Affordable Options For Medical Care Other Than The Va?

[AMMOroadkill]

I have been rated 60% SC since separation and have had 100% medical coverage through the VA since then.

-I am unmarried, no kids and unemployed

-I do not qualify for any state or local programs that I have found as technically I am not un/underinsured,

-I am over the financial need threshold (by as little as $7),

-I do not qualify for SSDI/medicare/medicaid as I have not had the medical documentation

-the only places that I would otherwise qualify for will not touch me because I have been on prescribed opiates for pain management for the last few years...

Since separation and entering into the VA medical healthcare system I have heard the words "not warranted" in regards to investigating or verifying service connected issues or those that could/would be secondary.

Any other medical agency I talk to apologizes and says that see other veterans in my situation frequently.

I dont need an ER visit, I need specialists and competent and timely follow up care.

Are there any other options available other than paying out of pocket, which I can not afford?

Also, how many others on here are in a similar situation?

[john999]

You can't get SSDI?

[AMMOroadkill]

No, I cant get SSDI ...Ive been out for 6 years and have not paid into SSDI in that time. I make too much for SSI and according to my denials from SSDI I did not have sufficient medical evidence until literally days after I was no longer eligible. I have a lawyer for SSDI and a trial coming up soon and he seems to think that there is enough evidence and documentation to prove my case. *edit* I have currently been denied twice for SSDI and am in the trial phase right now but SSDI is going completely off of my VA medical records...

I have also applied for TDUI/unemployability through the VA and in my last denial was told that they were going to wait to see what the decision was from SSDI before they made a decision on my claim... Is this even legal?

In the six years I have been in the care of the VA I have dropped out of school numerous times and have started and lost my own (financially successful) business, all as a direct result of my service connected injuries/disabilities... In the same time I have incurred significant debt and my credit is shot... Ironically enough, I am assuming that they (both Social Security and the VA) are using this as proof that I was able to work.

I had hope that I might qualify for something with this Obamacare debacle but... no.

If anybody here has found a solution or knows of other options to healthcare in my situation I would be happy to hear it.

Edited February 1, 2013 by AMMOroadkill

[AMMOroadkill]

To add to this aside from not qualifying for any other medical assistance that I have found...

If looking to pay out of pocket for a specialist or further imaging every place I have called has required a referral from a physician, a few places said that the ER might work but they would prefer primary care. The last ER bill I had was just shy of $10k...

-I have been unable to get a referral through the VA channels to an outside physician, so even if I could afford out of pocket medical care they wont see me.

Also, currently, I have too many significant pre-existing conditions to qualify for any paid for out of pocket private health insurance that sounds worth purchasing... I can find companies to take my money but the services that would be offered would leave me in essentially the same predicament with the exception of a significantly lighter wallet.

I also have a couple questions...

1.If I do end up finding a way to obtain medical care outside the VA will it negatively impact my medical and/or financial benefits from the VA?

2. Does anybody have any experience with having service connected problems paid for in other countries? I dont want to hurt anybodies feelings, and it leaves an empty spot in the pit of my stomach, but would the ex-pat route be a viable option...?

[kymike]

Hi Ammo, if feel your plight. I also have an spine surgeon that can be a backwards, stubborn, insensitive pain in the butt. Well that what you're got to work with. Call the clinic and tell them your symptoms are worse. Get an appt. with you doc. Tell him that you would like to consider surgery,they love hearing that. Explain your worsening symptom including any neurological problems you are having. See if he will get you a referral to a Neurologist. Specialist love ordering tests. Let him. Try to get an MRI, telegram, emg, blood work or any other thing he can think of. Go to your follow-up appt. and listen to what he has to say. If he recommends surgery say you are interested because you are so miserable. Even though you probably would dream of letting him operate. Say that you would feel more comfortable with a second opinion to ease you anxiety. Ask the clinic for a fee base consult with another surgeon. If they say no ASK the surgeon to right you a referral. Take all of your new diagnostic testing and imaging to the second spine surgeon. Sounds complicated but it may be your best hope without spending a fortune.

At the very least you would have updated imaging for your VA and SSDI claims. The EMG test could be important to establish any radiculopathy you might be having in you extremities. If it comes up positive, I would file a claim for those issues.

This just my option. I am no expert but have experience d the frustration of being shuffled around by my Spine doc. Wish the best and hope something I said helps.

Mike.