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Va Stealing Money From Veterans Through Private Health Insurance!


Troy Spurlock
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Moderators....not sure if this is the right forum for this discussion, but it does fall under the issue of disability compensation since it is directly related to it. So I made my best guess, but if I am wrong feel free to move it to the appropriate forum.

Anyhow, I, as the veteran, who is 100% service connected for a bladder disorder, chronic thoracic, cervical, and lumbar muscle strain, degenerative disc disease of the entire spine, fibromyalgia, IBS, and several other conditions just learned that the Department of Veterans Affairs has been billing my 3rd party private insurance company since July 2009 for examinations, blood tests, an MRI, and follow-up office visits for these service-connected conditions to a tune of over $5,000!!!!

On May 17, 2009 POTUS Obama proposed that he was considering having the VA charge 3rd party insurance for service related conditions; however due to the intense backlash, he nixed that idea on May 18, 2009.

http://www.cnsnews.c...px?RsrcID=45117 (May 17, 2009 article)

http://tpmdc.talking...health-care.php (May 18, 2009 article)

Despite the POTUS rescinding this plan, the VA is doing it anyway; and now I have just become a victim of it.

Has anyone else discovered that the VA has been charging their private health insurance for service-connected disabilities? I want to hear your story, as I am preparing an op-ed to submit to every newspaper and media outlet physically possible. I want to reignite the hail storm Obama got on May 17, 2009 for such an asinine proposal by proving it's happening nonetheless (probably under secret order of his Administration to do so regardless of his public announcement that he wouldn't do it)!

T.S.

Edited by Troy Spurlock
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Despite Obama rescinding the proposal to charge veterans’ private insurance for service-connected injuries in May 2009, the VA is doing it anyway.

July 30, 2010

By: Troy Spurlock

Early May 2009, President Obama proposed that the federal government, via the Department of Veterans Affairs Health Administration, begin charging veterans private health insurance for service-connected injuries. In immediate response a hailstorm rained down upon the Obama Administration from veterans across the country, to include veteran groups and organizations; not to mention members of Congress like Senator Patty Murray, D-Washington, said that such a proposal would be “dead on arrival” if it were sent to Congress.

As a result of this hailstorm of immediate and intense criticism for such an asinine and unpatriotic proposal stabbing veterans in the back, Obama rescinded this proposal. So it seemed all was well and veterans health care would continue to be taken care of, cost free to the veteran, for service-connected injuries. Well, so we veterans thought.

As a 100% Permanent and Total service-connected Desert Shield/Storm veteran seeking treatment from the Department of Veterans Affairs Health Administration in Portland, Oregon for those service-connected ailments; I just learned that the VA has been charging my private health insurance company for visits dating back to July 2009 to present to a tune of $5,618.76. These charges are unsubstantiated and tantamount to insurance fraud on the part of the Department of Veterans Affairs, Portland Oregon Medical Center.

Despite the POTUS declaring this proposal to charge veterans’ private insurance company for service-connected injuries would not be pursued, it’s patently clear that it is done. If it has happened to me since July 2009, just months after this declared rescission, there is no question it has happened to other veterans.

I highly encourage every veteran who has been granted a service-connected disability rating for a condition for which the VA has been billing their private insurance company, to advise their insurance company immediately that the VA is not entitled to such claims and seek reimbursement of those paid funds. In addition to contacting their insurance company, they should contact the VA medical center they have been seeking treatment from for those service-connected disabilities and demand they reimburse their insurance company of funds that they were not entitled to.

Moreover, I would recommend that each veteran write a letter to the editor of his or her newspaper – and contact your local media outlets – announcing this unpatriotic insurance fraud on the part of the Department of Veterans Affairs.

Senators SLAM Obama's plan to charge wounded veterans private insurance for service-connected injuries

President Obama Rescinds Proposal to Charge Veterans Private Insurance for Service Connected Injuries

Despite the rescission of this proposal, it is happening, as it has happened to me; and I imagine to several other veterans unbeknownst to them.

Check with your insurance company immediately to see if the VA has been requesting payment for services that they are obligated to pay for due to service-connection; and if they have, fight it as outlined above.

Edited by Troy Spurlock
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  • HadIt.com Elder

This is not uncommon, I had this happen, I called the insurance company after I got the paper they had paid........Their answer was, it was a legit claim so they paid it, pizzed as you may be, this is between the insurance company and the VA unless you are out monies due to this.

