Why Pay Medicare B When They Say I Cannot Use?

[SCIDVET]

Hello Vets.

Thanks for being there.

I realize I go on too much, this time, just the facts:

1) Disabled, S/C IU due to SCI dysfunction/disease. Paid over 7000 medicare B, auto deduct from SSD. Called them a year ago, they say "You have VA benefits for everything, so you cannot use the Medicare"

2) Live 160 miles from Portland, Or. Have a local VA clinic, nice people, but usually refer to Portland for everything important. Went local VA clinic for cloud in eye. VA Doctor rushed me to private ER, whom transferred me to private Eye doctor. Months later, (again!) I get notices to pay it all. Thousands. Again.

Have home, so cannot move back to Los Angeles, where the VA is better, for SCI, anyways. Fear losing home, credit rating plummeting due to this exact problem, repeated over last 6 years (VA says "Authorized by 60 mile rule to go to private hospital" then they dont pay it.) Fighting mad here, compadres. Even when a VA clinic DOCTOR authorizes private emergency treatment, VA portland says "Not paying". Actually, they dont "Say" anything.. they just dont do anything, evidently, thus no paperwork, evidence.

My Claim file in BVA DC for unrelated issues. Been warned not to rock boat or extend 15 year claim process.

3) Eye problem getting worse. Fear Portland VA, also very difficult to transport self. DAV van unable to transport-require me to sit up, belted, for 4 hours... four minutes near impossible.

4) Objective here is to learn how to use Medicare, or ask for refund (never used medicare A, B, ) of $7000 so I can maybe buy real healthcare.

5) Want to live here in Bend. Want to take care of health, not risk life at VA. Probably need:

a) Long term meds, ie, opiates

Antidepressants

c) Psych counseling for chronic pain.

d) SCI specialty follow up (Portland SCI is a room with a "SCI" sticker on it) (compared to So Calif)

6) My dream: Be medically treated as if it is desired for me to live, rather than as if the govt wants me to die off ASAP. (Yes, I realize nobody in govt cares either way)

That is as brief as I can be.

SCIDvet

[SCIDVET]

Jangrin, Morgan, Everyone.

Jangrin: Your post was very clear, and puts me ahead, because it says point by point what to do. I can do exactly as you say.

Jangrin and Morgan: You know, all these veteran days, memorial days, all the years I have had this problem, nobody thanked me for serving.. It means a lot. Means somebody knows.

The truth is I did not serve in a war, wish I had, some purpose in it, but in another way,, the war that injured...continues to injure me is with my own government, and it is never over,and there is no "going home" in several senses (getting "Back To Reality") (getting away from the conflict and its stressors) (As I move back to my remote hometown, I find more and more obstacles to treatment, medical access, acceptance in terms of understanding).

In my experience, Oregon is totally backwards in relation to California, and the "Outback" of Central Oregon (my home) is even moreso. Each time I moved out of Oregon to Idaho, California, the tables abruptly turned such that I was seen for who I am, affected as every test, MRI, etc, confirms. Upon returning, the exact opposite happens. I hope this info helps another Oregon vet, hence my running on about it.

A warning to all military personnel: If the govt harms you medically, they will not hesitate to make it YOUR fault.. by DEFAULT. Dont act brave, trying to win them over to the truth- fight from day one. It doesnt matter (as in my case) that I was under anesthesia twice when they messed up the operations.. I was still labelled as....anything but.... what I was- someone harmed by medical incompetence...

At risk of running on too much, malpractice happens anywhere- for me it was at NNMC Bethesda, so do not fool yourself into thinking because it is the "Best" hospital you are safe.

Thank you so much for your good words, advice, Jangrin and Morgan and everyone.

Mike aka SCIDvet

[Pete53]

Vet:

You should submit your bills to Fee Service at your local VA Hospital. They take a long time and you might have to appeal their decision but there is a good chance they will help if the reason for medical bill has something to do with Service Connection;.

In the meantime if you go for emergency service you need to call the VA and tell them as soon as you can. They will decide if they will transfer you or let you stay where you are for treatment.

