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Va Prescriptions


boomer2

Question

I would like to relate a situation I find myself in. I am SC'd for hearing loss 0% and I got an ear infection otitus externa and received a prescription from the VA ENT. I got the precsription and had to have it refilled as well.

Well I received a bill for said prescription, I assumed ( I should know better) that since I am SC'd for hearing loss and the infection is a result of the HA's then I did not have to pay for it, so I ignored the bill (mistake). Well I just received a letter from the VA that states that if I don't pay the bill within 30 days they are going to garnish my disability pay for the bill and to top it off they are charging me interest.

We should be able to bill them and charge them interest for if they don't give us accurate and timely answers to claims within 30 days.

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Unfortuantely you will have to pay them As they will make this very miserable for you. If you can't pay, you can always make payment arrangements with them. Once you are 50% or more then all medications will be free, no copays!

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In the future, when you are interacting with your pysician at your appointment, ask him straight up if he is marking this perscription as SC. I believe that in VISTA (VA's Medical Record System) they can indicate if a proceedure or perscription is related to a SC injury.

You might see if they can correct the coding on the perscription.

Best regards,

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It may depend on your income. If you have not recently filled out the "needs" form at your VA, or if your income is too high, then you will likely have to pay.

If you have little or no other income then you can likely get the prescription copays waived. The VA has a "tiered" system relating to income and disability percentage for copays, with the highest disability percentage and the lowest income having the lowest copays (zero).

I have seen it that if you dont go into their office and fill out a "needs" form, about once per year, they automatically assume a higher rate of income. Now that I am 100 percent, I do not have to fill in the form anymore, but I did when my percentages were less.

I will add that if you get an increase, say to 100%, then the VA will pay you back those copays after your effective date, but only if you ask them after you get your favorable decision.

Edited by broncovet
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In the future, when you are interacting with your pysician at your appointment, ask him straight up if he is marking this perscription as SC. I believe that in VISTA (VA's Medical Record System) they can indicate if a proceedure or perscription is related to a SC injury.

You might see if they can correct the coding on the perscription.

Best regards,

That is the easiest way to do it. Most of the time they skip that step as its a little quicker. You will have to call the number from your bill and explain that it is used for a service connected condition and you shouldnt be charged for it. They will help you. Next time just make sure you ask the Nurse or Doc to check the service connected box and all will be good. Dont forget about your Travel Reembursement.

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