Use Of Fehb & Va Benefits For Scn

[georgiapapa]

I am a Vietnam vet (67-68) who served with USMC 1966-1970. I was diagnosed with Multiple Myeloma (Smoldering) this year and am currently receiving care at the Myeloma Institute of Research & Therapy at the University of Arkansas in Little Rock. I live in Geoergia and drive to Little Rock every 3 months for follow up tests and staging updates. My disease is Agent Orange presumptive disease and I know I am eligible for VA benefits for the disease. However, I can not apply for benefits until I know positively sure that upon receipt of VA benefits my current FEHB insurance will not stop providing me with benefits for my treatment in Little Rock.

I know some folks wonder why I don't go ahead and apply for VA benefits and use the VA for treatment of my disease. Multiple Myeloma is a rare incurable cancer and very few cancer centers specialize in the treatment of this disease. The Myeloma Institute in Little Rock is reputed by some to be the best place in the world for treatment of my disease. Nothing personal against the VA doctors but I believe I would live longer if I continue to go to Little Rock.

I already posted a message on this forum and other forums regarding my situation but I have received so many different opinions from so many different people that I do not know what to do. It is hard for me to believe this situation has not arisen before. I know there is someone out there who can help. Someone with reliable documentation to back up their opinion. I have communicted with OPM and was told this was between my FEHB plan and the VA. I communicated with my FEHB plan and my question was sent to their claims office which provided a response which did not address my question.

I need input from veterans who currently have FEHB plan coverage and also have health care coverage through the VA due to their service connected disability and get their treatment for their service connected disability (disease or injury) at both their FEHB private providers and the VA.

NOTE: I am not talking about receiving treatment at the VA for service connected problems and treatment at FEHB providers for non-service connected problems. I am also not talking about receiving treatment at the VA for non-service connected problems and billing your FEHB plans. I am talking about receiving treatment for service connected disabilities(disease or injury) at both VA and FEHB private providers where the FEHB has no problems with paying benefits for a service connected disability.

Some folks on this forum have told me they received benefits from their FEHB plan for treatment of their service connected disabilities but it was not clear if there FEHB plan was aware they were receiving VA health care benefits for their SCN. I do not want to just take a chance and hope the FEHB doesn't find out about my VA benefits because it not only could cost me a great deal financially but it could jeopardize my longevity if my FEHB stops paying benefits for my Multiple Myeloma treatment in Little Rock.

Is there a SCN veteran out there who has used both FEHB and VA benefits for treatment of their SCN at both the VA and FEHB private providers and whom has something in writing from their FEHB plan or the OPM stating the FEHB plan can pay benefits for a scn disability at a FEHB private provider?

Also, if you have something in writing stating the FEHB plan will not pay the benefits, I also need to know. In this situation, my plan B would be to wait until I only have a few months left and then apply for VA benefits so my wife can receive DIC and CHAMPVA benefits after my death. I would have to carefully time this event.

There should be a directive or something addressing this question. However, so far I have not found it. Even Google could not answer this question.

Sorry for the length of this post and for being repetitive but I did not know how to make it any shorter without leaving something out and I wanted to be as clear as possible about what I am seeking.

Thanks...Georgia Papa

[john999]

I have BC/BS via FEHB and I have received treatment for SC conditions at the VA and via private doctors. I have never even been asked that question by private insurance. The only ones who want to know are the VA so they can try and bill my insurance. I think you are unwise not to immediately apply for service connection. It takes time to get benefits even for presumptive conditions. You don't want to leave this for your spouse to do while you are very sick

Have you applied for SSD? Are you still working? I don't have a document in front of me, but I think you are scaring yourself over nothing. If you seek treatment outside the VA that is fine with them.

[georgiapapa]

John,

How do you respond when you receive the questionaires from BC/BS asking if you have other health insurance? Wouldn't you have to tell them anything about your VA health care?

Believe me I really do not want to put off applying but at this time I do not think I would receive much of a rating for my disease because I am not to the point where I have a lot of disabling symptoms. I am retired but will not be eligible for Medicare for about 3 more years. I did contact Medicare and they sent me something in writing stating that once I was eligible for Medicare I could use both the VA system and private providers for SCN disease and Medicare would not have a problem with it.

I also don't think I would qualify for SSD since I am not totally disabled according to their definitinon.

I do appreciate your input but I am still going to try to get something in writing before I apply for the VA benefits at this time.

Thanks again... Georgia Papa

I have BC/BS via FEHB and I have received treatment for SC conditions at the VA and via private doctors. I have never even been asked that question by private insurance. The only ones who want to know are the VA so they can try and bill my insurance. I think you are unwise not to immediately apply for service connection. It takes time to get benefits even for presumptive conditions. You don't want to leave this for your spouse to do while you are very sick

Have you applied for SSD? Are you still working? I don't have a document in front of me, but I think you are scaring yourself over nothing. If you seek treatment outside the VA that is fine with them.