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Co-pays For Treatment By Va

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Ron II


I am aware that the VA charges a co-pay on medications in some cases. What about treatment for

a Service-Connected Disability?

I have never been treated by the VA, but I intend to see them about some cardiac and diabetes problems for which I receive VA compensation.

An example: I likely will need a battery replacement for my cardiac pacemaker in approximately two years. If the VA does the procedure, will I be subject to some charges dependent upon ability to pay? In this example, the cardiac pacemaker (sinus bradycardia) is SCed.

I used Tricare the last time I needed a "tune-up" and my co-pay was in excess of $2K.



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Ron, I use VA for most everything except my SC heart condition, I still have outside insurance. I would like to know too. I am 80% now so the VA pretty much does not charge me anything but they occasionally do try and bill my insurance and they ignore them as much as I do. I may request my PCP do put me in for a VA cardio consult to see what they have to say.

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If your condition is SC then the VA is required to treat you for free. That includes drugs for the condition. They often try and get out of this . For instance, you have AO related DMII. Almost everything your PCP does touches on your DMII and possible secondary conditions. However, the VA will bill your insurance everytime you see you PCP for bloodwork and exams. The bloodwork is necessary for DMII control as are urine tests etc., but the VA will try and bill you or your insurance for it. Every single drug I take is somehow related to SC conditions but the VA sends half the bill to Blue Cross. I tell BC not to pay them, but they just pay anyway. I would start using the VA just to build your claims up with documentation. I would also get a second opinion on anything they diagnose that is serious.

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If it's SC'd direct or secondary the VA has the responsibility

to provide all treatment, meds, prosthetics, everything for it,

(If the vet want's it).

Since my Hearing loss is SC'd at zero percent, VA provides

my hearing aids (they will also do this for any 10% vet) and

also the batteries required for the aids.

They provide me a tens unit and replacement pads and the

batteries for the tens unit, which this disability is not yet SC'd

but I'm over 50 %.

Also, a nebulizer, replacement hoses and tubes and the medication for it,

and I am not yet SC'd for this, but I'm over 50 %.

So I surely agree they will take care of what you need.

Also, remember once a vet is 50 % SC'd, there are no longer

any co-pays for any meds or medical conditions -- including those

that are not service connected and whatever the doctor said is

needed forwhat ever conditions.

Annual check-ups, yearly flu shots, 5-10 year pnemonia (sp) shots,

tetnus shots etc...

I may be a rare breed but except for a VA doctor assaulting me

and VA treating me like sheet about me filing a claim and getting

rid of said doctor -- I am thankful for all the health care I get from VAMC's.

(I do have some complaints about MH care).



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I am not service connected yet. My income and assets are above the va requirement, but below the geographagal requirement, so I do not pay copays on treatment. I am required to pay medication copays.

I had a pacemaker implanted in 1997 by an outside cardioligist. In 2006 my pacemaker battery died. The VA replaced the pacemaker with the very latest pacer/defibulator at no cost and no copay. No complaint here.

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