VetsLady

Very glad I could be of assistance Capt., Enjoy that meal ! ChampVA will reimburse you for any deductible, (after the ChampVA $50 deductible is met) and any out of pocket expense your wife incurred for medical (not dental) AFTER her other health insurance (aka: OHI) paid their share. So as an example, your wife went for a physical, the bill was $100, after the OHI processed the claim they paid $60 and you had to pay $40, ChampVA will reimburse you the $40. Without OHI, they will pay 75% of the allowable charge. ChampVA is not insurance, it's a benefit. A benefit you are entitled to, you earned it --- this benefit plus the education benefits I'm using since husband is 100% are the 2 things that brought my husband great joy as he felt security for my future. (I have an awesome hubby !) ChampVA won't reimburse for premiums paid for OHI, but they pay everything else, even any deductible your wife may have incurred. It's really a super benefit.....when she becomes eligible for Medicare, then ChampVa will be secondary coverage for her. I'm very happy I was able to put a light on the date issue......with all of the help and support that I have received from this web-site, it feels so good to help another.

Why is the start date 8/2 ???? Your wife's eligibility is effective on the date you become 100% service connected. Post or PM me if you have any questions....

If you have any questions, you can post them, call ChampVa or pm me and I will help you out any way I can. It's all about passing the information on .... to help one person, and then another. ChampVA has been awesome.

DeltaJ --- Thank you for your response ! You should see my office ! I have 5 years worth of EOB's in one stack, and 5 years worth of (almost) every provider I saw - I'm still missing a few statements from a few providers. First, ChampVA said to me yes, we like your idea of separating out the years as that will speed up the claims process. Then, I thought "I can't do that, they want all of the statements AND EOB's associated with them together......, there is no way I can do that as I was missing about 1 1/2 years worth of EOB's from my prior health coverage so the prior health plan provided me with a "print out" of all the claims ... they had to pull them from purged. I'll send in the 5 years all in the same package. It will take the claims person longer to review the claims this way but seriously, 5 years worth. No reasonable person even keeps their EOB's ...... I did ONLY because I did medical billing and accounts receivable for a medical practice so I was just used to doing it this way. (Lucky me!) ChampVA has been sooooo dang nice and super wonderful working with me, hope everyone else who utilizes them has the same experience. I called them this week and they said send it all in however you can but do so before August ----you have 180 days from the date the Beneficiary was granted benefits. ChampVA said then ..... if there are any missing claims or pieces of claims that you have submitted and we deny, you then have 1 year from the denial date to get it corrected. When I called ChampVA initially, I was only inquiring about my new benefit ...... The ChampVA rep told me about this prior benefit and what I needed to submit......I had no idea we could be reimbursed for our out of pocket on me for those 5 years ..... She said, it's as if your husband was 100% 5 years ago, but he was only notified of the benefit recently, which was indeed the case. For us as for many folks, it's been a rough few years. At least now we have Peace and relative security in our lives. I wish the same for all of our Veterans.....

Thanks all, was such a surprise to us to find out about this benefit would go back to the earlier effective date. I still have 5 years worth of doctors bills to send in. This will be a bigger challenge as ChampVA wan'ts the EOB's with the statements, (they need all the pertinent stuff on there like diagnosis, etc.) so......will split the EOB's into the years and add the statements from each doctor and send in smaller increments. If I start getting too close to the deadline, (180 days from date I was notified of eligibility, so it's about August) then I'll send it whatever I have and let ChampVA send me a notice "you missed this, you missed that, we need this, etc." --- that was the clock starts again and I'll have another year to get it all in. Thank you once again for all of you good wishes. It was a long and winding road to get to this point.

Back in December 2010, my husband received 100% and P&T with an EED of 5 years prior. With that came Chapter 35 for me and ChampVA. Imagine my SHOCK when I called ChampVA in January to find out what I needed to do to set up my benefits....and, they also told me I was eligible to receive ChampVA reimbursements back to the day my husband was award P&T --- which was 5 years prior (after an almost 8 year battle with the VA). My jaw dropped and my bottom lip fell to the floor .... I had no idea. I had insurance for that time frame but we also incurred alot of out of pocket expenses for medical a medical condition I had and a surgical procedure. I gathered up all of the RX claims from the pharmacy and submitted them about 6 weeks ago. Yesterday, numerous checks arrived ......... all for reimbursements of RX expenses. I haven't yet gathered all of the medical bills we paid, but have most of them together and will submit in smaller batches. ChampVA suggested that as the claims will be processed quicker. I knew I would be eligible for ChampVA if we prevailed in his claim (and I had no doubt we would eventually, but there were several dark and dreary days and nights, and many times, many of you threw me a lifeline or ladder to climb out of that dark and dreary place) BUT, I had no idea we would be able to recoop all of the expenses we paid out of pocket on my behalf and back to the date he was awarded P&T. Yes, Friday the 13th was a good day. I married my hero more than 20 years ago ..... and I'm a proud, proud wife of a Vietnam Veteran who spent 22 months there.

I just heard this quote from a Commencement Speaker at a College Graduation we attended yesterday. A graduation for multiple colleges for military families, personnel, Veterans. For me, it was an "Ah Ha" moment, as I'm enrolled in college now myself through Chapter 35 benefits my husband earned. There, they had several rows of seats with yellow ribbons to honor those receiving degrees while serving our Country abroad through distance learning courses. It was a proud day. A very, very proud day.

Woo ---- Hoo !!!!! Friday the 13th is a Lucky Day ;- )

Seattle has opened a satellite office in a town south of Seattle (Auburn) to handle Nehmer claims only. And that came directly from the Seattle RO. We have received correspondence and sent correspondence to the Auburn office. I could drive to Auburn in 15 minutes, but why waste the gas ..... ?

