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Fw: [Health.mil] Tricare Promises Continued Access To Prescription Meds
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allan,
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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
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I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
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However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
allan
To: Veteran Issues by Colonel Dan <VeteranIssues@yahoogroups.com>
Subject: [VeteranIssues] FW: [HEALTH.MIL] TRICARE Promises Continued Access To Prescription Meds
Date: Sep 17, 2011 6:29 AM
-----Original Message-----
From: health.mil-
Sent: Friday, September 16, 2011 10:26 AM
To: HEALTH.MIL@
Subject: [HEALTH.MIL] TRICARE Promises Continued Access To Prescription Meds
TRICARE Promises Continued Access To Prescription Meds
September 16, 2011
By Donna Miles, American Forces Press Service
WASHINGTON, Sept. 15, 2011 -- A dispute between Walgreens and a TRICARE
contractor will not stop beneficiaries from getting their prescriptions filled,
despite a Walgreen's ad campaign to the contrary, a TRICARE official said today.
"Don't let that advertising, letter and internet outreach campaign scare you,"
Navy Rear Adm. Christine Hunter, deputy director of the TRICARE Management
Agency, said. "Even if contract renewal negotiations fall through and Walgreens
drops out of TRICARE's retail pharmacy network on Jan. 1, beneficiaries still
will have plenty of other options for getting their prescriptions filled."
Hunter called the dispute between Walgreens and Express Scripts, Inc., the
contractor for TRICARE's retail pharmacy and pharmacy home delivery programs "a
business matter" between the two companies.
A similar impasse between the two companies in 2008 ultimately was resolved by
mid-November, about six weeks before the new contract was to take effect, she
noted.
Walgreens is a big player in the TRICARE pharmacy network, with about 7,000
participating outlets that Hunter said have filled prescriptions for one in 10
TRICARE beneficiaries at one time or another.
Concerned about a campaign that has alarmed some TRICARE beneficiaries, Hunter
offered assurance today that regardless of how this year's negotiations go,
patients will always have access to the medications they need.
"If Walgreens does drop out or fail to renew their relationship with ESI so they
are not included in the network, patients will still have 56,000 other
pharmacies to obtain their medications at retail," she said. "We have a very,
very broad network" that, for the vast majority of beneficiaries, ensures them
access to a participating pharmacy within two miles of their homes.
Meanwhile, Hunter emphasized other options TRICARE beneficiaries can use to get
their medications: a TRICARE military treatment facility or the increasingly
popular mail-order and home-delivery plans.
Hunter is a big proponent of the mail-order and home-delivery program, helping
boost participation by 9.9 percent this year alone as retail pharmacy use grew
by just 1.6 percent. Delivering medications directly to the beneficiary's home
assures an uninterrupted supply of medication, she said, while saving money for
beneficiaries as well as the Defense Department.
"I would recommend that this is a great time to consider TRICARE [Pharmacy] Home
Delivery for chronic medications," Hunter said.
But with more than three months left on Walgreen's current contract with ESI,
she emphasized, "There is no emergency, and there is time for people to
understand and consider their options."
Those who elect to stay with the retail pharmacy option but are concerned that
Walgreens could drop out of the TRICARE pharmacy network also have the option of
moving their prescriptions to another pharmacy in the TRICARE network now.
"We are not taking a position about whether patients should move their
prescriptions," Hunter said. "We are allowing this issue to play itself out, but
those who want to can do so, and that will absolutely be honored."
Because all prescription information is centralized, the only thing patients
need to do to move their prescriptions is to take their medication bottle or
tube to another pharmacy. "They don't need another prescription or visit to a
doctor," Hunter said.
NOTE: Locate a TRICARE Retail Pharmacy
<http://www.express-script.com/TRICARE/pharmacy/>
Beneficiaries also can elect to use pharmacies not included in the TRICARE
network. However, Hunter offered a reminder that these users will receive only
partial reimbursement for their out-of-pocket costs and could have to file their
own insurance claim, where network pharmacies do that automatically.
"Our focus is on ensuring patients have access to the care they need," including
reliable access to their prescription medications," she said. "Our goal is to be
sure people have the information they need so that they get their medications in
a timely fashion."
-------
SOURCE: American Forces Press Service News Release at
http://www.army.mil/article/65658/
__._,_.___ "Keep on, Keepin' on"
Dan Cedusky, Champaign IL "Colonel Dan"
See my web site at:
http://www.angelfire.com/il2/VeteranIssues/
http://www.facebook.com/dan.cedusky
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