Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • hohomepage-banner-2024-2.png

  • 27-year-anniversary-leaderboard.png

    advice-disclaimer.jpg

  • donate-be-a-hero.png

  • 0

Private Insurance Industry's 63-Day Lapse ”Gotcha” Vs Va Health Care Enrollment.

Rate this question


DrBarbae

Question

My situation: I am an expat living in Europe that is taking a much-needed pause from work after being in Afghanistan the last 3 years straight. I anticipate taking the next year off from work. I recently separated from my employer on 30 Sep 2013. I currently have no medical insurance coverage from a private company. Paying for my health care out-of-pocket is feasible. I am 90% disabled, and expect that soon will be 100% disabled once my claim finalizes (December or January). I would rather not spend money on costly COBRA or anything else if I am in the situation I am in. I am currently looking for insurance that will cover me if something terribly catastrophic would happen (hit by a car, etc).

My concern: CIGNA (and other big insurance companies do this too, I am sure) just sent me a ”certificate of group health plan coverage” indicating I was covered through 30 Sep 2013 that is seemingly useful to gain coverage for pre-exisiting conditions when getting a new policy **IF** I get insurance within 63 days of the policy expiring (approximately 02 Dec 2013 in my case). I want to make sure I do not screw myself by not taking action now, but do not want to buy insurance I do not need, or will be too much of a hassle to use.

My question: Does being a disabled veteran exempt me from this ”lapse in coverage” stuff, at least for service-connected conditions that might not be covered in the future? And what about being outside the United States? If I am enrolled for VA healthcare, am I good to go?

THANKS!

ro → en
the
Link to comment
Share on other sites

  • Answers 9
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Recommended Posts

If you are 50% SC'd the VA covers all of your medical conditions whether SC'd or not. Now I am not sure how the coverage works for someone who is out of the country. I would imagine that you could go to a U.S. military base and be covered that way. I would contact the VA and ask them about the coverage in the country you are in.

Link to comment
Share on other sites

I forgot to mention that I am enrolled in the Foreign Medical Program too. It seems though I am covered, but I do not want is for insurance industry to stick it to me because I gave them an easy opportunity to charge me more for an arbitrary time of not "paying into the system". I will call CIGNA tomorrow and hopefully will get a straight answer.

However, is this true if I am stateside, what is below? I thought the VA covered all of a veteran's medical conditions only if rated at 100% (and only if stateside). I thought 50% put me in the first priority group.

If you are 50% SC'd the VA covers all of your medical conditions whether SC'd or not.

Link to comment
Share on other sites

That is correct

At 50 % SC the VA covers medical expenses to include RX for

ALL medical conditions - NOT just SC'd conditions - that is

except for Dental care.

For dental care, in most cases you must be 100 % SC'd or

I believe SC'd at 100 % due to IU, or have a compensable SC'd

dental disability.

Link to comment
Share on other sites

Your eligibility for VA care will probably NOT meet re-insurance requirements for any commercial insurance company.

Currently, I am investigating/discussing an employer provided plan about a coverage clause the indicates medical services for military injuries are excluded? I fail to see how that will comply with elements of the ACA that address coverage for pre-existing conditions ( i need to dig into the text of the law to see if the congress gave insurers a HUGE loop hole). I have been told by the insurance company I qualify for care under the policy, but still want to know when and how this clause would be enacted and I also want to know if military injury is specifically mentioned in the ACA.

Best regards,

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Guidelines and Terms of Use