Good Luck

[Guest morgan]

Mike,

Sorry about the abbreviation...AOD stands for Administrative Officer of the Day. The VA has someone on duty 24 hrs a day, including holidays, nights and weekends, to document notification of private ER and/or hospital admission for urgent care involving service-connected conditions. Be sure to carry your VAMC's number in your wallet at all times. When the recorded greeting starts, press O for the Operator and ask for the AOD. When you reach the AOD, write down the name of the person on duty as well as the date and time you make contact--this must be done within 72 hours. This is, of course, assuming you are physically able to call. If not, ask a family member or friend to call. If you are alone, ask a social worker or case manager at the hospital to do it for you.

And to answer your question, VA will not pay as secondary to Medicare (or any other insurance coverage) as a "Medigap" policy would.

I agree, it is a shame that a disabled veteran has to be an investigator, and almost a doctor and lawyer, to operate within the guidelines of VA and Medicare. Working with the VA requires far more than simply being informed, which is rightfully expected of all of us in business and health matters. It gets even more frustrating when hospital emergencies are due to VA medical errors. I feel your pain and frustration.

I'm sincerely sorry to hear you are having such a hard time getting the help you need. I advise you to appeal the VA's decision not to pay your hospital bill. If you don't give up, I think you will win an appeal. Still, I know that does not solve your immediate financial crisis.

I wish you the best, and if I can help you further, feel free to email me privately.

[SCIDVET]

Morgan, Pete,

I understand, can act on, your advice and experience.

I say almost laughingly (and rhetorically) "How come nobody has every mentioned, in 25 years, the AOD at the VA?" I mean, is the ink to print this info on the back of the VA ID card (or fee basis card?) too expensive?

Really, I never heard of it.. but makes perfect sense. Thanks Morgan!

Pete: You can be sure I WILL try to submit the bills.. though they just took a few weeks to go to collections, theres probably a way.. I just dont know.. submit 'em to VA if blatantly service connected, Medicare if not?

So you know, I have felt so much happier the last few days, dont feel like I have been thrown under bus, have choices, things to do to make situation better, feel there is a path towards getting treatment by a real doctor in the near future!!

I know it is ill-advised, somehow verboten, to ever suggest the claims, health care process, is extremely depressing, but it surely is. I suspect all the anxiety is sort of loaded onto the average problems we all likely endure. Its laughable the VA doesnt consider this disabling (VA caused syndromes, to coin a phrase) because the disability will go away when one is done with the VA... but it takes a lifetime to ""Get Done"" with the VA.

I wonder if anyone has ever tried asking a congressman to (without revealing his status) try to get service connection, compensation and treatment from VA for a wartime, or treatment-caused-in-military, disability?

Oh! the delicious irony when the people who MAKE the laws see the blank faces, the patronizing pats on the back, the silent detachment, unwillingness to record the medical facts because they cast dispersions upon the government.. You know what I mean? The unspoken way doctor One doesnt record the effect of mistakes of other doctors, even if the original doctor (Two) wrote it down, and the record is in the hands of Doctor One? The only way to clarify is to use the phrase "Honor among theives". (But, really, I know they are often good people at VA, thousands of em, but they have their own careers and lives and family!)

Do you all remember the fellow in San Diego (or nearby) who stole a tank some years ago, and went on a rampage, but nobody in media would mention it was a VA hospital he was errantly fighting about? When that happened, I was watching as it was live, and tears came to my eyes, I know how powerless he felt, how he was making a stand, how insult was added to injury, literally, again and again, until he... essentially lost it.

When they tossed the grenade in, I somehow just KNEW he was fighting a VA (not a civilian) system, and all I could do was stand at attention, tears running down my face. Yes, he was wrong, but..... I still respect his situation... it really can (the Govt systems) make one kind of crazy.... my only suggestion is fight the good fight, and it is a path very slow, long, and like a giant ship, moves only with steady, extended, leveraged pressure. The biggest bang won't move the VA "ship"-just hardens it.

Thanks, so much, everyone.

MIke aka CSIDvet

[Pete53]

Mike:

If any of your bills are for Hospital there is also money that the Federal Government will pay them and let you off the hook. The problem is you have to ask them to do it. As a last resort as long as you make a small payment every month they have to take it. When I say small I mean like 19 bucks or so.

Did you know that many creditors do not even count medical stuff on credit reports against you. I think that it does effect your credit score though.