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Va Billed My Wife's Insurance


Guest terrysturgis

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Guest terrysturgis

I have been 100% TDIU P&T since 2001. I use private medical care outside of the VA but I have to go to the VA for a checkup twice a year. The last time I went they asked me if I had private medical insurance. I told that I am 100% P&T and did not give them any insurance information. My wife's insurance takes good care of me and I do not believe the VA has a right to bill them. Lo and behold yesterday I got a copy from my wife's insurance that the VA billed them for my semi annual visit.

I just got "reevaluated". They checked my earned income and sent me a decision letter that said "TDIU was to be continued". I am not gainfully employed.

Having said that the VA did not get the insurance information from me I wonder if they didn't discover the INS info during the reevaluation.

I guess what upsets me most is my private Doctor not the VA discovered the DMII and PN. By my using outside care I believe it leaves more room for other vets who do not have insurance to get health care they need. Terry Sturgis

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  • HadIt.com Elder

Terry

The VA does the same thing to me. Since I am SC for about 6 conditions how the devil do they have the gall to bill my insurance for anything? How do they separate out what treatment,like bloodwork, is for a service or NSC condition. I am SC for pain disorder and DMII so just about every treatment or med is for something SC yet the VA still finds some way to bill my insurance. I have fought over this with my BC/BS and they went along with paying the VA even when I told them the VA was cheating them. The VA even billed my insurance for a C&P exam. Billing a 100% vet for anything is a slap in the face.

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Terry

The VA does the same thing to me. Since I am SC for about 6 conditions how the devil do they have the gall to bill my insurance for anything? How do they separate out what treatment,like bloodwork, is for a service or NSC condition. I am SC for pain disorder and DMII so just about every treatment or med is for something SC yet the VA still finds some way to bill my insurance. I have fought over this with my BC/BS and they went along with paying the VA even when I told them the VA was cheating them. The VA even billed my insurance for a C&P exam. Billing a 100% vet for anything is a slap in the face.

I have to disagree with you. If you have insurance and don't give them the info then VA costs go up and maybe some other veteran who needs help is left out because of the money situtation and doesn't get the help he needs. Remember those costs are passed on to your provider. I have both options and use both doctors to my advantage

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  • HadIt.com Elder

They knew you have insurance so they found it.

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  • HadIt.com Elder

A past acquaintance was retired AF and had private company group insurance from our common employer as well as Tricare.. He usually obtained medical care from the local AF base clinic. The AF clinic billed the private group insurance, and collected some sort of minimal basic payment from him, since he was retired and not active duty. One older AF contract we worked under overseas had a provision that the AF would provide medical care. When all was said and done, The AF hospital (in Germany) billed the group insurance. They paid the claim, and forwarded an accounting to our employer. In turn,the employer added a management fee, and billed the contract. When the AF paid under the contract, the insurance company was repaid by our employer. Only the government can think of such a screwy way to do business.

About the same time, also in Germany, we had our second child. The base hospital was undergoing renovation and OB/Gyn was for all intents closed. As a result, my wife had to make prior arrangements with the German doctors and hospital. The group insurance complained about having to figure out how to pay a hospital bill in German Marks. On top of that, the hospital kept sending the bill to an incorrect address, and a very distant German relative who was quite elderly, as was his wife.

They knew you have insurance so they found it.
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  • HadIt.com Elder

By the way, it took ChampVA exactly one year to pay their portion of my wife's medical bill. I made so many trips to the providers and wrote so many letters to ChampVA it was not worth the effort.

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Here's a guess, and I only offer it as such - I know when we were still using Champus and had other civilian insurance that Champus was always the secondary payee (in other words, the civilian insurance paid their bennies first and then Champus kicked in). Also, for braces, our civilian dental insurance was the first payee and the military Delta Dental was the second payee. In all cases, we were told by both military and civilian health insurance reps, that if you have 2 insurance policies the government policy is always the second payee. While I haven't used Champus or Delta Dental for over 10 years so I'm sure some things have changed, I wonder if this (the government always being a secondary payee) is the underlying reason why your civilian insurance company is being billed by the VA for treatment even if the disability being treated at VA is sc. Again, I offer this as theory only, not as fact.

Why don't you just call VA billing and ask them and post the answer. While you're at it, ask them how they found out you even had private insurance. That one I don't have any guess on.

Keep us posted on what you find out.

Thanks,

TS

Edited by tssnave
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I have to disagree with you. If you have insurance and don't give them the info then VA costs go up and maybe some other veteran who needs help is left out because of the money situtation and doesn't get the help he needs. Remember those costs are passed on to your provider. I have both options and use both doctors to my advantage

I understand what you're saying here, but it's faulty logic. It doesn't matter who pays the bill in the end, because your tax dollars are used to subsidize both the private insurance companies and the employers who use them, so it's all coming out of the same pot eventually. The only thing that changes is that the VA can claim they "saved" X amount of dollars in some bogus budget report, but that just means they're taking tax dollars from some other fund.

As I said in the other thread about universal health care, we already have socialized medicine...the only difference between ours and the rest of the world's is that more people are profiting in our system, it's far less efficient and 50 million people have no health insurance (and countless more have sub-standard insurance).

So, no, the VA shouldn't be billing other companies for medical services provided to deserving veterans.....

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This is an interesting post. My wife works for the VA and her insurance gets billed for my care, Even SC treatment.

Now most of you know that Vets rated at 10 percent or more do not pay copays except for meds and that ceases when you reach 50 percent and get moved to priority group 1.

Go to the VA site and type in the search box (Who pays copays).

The VA has the right to bill insurance companies for non SC conditions for all Veterans that have insurance.

Now for SC conditions, the insurance industry should investigate this because I am willing to bet the VA has taken millions they should not have.

I would like to see the slugfest between the VA and the Insurance companies. It is going to happen, only time will tell us when.

JBasser

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