:53 PM

2023-10-26T18:53:26-04:00

I struggled over the same issue when I was first awarded in 2020.

I am P&T disabled with TDIU, resulting in free full medical coverage by the VA--including vision, dental and hearing. As a federal retiree on disability, I have full coverage (with the same benefits) by Medicare and my Federal insurance health coverage, no out of pocket except premiums.

The decision came down to the question of stability of coverage. I knew I could keep my self-paid insurances and go on about my way. If I chose VA medical and dispensed with my established coverage, regaining the same coverage would be nearly impossible should something happen to my VA coverage. Specifically, if I cancel my employment-based insurance, I will no longer qualify for the Federal insurance policy I have already.

I chose to go with both. I maintain my Medicare and Federal insurance coverages, and use the VA as my primary provider for medical treatment. VA covers all my medica needs, and if Congress, in its infinite wisdom, should take actions that endagar my VA care, I have a backup.

A few things to keep in mind when making the decision.
**Does your level of VA coverage take care of all your medical issues? Check the CSR to determine what level of medical coverage you are being provided. It is based on your disability rating and status.
**If you carry private insurance and are receiving VA Health, federal law allows VA the discretion to submit to your insurance carriers under certain circumstances.
**If you should leave your place of employment (whatever the reason), can you carry your coverage with you; will you be able to afford the premiums, deductibles and copayments without your employment?

I would contact the Patient Advocate at your home VA hospital/clinic/center to set you up with someone who can go through all the issues with you personally. They will be more qualified than outside sources to identify any particular issues that may arise in your situation.

Sorry to be so long-winded, but I remember the struggling I went through to make these decisions. Good Luck!

Response by SPC Francis Grimmer made Oct 27 at 2023 12:00 AM

2023-10-27T00:00:01-04:00

Yes, I would do that. I also have a good work insurance program; I am retired now ... :) You will be able to access the Community Health Care Program. There are other benefits too numerous to mention here. One would be My Health Vet. I get all my VA prescriptions filled through that, also am able to securely talk to my doctor and nurse via email. I use the Community Health Care for my chronic back pain. I use a local massage therapist for deep muscle massage. The nearest VA hospital is 91 miles away. The local clinic is only 16 miles. I hope this helps you decide what you want.

Response by A1C Medrick "Rick" DeVaney made Oct 27 at 2023 7:02 AM

2023-10-27T07:02:48-04:00

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Response by TSgt Kenneth Turner made Oct 27 at 2023 9:04 AM

2023-10-27T09:04:18-04:00

We need to discuss what your rights are and future claims. Contact me at [login to see]

Response by PO2 Mark Fraktman made Oct 27 at 2023 11:51 AM

2023-10-27T11:51:36-04:00

Depending on how far you live from the nearest VA Medical Facility (time or mileage) you may be eligible for community care. If so, they MAY cover some or all of your out-of-pocket expenses, or at least work with your insurance company to help.

Response by MAJ Joe L made Oct 27 at 2023 7:39 PM

2023-10-27T19:39:17-04:00

Yes. It will benefit you and help offset the cost of healthcare when you get older.

Response by SPC Kynthia Rosgeal made Oct 29 at 2023 7:17 PM

2023-10-29T19:17:38-04:00

VA, on two separate occasions, has kept me from dying. Liver failure from acetaminophen and a gall bladder which leaked internally (sepsis).

Is the VA perfect ? No, but I'm 65, healthy, living on my own.

I recommend registering in case something happens to your private insurance. Plus a lot of the staff at our VA facilities are veterans themselves. It's much easier sometimes to discuss our experiences with someone who's actually been there and didn't just read a paragraph about the veteran experience and consider themselves an expert.

Response by CDR Bob Lange made Nov 27 at 2023 4:46 PM

2023-11-27T16:46:39-05:00

I have been covered by Tricare (Champus) since retiring in 2000 after 33 years in the Navy. I worked my way up to 30% service connected, 10% at a time until diagnosed with Multiple myeloma 5 years ago. Since I'm a Vietnam vet, I was rated 100%. Trickle would have covered all the costs of my bone marrow transplant, but because I had been checking in with VA primary care annually, using VA services provided the full treatment PLUS the lodging for my wife and I for the 2 months in Nashville required for the transplant. The VA also provides my hearing aids and shoes at no cost for other issues. Since I'm 100% permanent and total, I get all my dental work, including crowns, done at the VA. It's well worth the initial effort.

Response by WO1 Dean Casey made Dec 4 at 2023 3:15 PM

2023-12-04T15:15:37-05:00

Yes. Issues is service connection and when you pass from service connection disability wife can apply for DIC.