Service Connection And Your Va Copays/prescriptions

[Capt.]

Hello All,

I thought it would be somewhat helpful especially to our Veterans new or old to remind all that use the VA and its prescription program that you may be entitled for reimbursements for the copays.

I became service connected and started receiving Copay notices for prescriptions that were ,,,,,in my opinion directly RELATED to the treatment of those Service Connected diseases/injuries.

My first step was to write a letter of appeal to the finance office where charges occurred which were several years worth. I listed all of the prescriptions that even possibly could be associated with the claim that were service connected and those diseases granted not long ago .

Within 2 weeks I received a phone call from the Finance dept and a very nice pleasant representative that informed me they had carefully examined my appeal and TOTALLY agreed with my concerns and said that they were changing the billing formality that affected me. Isn't is nice to have some really nice folks to deal with at the VA. Its not all bad.

While talking with her , I also asked about the reimbursetment of medications BACK TO THE EARLIEST EFFECTIVE DATE OF THE SERVICE CONNECTED DISABILITIES. She informed me ,,,YES,,,, she had already filed a request of audit of the account because of my request. Now that is splendid news and it does mean reimbursement of those funds back to the EED. I thanked her for her help and kindness and had to have another smile for yet another small victory by being persistant and patient. Life is still good and not all a major battle with the VA.

Now the audit also will include any copays for the Doctor Visits for those Service Connected Disabilities recently awarded.

I hope I can remember this correctly and someone correct me if I am wrong but I believe it is 30%or more that will start this type of process repayment. If a Vet gets to 50% THEN ALL of the Meds and Doctors Visits are taken care of.

I also hope this helps another Veteran to pursue their benefits and the correct benefits that a Veteran is entitled to. Sometimes the old saying .....You don't get it unless you ask for it applied here.

NEVER GIVE UP. God Bless, C.C.

Edited March 19, 2012 by Capt.Contaminate

[Pete53]

Thanks CC we all need reminding from time to time.

[Philip Rogers]

Good post, CC!!!

pr

[Berta]

I agree!!!!!

This is a good reminder to all.Thank you Capt Contaminate!

I never asked for any co pay refund on my husband's meds for HBP or 6 years. It was one of the Section 1151 conditions I proved that he had and maybe even I think he paid co pay for the 6 years of sudafed that VA ultimately said was a contributing med error that caused his death.

But maybe it is too late to ask ???

[Quaymar]

Thanks for the info! Hopefully, I won't have such an issue in the future. But, if I do...I will know how to resolve it. Thanks!

[Capt.]

Hello Pete, Philip, Berta and Quaymar,

Berta , I think you can still apply for that and 6 years is a pretty nice number , that you are entitled to . I think I dealt with Topeka , Kansas Finance at VA. I think anytime that a Veteran has to pay and then gets his SC he should recover that which was paid in. I think Jbasser told me about this but I only followed thru with all the phone calls and letters over the last 6 weeks since I was SCd. Glad this could help. NEVER GIVE UP. God Bless, C.C.

Edited March 19, 2012 by Capt.Contaminate

[Chuck75]

I went through the hassle to get a refund as well. It initially started with the VAMC, the VARO, and VA Finance pointing the finger at each other in a circular fashion.

Eventually, I had to request an audit at the VAMC. This got things done. However the audit results are not detailed enough to determine what period the audit covered, what it covered, etc., although it did result in a significant refund. An UN-amusing side issue was that the VA was also trying to charge fees and interest on amounts already refunded as a result of the audit. Part of the mess had to do with a retroactive award that made all charges refundable, and the VA's failure to follow publicly stated practices concerning co-pay for presumptive conditions. I still don't know if the VA actually refunded insurance company payments that were improperly charged.