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My father (WWII vet) ran into that drug issue when it came to a specific drug his family doctor prescribed. IIRC - the doctor had prescribed a brand name time release version of the drug. The VA formulary only had the cheaper generic non-time release version. Can't remember exactly what happened. I think my father wound up getting the drug through his Part D plan and paying the larger co-pay.
FWIW - I'd really dig into the particulars regarding specific VA facilities. I know our big local relatively urban one in JAX has issues with wait times:
As veterans of Korea - the Vietnam War and even later wars get older and have more health issues - the VA system - like many parts of the medical system - will likely continue to be under stress. And I doubt there will be (m)any facilities that will escape the stress entirely:
P.S. Our area has a large military presence. And one thing I've noticed increasingly is that providers are refusing to take Tricare patients (don't know why - maybe reimbursement is low - slow - or both). So anyone relying on Tricare should see what the situation is in a particular area. Of course - many providers in many areas are increasingly limiting or eliminating their Medicare practices (this is more prevalent in primary care than better paid specialty areas). So it pays to look into that as well. These days - it's a good idea to have a plan A - a plan B - and often a plan C when it comes to medical care.
I am a VA nurse and if you are thinking of enrolling post retirement at the VA in the area you will be relocating to I would suggest you enroll now at your current local VA to get familiar with the VA model of care because it is different than private sector healthcare. For example, the VA I work at does not perform cardiac surgery or neurosurgery, so if you require either on a non emergency basis you will be sent to West Haven or West Roxbury VA for the surgery you require. Also obtaining certain medications can become an issue if you continue to also see doctors in the community that prescribe medications for you. If your community doctor prescribes a medication that is not on the VA medication formulary, if the VA pharmacy approval committee feels a formulary med can be substituted despite your community doctor feeling opposite you will not get that med from the VA. Lastly, when you enroll you will be means tested whether you have combat exposure or not. If you do not have a certain % of service connected disabilities and or your income falls above an income threshold which off hand I don't know what it is but it is pretty low you will be expected to pay copays for certain services and medications. At present medication copays are $9.00 a prescription, and visits with a specialty doctor such as an orthopedic surgeon you will have a $50 copay. Unfortunately a number of Vets who have not sought VA care prior to retirement opt out of healthcare supplemental insurance because they think the VA will be their supplement for community healthcare services and are pretty distressed when they find out that this is not how the VA model of care works.
I do not know how much VA care I will take advantage of. I am applying for disability due to some minor problems here in MA. Okay not quite so minor. Knee, shoulder and back issues are beginning to bother me. I do have BCBS and will carry that until I figure out if part b is better or less expensive. I might use them for medications if I can but as I said I am fairly well covered either way. I do not really know how all of that will work with me but I know that DW and I will just enjoy the time we have together. Oh in conclusion. Thank you for your service in the VA and military if that applies. It is people like you that make it all worth it for us.
My father (WWII vet) ran into that drug issue when it came to a specific drug his family doctor prescribed. IIRC - the doctor had prescribed a brand name time release version of the drug. The VA formulary only had the cheaper generic non-time release version. Can't remember exactly what happened. I think my father wound up getting the drug through his Part D plan and paying the larger co-pay.
FWIW - I'd really dig into the particulars regarding specific VA facilities. I know our big local relatively urban one in JAX has issues with wait times:
As veterans of Korea - the Vietnam War and even later wars get older and have more health issues - the VA system - like many parts of the medical system - will likely continue to be under stress. And I doubt there will be (m)any facilities that will escape the stress entirely:
P.S. Our area has a large military presence. And one thing I've noticed increasingly is that providers are refusing to take Tricare patients (don't know why - maybe reimbursement is low - slow - or both). So anyone relying on Tricare should see what the situation is in a particular area. Of course - many providers in many areas are increasingly limiting or eliminating their Medicare practices (this is more prevalent in primary care than better paid specialty areas). So it pays to look into that as well. These days - it's a good idea to have a plan A - a plan B - and often a plan C when it comes to medical care.