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  • Moderator

I suggest one go to the press and explaint his to them so the Insurance Companies will understand thay are paying millions of money they shouldnt be paying.

That will wake them up.

Join the club I have been complaining since 2005.

J

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I suggest one go to the press and explaint his to them so the Insurance Companies will understand thay are paying millions of money they shouldnt be paying.

That will wake them up.

Join the club I have been complaining since 2005.

J

I've sent my initial brief op-ed to O'Rielly, Hannity CNN, Fox News, local channels and newspapers, and various other news sources. I will continue to do so until it gets attention, that's for sure. This is down right INSURANCE FRAUD, especially when the VA has been back dating claims, because they only just learned I had private insurance (within the last couple months), yet their claims go back to July of 2009. Each and every request for payment is for a service-connected disability; none of these claims they are entitled to, much reimbursement for monetarily wise.

T.S.

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I've sent my initial brief op-ed to O'Rielly, Hannity CNN, Fox News, local channels and newspapers, and various other news sources. I will continue to do so until it gets attention, that's for sure. This is down right INSURANCE FRAUD, especially when the VA has been back dating claims, because they only just learned I had private insurance (within the last couple months), yet their claims go back to July of 2009. Each and every request for payment is for a service-connected disability; none of these claims they are entitled to, much reimbursement for monetarily wise.

T.S.

Good Luck Troy!!! This is the reason that when the VA asks for my secondary insurance I say NONE!

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  • HadIt.com Elder

If the VA claims and collects from my Insurance I no longer have a problem with it. Why not these damn insurance companies have gotten a free ride on me since 1991 and I am sure money recovered from private insurance should help other Veterans.

Just my opinion

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The VA has been doing this since at least the 90's.

I didn't think much about it when they were trying to recoup funds.

But- come to Think of it.............

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  • HadIt.com Elder

I have private insurance as part of my retirement benefits from the federal civil service. When the VA is allowed to cost shift to my private insurance it helps to drive up my premiums. This is a small part of why my premiums keep going up, but I still resent it. The VA is supposed to "own" my medical care. Well, I think they outsource the costs. The VA knows they can bill the insurance companies for service connected care because the insurance companies have no way of knowing what is and what is not SC'ed. Even if they know it costs more to separate them out than to pay them. This is what BC/BS told me.

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  • HadIt.com Elder

this has been going on for years this did not start last year it may be the first time you have ever seen it but the Army hospitals and the VA both having been doing this since 1994 that I know of I used to complain to my private insurance company about it and like John said they don't care it's easier for them to just pay the bill they will make it up someplace else when they bill the govt for something I don't see any of the health insurance companies filing bankruptcy anywhere this is not a democratic or republican issue this has been going on since Bush 41 and maybe even before that

Edited by Testvet
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  • Content Curator/HadIt.com Elder

I go to my VAMC business office at least every couple of years and have them reverse the charges. If you don't stay on them, they will ignore you.

Note: Even though I'm rated 70%, they were only able to reverse charges for my service connected conditions. They still billed and collected for my NSC conditions.

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I have private insurance as part of my retirement benefits from the federal civil service. When the VA is allowed to cost shift to my private insurance it helps to drive up my premiums. This is a small part of why my premiums keep going up, but I still resent it. The VA is supposed to "own" my medical care. Well, I think they outsource the costs. The VA knows they can bill the insurance companies for service connected care because the insurance companies have no way of knowing what is and what is not SC'ed. Even if they know it costs more to separate them out than to pay them. This is what BC/BS told me.

John999 I doubt very much that the VA is the reason your private insurance premiums go up??? The VA was very up front with me when I signed up for VA medical insurance that if I had Private insurance too, they would send the private insurance company a bill in hopes that it can recoup some of the charges. By the way it never happens. My private insurance company never pays any of the cost. The VA medical center informed me of that from day one. Also it informed me even if the private insurance company did NOT pay any of it, I would NOT have to pay for anything. The VA would provide me with 100% free medical insurance which I do get and am very happy that I do.

