ptsd Co Pay?

[usdart]

The VA diagnosed me with PTSD and scheduled Counseling. Now I find out I am being charged a co-pay for each visit.

The total I owe now is over $120.00 that is an unexpected expense. Not much to many people but, a budget breaker for me.

I sent a Secure Message on Myhealthyevet to my Phsyc and asked her to please Service Connect me 'Officially' so that these charges go away.

Is that the right approach?

I am waiting for my PTSD claim now, so all this MAY go away at that point. I expect to hear within a month as my Claim is at the Rating Phase now at the RO.

[carlie]

Yes once you are 30% or over go to the eligibility office and they will give you a receipt to take to the cashier and get your co-pay back.

Stillhere

I believe you do not pay any co-pays for issues that are SC'd and/or

no co-pays, when you hold an evaluation of SC'd at 50 percent or higher.

I have never seen - no co-pays for non-SC'd issues at the 30 percent evaluation.

30 percent or higher is where additional compensation for dependents comes in.

I feel confident that someone will correct this, if it is not accurate.

http://www.elderlawanswers.com/co-payments-for-veterans-health-care-12011

Prescription co-payments

Prescription co-payments are charged only for outpatient treatment. The following veterans do not have to pay anything for medications:

• A veteran who is 50 percent disabled or more with a service-connected disability
• A veteran who has been determined by the VA as unemployable due to his service-connected conditions
• A veteran who needs medication to treat a specific service-connected disability
• Former POWs
• A veteran whose income is below the maximum annual rate for a VA pension
• A veteran who needs medication to treat conditions related to a veteran's exposure to herbicides during the Vietnam era ionizing radiation during atmospheric testing, or ionizing radiation during the occupation of Hiroshima and Nagasaki
• A veteran who served in the Gulf War, in combat after the Gulf War, or during a period of hostility after Nov. 11, 1998, and who needs medication to treat a service-related condition
• A veteran who needs medication to treat a military sexual trauma
• A veteran with cancer of the head or neck caused by nose or throat radium treatments given while in the military
• A veteran participating in a VA approved research project

ANOTHER LINK:

http://www.veteransaidbenefit.org/health_care_benefits_for_veterans_receiving_pension.htm

Outpatient Services*

Basic Care Services—services provided by a primary care clinician $15/visit

Specialty Care Services—services provided by a clinical specialist such as surgeon, radiologist, audiologist, optometrist, cardiologist, and specialty tests such as magnetic resonance imagery (MRI), computerized axial tomography (CAT) scan, and nuclear medicine studies $50/visit

*Copay amount is limited to a single charge per visit regardless of the number of health care providers seen in a single day. The copay amount is based on the highest level of service received. There is no copay requirement for preventive care services such as screenings and immunizations.

Medications

For each 30-day or less supply of medication for treatment of

nonservice-connected condition $8

(Veterans in Priority Groups 2 through 6 are limited to a $960 annual cap)

VA does not charge a copay for medications used for treatment of —

• A veteran who is 50% or more service-connected
• A veteran who has been determined by VA as unemployable due to their service-connected conditions
• A veteran’s specific service-connected disability
• A veteran who is a former POW
• A veteran whose income is below the maximum annual rate for VA pension
• A veteran’s conditions related to a veteran’s exposure to:
  • Herbicides during the Vietnam-era, OR
  • Ionizing radiation during atmospheric testing, OR
  • Ionizing radiation during the occupation of Hiroshima and Nagasaki
• A service-related condition of a veteran who served:
  • In the Gulf War, OR
  • In combat in a war after the Gulf War, OR
  • During a period of hostility after November 11, 1998
• A veteran’s military sexual trauma
• A veteran’s cancer of head or neck caused by nose or throat radium treatments given while in the military
• A veteran participating in a VA approved research project

[carlie]

Pamphlet - VA Medication Copay

http://www.va.gov/healthbenefits/resources/publications/IB10-336_medication_copay_brochure_07152013.pdf