Wonderful News, you fought the battle and won the war. I'm very proud to read this positive news ! Very, very happy for you....,

I want to thank everyone for their responses, I don't think there is a right or a wrong answer as every case is probably different. This being 100% is all new to us and I know VA has guidelines as to the what, who, how and why for everything - I wanted to cover all bases. We'll see what happens. Thankfully, he has MedAdvantage. Again, Thank you to Everyone. I appreciate the responses.

The hospital would not bill VA of course, only Medicare...actually a MedAdvantage plan. We probably should have let the hospital bill us directly and then turned that bill in to the VA. Oh well, we'll see where this ends up.

Thanks David, Yes, I did contact them through the tele-nurse AND, pre-admit and after his discharge from the hospital --- and, he had a post hospital stay office call with his VA primary care doc. Hopefully, I covered all the bases.

We were recently traveling out of state when my husband became seriously ill. I called the VA 24 hr tele-nurse who had me take his blood pressure and said to call 911 immediately. He was admitted to a community hospital and kept overnight for severe dehydration and tests. He is a 100% sc Veteran and there were no VA "hospitals" closer to where we were so we were so we went to the nearest community hospital via the VA tele-health nurse. She said get him to the hospital immediately, no ifs ands or buts about it. He is covered with Medicare and the hospital said that is who they would be billing. My question is ....... do we submit the billing to Fee Services for payment or ...... ????

Here's a question that is stirring around my brain ....... My husband is part of the AO Nehmer claim issues and yes, he does have heart disease. VA sent him out for a QTC exam but we have not yet heard anything on this yet. He was recently hospitalized while we were in another state on an emergency basis and we found out via the EKG that was done in the ER that he had suffered a prior heart attack ..... the ER doctor called it a "Silent Ishemic Event" Backing up a bit, VA re-opened his hypertension claim from long ago and we know it's going to be denied as VA says there is no new evidence in the C-file and didn't list the hypertension as part of his original appeal long ago. AND, they say ...... we have to PROVE the hypertension is related to the DM2 that is a direct connection to the AO exposure and he is already sc for. My question is ..... and, perhaps I already have it figured out (maybe) ....... the hypertension re-open is dated August 2010, the AO IHD claim is May 2010. My thought is the hypertension is going to be denied as the IHD preceeds it as far as a medical condition goes. Am I making any sense or is it just a jumbled mess in my already jumbled brain ? eeek !

GREAT news Hedgey !

Yes, it's retro --- back to the date of the Veteran's effective date at 100% P&T. I'm in the process of photocopying 5 years worth of my rx and medical bills as ChampVA will reimburse us for any out of pocket co-pays, deductibles, etc we paid. The hardest part was remembering some of the doctors I'd seen 5 years ago ! Called our insurance company and they sent me a print out as you have to send in an itemized statement to ChampVA for the medical. With the insurance printout of the Explanations of Benefits (EOB's) I was able to recall a few docs I'd missed. For most I have already called them and asked for an itemized statement and they have all been really helpful. A printout of the rx from the pharmacy is sufficient so long as it has what ChampVA wants .... NDC#, prescriber, quantity, etc. It's in the ChampVA packet they send out to you after you file for it. ChampVA has been great to work with .... this was a surprise benefit (the 5 yrs reimbursement part) and well worth it. ChampVA did suggest sending in the rx and the medical statements separately as they are both processed by different departments.

Wonderful, wonderful news on your award !

Hedgey, Before you spend the $ for gasoline, try sending in an IRIS about this issue and also call the 1-800 line, I know, I know .... you don't always get the same answer at the 1-800 BUT all you want is a phone number. I bet most of this can be taken care of (if needed) by FAX. Unfortunately, it doesn't happen overnight. I just went through the DEA enrollment process and today is actually Day 1 of the quarter, I started the DEA claim as soon after we received my husbands new rating and a trip to to local community college and speaking with the VA Rep there helped out alot. She gave me a list of things to do, file the claim through VONAPP, etc. Did you daughter go to school locally ? You might start with the VA Svcs office at the school first. I'd tell ya not to give up but it sounds like you have no plans to.

Hedgey ... There is an obvious mistake someplace. DEA is started either 1.) the date you became eligible to receive it or 2.) the date you choose, so long as it's completed within 10 years from the date you were notified. Your daughter has a choice which date to use. Was she full or part time student ? FT = a higher rate of assistance, in our state, 12 credits = FT @ $936.00 a month. Rates for 3/4 and 1/2 time are options as well, perhaps all states are different BUT your DEA date is the date you choose as it was outlined in your award letter.

Wow ---- zers !!!! Enjoy that good feeling, you earned it.

The sweet taste of victory is even sweeter when your victory is on your own merits ..... !!! Congratulations !

Wonderful news Sapper !

You have to have an "in person verification" process completed. Either by way of your local Regional Office or, as my husbands case (and I just found out this today) since he is 100% we had gone to the local base to receive his MSW card and they did an in person verification, even though he was already in the DEERS system having been active duty (years ago), they still did an in person verification for him to receive his MSW card. Lo and behold, I decided to give a shot today and was issued a verification number and went right into the ebenefits site, no problem. Maybe and I'm not 100% sure, but perhaps this is the reason you can't access anything ?

A sweet sentiment ..... for certain. My guy says the same thing. The times it really hits me in the heart is when I hear from friends or family that he tells he could not or would not have made it through with me. I know he would do the same for me as you would for your spouse....