Edited by Chu Lai69
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  • HadIt.com Elder

The rule is that the VA can bill even 100% vets for NSC treatments. That is not really ok with me. A vet who is 100% service connected disabled should have all this medical care paid for by the VA. The VA got their foot in the door on this. Recently, a bill to charge insurance even for SC conditions was defeated. The VA is good for two things: cheap pills and documenting your treatment for disabilites. I wonder how the VA decides which of my treatments are NSC since I am SC'ed for CAD, DMII, Chronic Pain, PN and mental health conditions. They don't bother. They just send the whole bill to my private insurance.

Chulai

Would you go to the VAMC if you needed open heart surgery since you have the option of using your private insurance, and picking your own doctor? I know you say you are happy with the care you get from the VA, but if your life depended on it would you use the VA?

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  • HadIt.com Elder

The last time I went to the VAMC for treatment of a SC combat disability, and was asked for my private insurance info. I refused and got the evil eye and a lecture from an apathetic clerk. An hour later, I was seen by the Dr.

Edited by Commander Bob
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The rule is that the VA can bill even 100% vets for NSC treatments. That is not really ok with me. A vet who is 100% service connected disabled should have all this medical care paid for by the VA. The VA got their foot in the door on this. Recently, a bill to charge insurance even for SC conditions was defeated. The VA is good for two things: cheap pills and documenting your treatment for disabilites. I wonder how the VA decides which of my treatments are NSC since I am SC'ed for CAD, DMII, Chronic Pain, PN and mental health conditions. They don't bother. They just send the whole bill to my private insurance.

Chulai

Would you go to the VAMC if you needed open heart surgery since you have the option of using your private insurance, and picking your own doctor? I know you say you are happy with the care you get from the VA, but if your life depended on it would you use the VA?

Sorry John999 your off on a different topic now??? We were talking about VA requesting private insurance companies to help with cost of treating a veteran. I understand some of you do not like the VA health care that you get. Sorry about that, but there are tons of people here that VA insurance is the only insurance they have!! I can understand people get frustrated with the VA, but I also understand that people get frustrated with private insurance companies too. What would YOU, ME, and others do if we had NO VA?? The VA is NOT all bad. They are no different then any other private medical institutions when it comes to treating patients Vets or non vets in my opinion. There is good and bad in both. And yes if my life depended on it, I would use the VA. I am doing that now and they have been a big help in getting my LIFE back in order. Again there is good and bad in any medical facility. I am just am not one of those that continue to bash the VA at every chance I get. Sorry!! What happens at the VAMAC happens at other private medical faculties also. Just pick up the local paper and read about them. They don't get as much publicity as the VAMAC because they are private and not Federal. Getting back to the point, I think its fine the VA tries to recoup from private insurance companies. In-fact if you have 2 private insurance companies, they do the exact same thing!! What one does not cover, the other will!!!

Edited by Chu Lai69
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Moderators....not sure if this is the right forum for this discussion, but it does fall under the issue of disability compensation since it is directly related to it. So I made my best guess, but if I am wrong feel free to move it to the appropriate forum.

Anyhow, I, as the veteran, who is 100% service connected for a bladder disorder, chronic thoracic, cervical, and lumbar muscle strain, degenerative disc disease of the entire spine, fibromyalgia, IBS, and several other conditions just learned that the Department of Veterans Affairs has been billing my 3rd party private insurance company since July 2009 for examinations, blood tests, an MRI, and follow-up office visits for these service-connected conditions to a tune of over $5,000!!!!

On May 17, 2009 POTUS Obama proposed that he was considering having the VA charge 3rd party insurance for service related conditions; however due to the intense backlash, he nixed that idea on May 18, 2009.

http://www.cnsnews.c...px?RsrcID=45117 (May 17, 2009 article)

http://tpmdc.talking...health-care.php (May 18, 2009 article)

Despite the POTUS rescinding this plan, the VA is doing it anyway; and now I have just become a victim of it.

Has anyone else discovered that the VA has been charging their private health insurance for service-connected disabilities? I want to hear your story, as I am preparing an op-ed to submit to every newspaper and media outlet physically possible. I want to reignite the hail storm Obama got on May 17, 2009 for such an asinine proposal by proving it's happening nonetheless (probably under secret order of his Administration to do so regardless of his public announcement that he wouldn't do it)!

T.S.

I gave my private ins. info when I enrolled in the VA system, but to my knowledge they have never billed my private ins. Not sure why...

