Copays And Very Trickey Process Repay Va

[Capt.]

http://www.va.gov/he...ce_brochure.pdf

Hello All,

Please read the above first.

I would like to alert our Veterans and their Dependents to a problem that is happening not just to me , but many Veterans. I would also like to hear from some of you on your thoughts if you ever got your copays refunded to you once you became 50% or more, or when you hit the 100% SC mark.

So first lets put the program out there so the Veteran can see how he can quickley get in trouble and have his copays TAKEN OUT OF HIS DISABILITY CHECK if under 50% SC.

This is really sick also.

Here some scenarios that can happen and have happened to me.

If a Veteran under 50% SC decides that he can qualify thru the Means test to reduce or have his copay forgiven and files his Means test (must be done yearly) and he makes a mistake that will put him above the minumum threshold which is roughly 13200 per year net with one dependent. The VA has been paying copays because the Veteran is under 50%. Ok it gets worse. The VA only will pay those Copays that are related to the service connection. They can bill you for anything they feel that is not service connected on your copays and office visits, hospitals or fee basis procedures or visits. BIG PROBLEM. Because once you catch the mistake the timeline is gone and you only have that short window to correct it. The issue gets clouded because the VA does not notify you until they make sure it has some time on it so you can't correct it. Out goes the notice that you do not qualify for the Copays and they want you to repay. You can sign an agreement with the Finance Office but if more than one Medical Billing office is involved you can really get confused. Thinking you have sent your payment to one and have another say your late. Here is where the problem starts to really get big. The VA can then garnish your SC Disability Check until ALL of the owed Copays are paid back. And not only that but remember as long as you are under 50% SC , this can go on for many years until a Vet files for higher scheduler on his or hers rating and that means appeals process in most cases.

Also remember that the VA may decide several meds and visits really do not meet the criteria for a service connected copay. This is also where a secondary disease or service connected , say aggravated by an S/C award can also be charged to the Vets account.

Now imagine the Veteran is hoping to get his Disability Check and Whammo....its not there in his or hers account. And they do it for 2 or 3 or 4 months. Oh yes ,,,,,they make a mistake and take out too much......sorry . After lengthy phone calls you finally find someone who may help you to figure out they took out too much. Now it will take 30 days to get the check mailed to you. It will not be put back into your account as autodeposit either.

Your means test is very important and your making sure there are no mistakes as well as any hardship or waiver request be done and without missing a step. You can still get caught in this endless circle.

Folks , it sounds like this is hypothetical but I can assure you it did happen to me.

Now here is where it really gets bad. The Veteran is trying to get his or hers disability claim resolved correctly the first time at the VARO. We know that is impossible. What is also opening the door for the above is the faulty decision that puts the Veteran at 40% ,,,,,,,,,,,, its never 50 or 60 or 70 the first time out. So the Veteran has this problem looking at him every year because of a faulty decision and has to pay back to VA . So several years down the road and much pain and financial hardship later, the VA finally gets it right and gets you the INCREASE Granted above 50 % or higher and you then are finally free of this sick little trap , carefully put together by those who brought you the mess in the first place.

I would love to hear from the board on how many of us have had to go thru this plot and also .....How many have recovered all medical and prescription copays from the VA when you got either above 50%, but I believe it is above 100% and all of it has to be repaid back to the Earliest Effective Date or the Award claim letter date? Also how long did it take???

Remember just because they said you would only have a slight copay and can pay it back really does not happen. They will take it until they decide other. So lets hear some more stories and I am sure that their are some folks that can give help to our Veterans on suggestions or ways to not let it happen and to recover those copays and how long will it take. I know I have had to decide to NEVER GIVE UP ......or I would not have gotten it straightened out. God Bless, C.C.

Edited November 1, 2012 by Capt.Contaminate

[broncovet]

CC

Yes. Copayments for Vets were increased in year 2010.

http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1910

I never did figure out how/why copayments for Veterans was increased in 2010, while, at the same time the government was telling Vets there was no inflation and no cola.

I had VA copayments, that I could not afford to pay, deducted from my tax return checks. I never did get that money back. This came at a time when I could least afford it...VA said I was only 40%, but I was not working and no other income. Try living on $460 per month with a family of 4.

[Capt.]

Hello Bronco,

I am getting ready to find that out too on living with nothing coming in. Did you know that the copays and medicals are to be reimbursed but the Vet has to send them a letter requesting it? I am planning on doing this immediately once I hit the VA SC board at 50 % or the 100%. I still can't find the law pertaining to it so hopefully one of our folks that may have it archived can remember and post this. Thanks Bronco. NEVER GIVE UP. God Bless, C.C.

Edited November 1, 2012 by Capt.Contaminate

[deanbrt]

My co-pays were reembursed when I reached 100%. But I went from 30% to 100%. all had to do was make a phone call to Omaha and that triggered the audit that led to my reimbirsement.

[Capt.]

Hello Deanbrt,

I know that most of my financial questions and problems were taken care of much quicker than dealing with Regional Offices. Still most of the financial questions took about 3-4 weeks to be solved. Some thur Omaha and some thru Smyrna , Tennessee. Thanks again for bringing that info on copay reimbursements here. NEVER GIVE UP. God Bless, C.C.

[deanbrt]

"Still most of the financial questions took about 3-4 weeks to be solved."

Even longer for me They found some $2.38 addition to the co-pay retro that I received via check in the mail and then the full retro two weeks later. Perhaps two and 1/2 months total...

[Chuck75]

The VA has an attitude - - - If they owe a veteran money, they may eventually get around to paying. If they think the veteran owes the VA money, they want it yesterday, and often add service charges.

After short times determined basically by laws an regulations, they will do things like pull money from such places as the veteran's IRS payments, VA payments, and anything else they can get their hands on. It's even possible for them to pull money from VA direct deposit bank accounts, thanks to banking law.

With decades of practice, the VA has become quite adept at doing things like this, simply because they are a creature of Congress, and Congress has been unwilling to deal with the problems caused by the VA.

Another shortchange the veteran issue.

You can determine a reference location for a zip code using the national weather service, simply by typing the zip code in a box.

The VA uses a computer program that does something similar.

Suppose the veteran's address is in a part of the zip code that is quite different from the reference location - what happens to the mileage reimbursement?

In my zip code, the reference location is several miles closer to the nearest VAMC than the majority of the local metropolitan area.

A rough estimate, using 152 VAMCs, involves millions of dollars veterans are shortchanged each year. At the same time, a few fortunate veterans may be slightly overpaid. The closer a veteran lives to the VAMC, the more acute the problem can be.

Edited November 5, 2012 by Chuck75