Va Rx

[LarryJ]

"fill out the proper form(s)"

What forms are needed. So far, my VAMC claims they don't exist, etc.

The only form admitted to is a waiver form for low income.

Go to your VA Medical Center, with your 50% award letter in hand, and seek out the "cost recovery" office (this is the same office that bills your civilian insurance for your treatment). Go in and get them to fill out the appropriate paper work. This will get you off of the "co-pay" list and get you your refund for all the co-pays since your effective date. This can be a substantial amout of money (my mental health clinic and pain management clinic visits (each clinic had me coming in for group meetings once a week for Months) were all on a co-pay basis for which the fee was substantial, and then there were the drug co-pays. I received a VERY LARGE "refund" for my clinics' cost and, as I said, almost a thousand dollars for my drug co-pay re-payment.

This, by-the-way, is a most often overlooked aspect of your being over the limit on your percentage of disability that negates your having to pay co-pays. There is (has to be!) a kazillion dollars that vets have paid in because of their co-pays that are NEVER recovered by the veterans. Of course, you'd expect that this is something that could easily be taken care of when the veteran reaches the co-pay cut-off disability percentage by the VA.......you know, something "automatic", generated simply by the computer, or even a simple letter, also via the VA computer.........................................................................yeah, RIGHT!

[Berta]

VERY important points Larry-

"This, by-the-way, is a most often overlooked aspect of your being over the limit on your percentage of disability that negates your having to pay co-pays."

You are so right there!!!!!

[SLEDGE]

My co-pay refund was over 1700 bucks.

Today I received a letter from the pharmacy, Clinical Pharmacy Coordinator.

One of my medications does not fit the mold any more.

So, the pharmacy is changing it for me.

Isn't that just swell?

sledge

[Chuck75]

I have to deal with them remotely. The issue has to do with treatment for "presumptive" SC'd treatment. I preciously posed VA documents showing that the VA "does not charge co-pay" for treatment of presumptive A.O. related conditions. The VARO has been dragging it's feet on the related claims for years. Further, the VARO has repeatedly awarded side issues at low values, deliberately to keep the VA total below 50%. The claim total if properly awarded by the VA schedule would equal ~ 150% or so before VA math is used. Since one A.O related presumptive has a schedular rating of 100%, and is fully documented by both medical evidence and SSDI (dating back for several years, and specifically for A.O. presumptive conditions only) It's just a matter of time.

Go to your VA Medical Center, with your 50% award letter in hand, and seek out the "cost recovery" office (this is the same office that bills your civilian insurance for your treatment). Go in and get them to fill out the appropriate paper work. This will get you off of the "co-pay" list and get you your refund for all the co-pays since your effective date. This can be a substantial amout of money (my mental health clinic and pain management clinic visits (each clinic had me coming in for group meetings once a week for Months) were all on a co-pay basis for which the fee was substantial, and then there were the drug co-pays. I received a VERY LARGE "refund" for my clinics' cost and, as I said, almost a thousand dollars for my drug co-pay re-payment.

This, by-the-way, is a most often overlooked aspect of your being over the limit on your percentage of disability that negates your having to pay co-pays. There is (has to be!) a kazillion dollars that vets have paid in because of their co-pays that are NEVER recovered by the veterans. Of course, you'd expect that this is something that could easily be taken care of when the veteran reaches the co-pay cut-off disability percentage by the VA.......you know, something "automatic", generated simply by the computer, or even a simple letter, also via the VA computer.........................................................................yeah, RIGHT!

[LarryJ]

I have to deal with them remotely. The issue has to do with treatment for "presumptive" SC'd treatment. I preciously posed VA documents showing that the VA "does not charge co-pay" for treatment of presumptive A.O. related conditions. The VARO has been dragging it's feet on the related claims for years. Further, the VARO has repeatedly awarded side issues at low values, deliberately to keep the VA total below 50%. The claim total if properly awarded by the VA schedule would equal ~ 150% or so before VA math is used. Since one A.O related presumptive has a schedular rating of 100%, and is fully documented by both medical evidence and SSDI (dating back for several years, and specifically for A.O. presumptive conditions only) It's just a matter of time.

BTW, you need to be keeping records of how much co-pay you've been paying UNLESS you wish to depend upon the VA to be keeping accurate records of your expenditures................................................ ?

[john999]

VA is committing massive fraud by sending co-pays for SC conditions to vet's private insurance. The insurance companies pay up because the VA hides the nature of the co-pays. They lump them together for drugs and services. I had 53 claims for VA drug co-pays and the VA says only 3 were for SC conditions. They told this bold faced lie to my congressman. I have told my insurance not to pay and my congressman what is happening and I get nowhere. It is just fraud and I resent it. I am 100% HB. Why do I have any co-pays? Soon they will try to charge my insurance for SC conditions officially. Obama came up with that idea. That really gets me since I voted for him. The idea was shot down, but I see tricare rates may go up. Screw the vet every chance you get is the VA motto.