JMO,

Bergie

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https://iris.va.gov/...hZ2U9MQ**&p_li=

Will you bill my health insurance carrier?trnsp.gif

Inquiry Will you bill my health insurance carrier?trnsp.gif

Answer The law requires VA to bill insurance carriers for covered veterans.

Some veterans may have health insurance coverage under a spouse's policy.

If you are receiving care for a non-service-connected disability and have health insurance, your insurance carrier will be billed.

VA does not bill your health insurance carrier for VA-adjudicated service-connected disabilities.

(An adjudicated service-connected disability is one for which you have filed a claim and VA has determined that you are service-connected)

https://iris.va.gov/...hZ2U9MQ**&p_li=

Inquiry

Do enrolled veterans have to pay the deductibles that their insurance carrier requires when treated at VA?trnsp.gif

Answer

No. VA does not require veterans to pay those charges.

In fact, many insurance companies will apply VA co-payment charges toward satisfaction of their annual deductible.

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  • HadIt.com Elder

...I am just am not one of those that continue to bash the VA at every chance I get. Sorry!!

Chu Lai69, I am glad to hear that you are satisfied with the VA in your area. That is encouraging, and gives me hope for the future of the VA.

However you should not label the many vets that are having problems with their claims or treatment as "VA bashers". Over the last four + decades, I have witnessed too many cruel & unusual actions against vets, at the hands of the VA. Behavior that would not be tolerated in a private setting. JMHO... It is the nature of this massive beast, the VA,

JMHO. the over-all quality of the VA experience is unacceptable, and is in need of some serious oversight.

I agree that some people will complain about anything, however, we cannot discount those vets who have legitimate complaints and issues with the VA...

edited for grammatical corrections.

Edited by Commander Bob
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  • HadIt.com Elder

The heart and soul of Hadit is the recognition that the VA has mistreated or left Veterans out in the cold

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The heart and soul of Hadit is the recognition that the VA has mistreated or left Veterans out in the cold

No one is saying they haven't done that Pete and Commander Bob. I stated that there is good and bad every where. I also stated that I am not one of the ones that will bash(complain)about the VAMAC (at this time). I did not mean to insinuate that ALL people here bash(complain)about the VA, but quite a few do so and probably with just cause. I am just not one of them at this time. Again I am happy with the care I receive and have not ran into some of the nightmares that some of the vets post here have. I have been going to the St. Louis, VAMAC for 3 years now and have good,(not great) but good treatment so far. I get just as good a treatment at my VAMAC then I did with my Private insurance/hospital. JMHO only.

Edited by Chu Lai69
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The heart and soul of Hadit is the recognition that the VA has mistreated or left Veterans out in the cold

I am sorry, but I thought the heart and sole of Hadit was to help veterans with information on how to get the benefits they have coming to them. Again the VA has not mistreated me(as of yet), and they have not (left me out in the cold as of yet). Some may have had that experience and it is understandable. Pete can I ask you a question? Where would you, me, and all the other fine brothers and sister veterans be if there was no VA with benefits for all of us veterans?????? I was taught you have to take the good with the bad. That's every where you go. By far the VA is NOT perfect. And I do understand how frustrating the system can be. But its the only system that we have right now. Of course it seems like they play with vets minds sometimes. Its terrible on some of the things you read that has happened to our vets. But its also refreshing to hear and read some of the success stories after getting the help here in this forum. That's what I personally think the heart and sole of Hadits is. NOT just to only reorganize any mistreatment that "some" NOT all might have experienced. Again, if we had NO VA at all, we would not even be posting in this great forum.

Edited by Chu Lai69
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This thread is over 365 days old and has been closed.

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For almost everything you are going to want to post in VA Claims Research.

If this is your first time posting. Take a moment and read our Guidelines. It will inform you of what is and isn't acceptable and tips on getting your questions answered. 

 

Remember, everyone who comes here is a volunteer. At one point, they went to the forums looking for information. They liked it here and decided to stay and help other veterans. They share their personal experience, providing links to the law and reference materials and support because working on your claim can be exhausting and beyond frustrating. 

 

This thread may still provide value to you and is worth at least skimming through the responses to see if any of them answer your question. Knowledge Is Power, and there is a lot of knowledge in older threads.

 

 

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