Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I have about a year and a half until I qualify for Medicare. I just got an application in the mail from the VA that says I might qualify, however, there is something in there about income qualification based on the previous year's income.
I am hoping I can keep working until I hit 65 and beyond, but the way I have been feeling lately I don't know if I will make it.
There is also something in the application about the VA being able to bill my employer provided insurance for payment. I actually have an HSA at work, that I have to meet my deductible out of before the insurance starts to pay. I guess the VA would tap the HSA and then the insurance co?
I am trying to figure out if I should just not apply for VA at this point, unless I need to bail before I qualify for Medicare, or go ahead and apply. I make a fairly good wage, so I am thinking it would not be a good idea to apply until I have to.
Does anybody have any experience with an issue like this?
They can't tap your HSA unless you allow that (pay them out of your HSA). Those are your funds. The VA will bill your health plan just like a doctor's office will bill your health plan and then, if you haven't met your deductible, you will have to pay the VA, just like you would if you went to your doctor down the street.
VA Health Care is not insurance, it is a benefit program for veterans. What, how, when, is all determined by Congress and subject to change. There are many aspects of the benefit that you will need to explore. The first step is to determine your Priortiy Group as that is the number 1 factor that dictates what benefits you will receive, the likelyhood of them being changed, how much, and if financial eligibility will need to be reviewed. You can get your Priority Group and basic determination from the VA at this site: Health Benefits Explorer - Military Service Questions
To claify one confusing aspect, the health benefits are a funded entitlement which means Congress offers it as little or no cost to you at this time. If you have no insurance, you may get it free if financially qualified or in certain Priority Groups. If you have insurance, the VA will bill and accept any insurance payments reveived. If you have an insurance deductable, the VA will not get paid until you reach that deductable but the VA will not bill you the difference. Basically you reach your private insurance deductable based on what the VA bills yet you never really pay that out of pocket. You must disclose any insurance, HSA, FSA, etc because if they find out you had a source of payment and didn't disclose it, you will be billed the full amount plus face a federal fine.
One word of caution, because VA health care qualifys as coverage under the ACA, many otherwised capable veterans who could afford or had private health insurance, have dropped it to use the VA system,. In many areas, the system has become clogged and will only get worse. In addition, VA does not pay for any medical services outside of their system unless they authorized that care. So you can't use it to see your own doctor, or have medical care at a non-VA facility. You may find that you have one heck of a travel distance to se their doctor about a probelem. It's also a possibility that certain care to certain Priority Groups will be curtailed in the future to focus care on those with SC issues and higher Priority Groups. You can imagine it as the most restrictive of restricted HMO's in the US. The VA system is socialized medicine at it's core.
Before deciding to use the VA system, a veteran must carefully evaluate all the pros and cons beyond just the fact that its free or near free - there is a whole lot more to consider!
I think that my best option is to wait and hope that I can keep working for another year and a half until I turn 65. If I have to retire, then I just apply for VA asap. Looking back at all I have paid into insurance, most of my health costs have been less than that. If I could have just bought catastrophic coverage and "self insured" the rest I would have been further ahead.
So, can a Vet just use VA for catastrophic coverage only, or would there be an issue with the VA if I did that?
Also, how long does it take to actually get approved for VA health benefits, on average?
The average time for preliminary approval is about 1 hour if you go into a VA facility, have everything they need, and get processed in person. If doing it online, it can take up to 30 days for the application to be processed, appointment scheduled and identification card issued. You could face delays when you go into a facility based on volume of people signing up or if you need some documentation you don’t have.
As for using it for catastrophic coverage, that’s fine so long as you have the ability to plan that illness/injury so you can use the VA facility. But if you get sick or have an injury that needs immediate attention, you have to consider if going to the closest medical facility is best or going to the VA.
The first thing you want to do is find out where all the VA medical facilities are located and consider the distance to your residence. Additionally, places like the CBOCs are like HMO clinics and are not open after hours. Remember, this is not for critical emergency care. Even routine treatments can take time as they go through your entire medical history and do test. You can cut this down by having your current doctors transfer your records to the VA where you will be seen.
Did you do the pre determination to see what Priority Group you’re in?
Try the Priority Group List and see where you fit. Hopefully you can figure out your group using just the descriptions: Health Benefits :: Priority Groups Table
They can't tap your HSA unless you allow that (pay them out of your HSA). Those are your funds. The VA will bill your health plan just like a doctor's office will bill your health plan and then, if you haven't met your deductible, you will have to pay the VA, just like you would if you went to your doctor down the street.
Not correct....With his income he may have to pay a co-pay of around $50.00, if you see a doctor, and nothing more..You are not charged like you are at the doctors office down the street....I have been using the VA for over 10 years.. And if he has a Purple Heart he wont have to pay anything....For in hospital stay there is a yearly limit on how much the vet has to pay and it isn't that much compared a private hospital..
Not correct....With his income he may have to pay a co-pay of around $50.00, if you see a doctor, and nothing more..You are not charged like you are at the doctors office down the street....I have been using the VA for over 10 years.. And if he has a Purple Heart he wont have to pay anything....For in hospital stay they is a yearly limit on how much the vet has to pay and it isn't that much compared a private hospital..
Even if he is still working and has another insurance plan???? Are you sure???
Even if he is still working and has another insurance plan???? Are you sure???
Based on the Priority Group, the veteran pays a small co-pay or no co-pay. If the veteran has insurance, the VA will bill the insurance and accept whatever they receive, but the veteran isn't responsible for any deductible or difference between the billed amount and insurance paid amount.
For a long time, the VA didn't even bill private insurance, they just provided the care. With so many veterans needing medical insurance (pre ACA) the VA started billing and accepted whatever they received to offset the huge cost. However, the need pre ACA was so huge as many veterans were unable to obtain private insurance, the VA had in start prioritizing the care and setting eligibility standards.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