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Few are aware that the original mission of the VA was to provide care to the poor war wounded veteran. In the mid 80s the enrollment numbers of Vets began to drop thus began a recruiting effort to encourage all Veterans to enroll regardless of income and whether or not they had combat exposure or illness or injuries related to that exposure. Enrollment further increased when private healthcare insurance premiums began to increase which prompted many Vets who would have not sought VA care previously began to enroll in huge numbers and still are. Unlike primary care doctors in the community where their patient load gets to a certain number they can refuse to take on new patients, the VA can't do this and this is what has created many of the waitlist issues. Many Vets especially the older ones have numerous doctors in the community and only want from the VA the ability to get their medications. Unlike retired military Vets who can go directly to a base pharmacy and get a prescription by an outside provider filled, at the VA if a Vet wants to get a prescription filled that was written by an outside provider they have to be enrolled in VA primary care and that med has to be represcribed by the VA primary care provider or specialty provided if it is a specialty restricted med. This situation has become a nightmare because a good part of the VA primary care doctor's time is spent reviewing documents from outside providers with med prescribing requests. Since the VA doctor who represcribes a med is now responsible for the actions and reactions of that med they have to review the volumes of those documents that come in that support the need for that med. And what adds to this nightmare is the VA doctors knows that most patients will not purchase a small supply of the needed med on their own prior to having the VA approve their request for a certain med. So if a prescription request for say Plavix comes in which is a med if missed can lead to a life threatening event, this creates all the more pressure to review those hundreds of incoming med requests and this all takes time away direct patient care. It is a little after 4:00 am that I am writing this post, and I can tell you that the two primary care doctors I work with whose day should start at 8:00 am are currently driving to work to get a head start on the volumes of paperwork they have to review and will still be doing the same when I leave work at 4:30. Not surprising that both these exceptional doctors will be retiring at the end of 2016 because they just can't keep up with the work load any longer.
I can't predict the future for the VA, but it would not surprise me if one day in the not too distant future the bulk of the care will be privatized and all that will remain will be health care services and research focused on specific military related illness and disorders such as those caused by Agent Orange exposure, PTSD, etc.
I do not know how much VA care I will take advantage of. I am applying for disability due to some minor problems here in MA. Okay not quite so minor. Knee, shoulder and back issues are beginning to bother me. I do have BCBS and will carry that until I figure out if part b is better or less expensive. I might use them for medications if I can but as I said I am fairly well covered either way. I do not really know how all of that will work with me but I know that DW and I will just enjoy the time we have together. Oh in conclusion. Thank you for your service in the VA and military if that applies. It is people like you that make it all worth it for us.
I am not military, but I most definitely feel like I was as I was a child of a career Navy father. My father's last duty prior to retirement was skipper of the admiral's barge in Newport, R.I. My mother was quite ill at that time, so the admiral knowing the situation with my mother would let my father take me to work when there was no baby sitter to take care of me. My father would dress me in a little sailor dress with cap for those work outings, and with my curly hair I looked very much like Shirley Temple who by the way I was named after
You are welcome with regards to my service with the VA, and am very honored that I had the opportunity to serve those who have served.
PS Do not wait to file those comp & pen claims because processing involves various exams, x-rays, etc., which can be a lengthy ordeal.
I do not know how much VA care I will take advantage of. I am applying for disability due to some minor problems here in MA. Okay not quite so minor. Knee, shoulder and back issues are beginning to bother me. I do have BCBS and will carry that until I figure out if part b is better or less expensive. I might use them for medications if I can but as I said I am fairly well covered either way. I do not really know how all of that will work with me but I know that DW and I will just enjoy the time we have together. Oh in conclusion. Thank you for your service in the VA and military if that applies. It is people like you that make it all worth it for us.
golfingduo, we both have similar issues - I also have knee, back, and shoulder problems. I have a VA disability rating for my left shoulder, left knee, lower back and hearing. Unfortunately, my right shoulder and right knee didn't start bothering me until after I had already retired, so no VA rating on those. I have a couple of issues that I should have claimed but didn't, so not only do I miss out on a higher overall disability rating (assuming that they would have been rated), but now any treatment is all on me.
My advice to you is to make sure you document every little ache and pain no matter how minor you think it is now. 15, 20, or even 30 years down the road that minor pain may have become a major issue. Everything that gets documented now and VA rated (even at 0% now) can be treated at a VA facility at little or no cost. You can always request a reevaluation if the issue gets worse.
I am not military, but I most definitely feel like I was as I was a child of a career Navy father. My father's last duty prior to retirement was skipper of the admiral's barge in Newport, R.I. My mother was quite ill at that time, so the admiral knowing the situation with my mother would let my father take me to work when there was no baby sitter to take care of me. My father would dress me in a little sailor dress with cap for those work outings, and with my curly hair I looked very much like Shirley Temple who by the way I was named after
You are welcome with regards to my service with the VA, and am very honored that I had the opportunity to serve those who have served.
PS Do not wait to file those comp & pen claims because processing involves various exams, x-rays, etc., which can be a lengthy ordeal.
Quote:
Originally Posted by djplourd
golfingduo, we both have similar issues - I also have knee, back, and shoulder problems. I have a VA disability rating for my left shoulder, left knee, lower back and hearing. Unfortunately, my right shoulder and right knee didn't start bothering me until after I had already retired, so no VA rating on those. I have a couple of issues that I should have claimed but didn't, so not only do I miss out on a higher overall disability rating (assuming that they would have been rated), but now any treatment is all on me.
My advice to you is to make sure you document every little ache and pain no matter how minor you think it is now. 15, 20, or even 30 years down the road that minor pain may have become a major issue. Everything that gets documented now and VA rated (even at 0% now) can be treated at a VA facility at little or no cost. You can always request a reevaluation if the issue gets worse.
I am in that process now. I have stuff already documented in my medical records and those are just the ones from my National Guard ones. I have others that will come from the Active Duty records once the process gets going. I have a VA advocate working for me now so I am fairly confident I will get things done proper like and even though I could have started this process years ago I didn't want any of my medical issues kick me out since my full time job depended on my continued service which is coming to a graceful end in March.
I am in that process now. I have stuff already documented in my medical records and those are just the ones from my National Guard ones. I have others that will come from the Active Duty records once the process gets going. I have a VA advocate working for me now so I am fairly confident I will get things done proper like and even though I could have started this process years ago I didn't want any of my medical issues kick me out since my full time job depended on my continued service which is coming to a graceful end in March.
Good to hear you got the claims process rolling. My late BIL was diagnosed with lung cancer and his oncologist told him his type of cancer was likely caused by Agent Orange exposure while serving in Vietnam. My BIL did not want to file a claim initially, but my father and I pushed him telling him if he did not live long enough to fully utilize the benefits my sister would inherit them which he was unaware of. My BIL was granted 100 % SCD one month prior to his death. Since my sister had retired early from teaching to take care of my BIL, she ended up with a very small pension and would have no health insurance after he died. She ended up inheriting a little over 1/2 my BIL's SC disability check which made up the difference in her pension loss, as well as she was able to receive her medical care at the VA until she became Medicare eligible. It was very sad loosing my BIL, but glad that the VA is taking care of my sister.
Few are aware that the original mission of the VA was to provide care to the poor war wounded veteran...
Perhaps it is time to dial things back in that general direction - at least for veterans who are fairly well off and don't have any service related injuries/disabilities? And perhaps some of the problems will dissipate as the remaining WW II veterans (there are over 800,000 of them) leave this world:
Perhaps it is time to dial things back in that general direction - at least for veterans who are fairly well off and don't have any service related injuries/disabilities? And perhaps some of the problems will dissipate as the remaining WW II veterans (there are over 800,000 of them) leave this world:
I concur Robyn. One of the disabilities I would like them to get a handle on is PTSD. I do know of a few that have tried to claim that in spite of not having really been in combat. Just in the zone where combat was happening. In particular my unit being a maintenance unit went to Iraq in 2003. We arrived in theater after the ending of hostilities per se. We were positioned in the southern area where the majority were Shiite and not Sunni. These were the folks repressed by Sadam's regime. We had it fairly quiet so when I heard a few of our soldiers claim that I was kind of set back. I do not claim I have any PTSD. Did I see things I didn't want to? You bet. Did I hear gun fire? Yes I did. Did I see anyone get shot? No. Did I fire my weapon? No but I came close when someone didn't listen to direction and leave an area. But I and my soldiers came home safe and sound and a little bit worn but alive.
I concur Robyn. One of the disabilities I would like them to get a handle on is PTSD. I do know of a few that have tried to claim that in spite of not having really been in combat. Just in the zone where combat was happening. In particular my unit being a maintenance unit went to Iraq in 2003. We arrived in theater after the ending of hostilities per se. We were positioned in the southern area where the majority were Shiite and not Sunni. These were the folks repressed by Sadam's regime. We had it fairly quiet so when I heard a few of our soldiers claim that I was kind of set back. I do not claim I have any PTSD. Did I see things I didn't want to? You bet. Did I hear gun fire? Yes I did. Did I see anyone get shot? No. Did I fire my weapon? No but I came close when someone didn't listen to direction and leave an area. But I and my soldiers came home safe and sound and a little bit worn but alive.
If you talk to WWII vets in my father's generation about PTSD (everyone male in my family in my father's generation was in WWII - ditto when it comes to all males in my family and WWI* - and I doubt I am unique when it comes to that) - most would pretty much look at you like you had 2 heads. Even my late uncle - who was in the Battle of the Bulge. He died of Alzheimer's at 90+. I think when these guys got home - they just wanted to get on with their lives. Although some were better or worse at it - whether or not they had physical wounds/disabilities. As was shown in this - one of the best movies of all times - The Best Years of Our Lives:
If anyone here hasn't seen this movie - it is a "must see" IMO. Robyn
*Both of my grandfathers were recent immigrants to the US in the early 19th century - and gained their citizenship by volunteering to fight and fighting in WWI.
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