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For Vets Who Increase Above 50 Percent.


Guest jstacy

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Please be aware that when a Vet gets increased to 50 percent , They are usually placed in priority group one. Once the 50 percent plateau has been reached the Vet can do the following:

Apply to the VA to have Pharmacy Co pays refunded to the Veteran back to the effective date.

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Today, I received a check from the Federal Treasury, $158. It was about co-pay on VA medications, I think. :D

I haven't received my Initial Rating, yet, and they are refunding my co-pay? Wonder why they are doing this? I am only currently rated as 10% for Tinnitus. In July 2005, I filed for multiple claims and haven't received a rating yet.

Why would they refund my co-pay on VA meds at this point in my claim(s) ? Any ideas, please?

:huh:

B)

jstacy,

Does this include reimbursment of any prescription co-pays even if they aren`t related to your military disability?

Cavman

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It goes back to the effective date. Vets at 50 percent pay $0.00 for prescription copays. You should ask for it all back to the effective date.

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Guest jangrin

1968

Have you paid any co-pays for SC disabilities? Also, has your income stayed the same or have you filed a new or different income statement? I know when our income changed we were refunded alot on co-pay.

If you haven't done either one of those, maybe they know something about an award that you haven't received notice of yet. :D That would be kool.

Jangrin B)

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I paid a co-pay for meds for ptsd from the time I was diagnose un til I filded a claim and was granted 30%. At that time the va paid me back my co-pays back to the date i applied for disability. I appealed the 30% and was granted 50% awhile later. the va then went back and payed me back for non service co -pays They had collected from me for the remainder of the meds I had recieved from them to the date of my original award, which covered over two years. I did have to pester them a little about it but they did pay me back hope this helps.

kkp

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  • HadIt.com Elder

Even if you are 100% service connected the VA will bill your insurance for non service connected conditions and the meds for them. Every single time I go to the VA they ask for my medicare card and my BCBS. Now they have some new appointment scheduling method. You can tell that they are trying to squeeze every nickle out of vets who use the system.

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Although I don't pay any co-pays, my Blue Cross is billed and pays for my meds for non-service-connected conditions (for awhile the VAMC was billing and getting paid for service-connected visits and meds, but hopefully I have stopped that)! Anyaway, I have total 170% service-connected ratings(using their math) and they still bill for my meds for non-service-connected conditions. Is this allowable under current VA regs?

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If the meds were for Sc condition then you don't have to pay co-pay for those ,no matter what % you are. Also when u do your means test if may determine that you were not supposed to be paying co-pays. I have been refunded in the past for both of these scenerios.

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  • HadIt.com Elder

JesseJames

I don't think 100% vets should be billed under any circumstances. I resent them billing my private insurance. We are supposed to be the "true consituency" of the VA and yet we still get billed.

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Big Al

That shows the inconsistency of how different VAMC's operate. BCBS says the VA has the right to bill for NSC conditions even if you are 100%. They are paying the bills so I guess they know. I have no co-pay but I don't want them to pay the VA anything.

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If you arre rated at 50 Percent service connect no copay even for non service connected treatments.

If your 50% or over you can be a millionare and no means test, no co-pay for SC or non-SC. I've never been asked about my finances, nor about if I have medicare part D or my other private insurance form my wife's work.

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  • HadIt.com Elder

I am 80% IU and I my insurance is billed for every NSC condition. They even billed the insurance for a C&P exam. Yes, I complained about that. I use the busiest VAMC in the nation and they bill everyone for everything.

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Guest jangrin

1968,

You might try and call your group insurance and ask if they paid your medication co-pay or anything recently for the VA.

Last week we got a paper from the VA where they adjusted all co-pay and office visit charges due to our income loss. It was adjusted fron the time my husband was unable to work and applied for SSD. It was $1700.00 approximately , that we were credited.

Also, when I called the VA finance number on the notice, the lady there was so helpfull, you would be surprised at the information they have in their COMPUTER. I was on the phone for 30 minutes with her and she was VERY informative.

You might give them another call and see if you can pin point the credit, or any notices they might have received from other parts of the VA.

Jangrin

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Guest jangrin
I think, there is something "FISHY" with what they told me at the local VA Finance Office.... FISHY..... untrue.

B)

1968,

Dept. of veterns affairs, Statement of Medical Care Cost Recovery Account Activity. Telephone number to ask about your account. 1-866-347-2353

I'm not certain this is for everyone or just for the Northern California area. Although we moved to Texas, this is where my husbands file is supposed to be at the rating board. Try this number if not the right one I'm sure they can provide one for the area you need. They answered alot more questions than just finance for me.

Very informative.

Jangrin

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1968,

You might try and call your group insurance and ask if they paid your medication co-pay or anything recently for the VA.

Last week we got a paper from the VA where they adjusted all co-pay and office visit charges due to our income loss. It was adjusted fron the time my husband was unable to work and applied for SSD. It was $1700.00 approximately , that we were credited.

Also, when I called the VA finance number on the notice, the lady there was so helpfull, you would be surprised at the information they have in their COMPUTER. I was on the phone for 30 minutes with her and she was VERY informative.

You might give them another call and see if you can pin point the credit, or any notices they might have received from other parts of the VA.

Jangrin

Jangrin,

You said they paid you back for co-pays back to date of when your husband was unable to work. Is the date your husband was unable to work the same date that they awarded or increased his compensation to? I am curious because I have a pending claim(s) for my husband and he has been disabled and unable to work for the last nine years. The disability date is also what SSDI agreed to as a effective date. I am curious if the VA approves our pending claim(s) for disability will we get reimbursed for his NSC medications.

Brandy

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Guest jangrin
Jangrin,

You said they paid you back for co-pays back to date of when your husband was unable to work. Is the date your husband was unable to work the same date that they awarded or increased his compensation to? I am curious because I have a pending claim(s) for my husband and he has been disabled and unable to work for the last nine years. The disability date is also what SSDI agreed to as a effective date. I am curious if the VA approves our pending claim(s) for disability will we get reimbursed for his NSC medications.

Brandy

Brandy,

What happened is I got a notice from the federal government that they were going to attach my husband SSD to pay for veterans copays and office visit payments. When my husband was diagnosed with all his stuff he could no longer work. During that time he had so many doctor appt and prescriptions with the VA that we had a very large bill. He was not working so we couldn't pay.

However, with all this going on he filed "new" financial paperwork with the VAMC, because we had NO income as my husband was self employed. So he had no disability or unemployment. You don't have that when you are self employeed. So the VA changed his status at the time he filed the not working no income.

Well, I guess it finally got credited to the account because when I called about making payment or what we could do to keep the federal government from deducting from his SSD, the VA financial gal told me that the account had been audited and we only owed about $110.00 instead of the $1700.00. I'm sure if we had been able to pay all along we would have been refunded instead of credited.

My husband has never been rated as service connected yet. He has a claim for DMII and many many secondarys we were told it is at the rating board. When we hear something, if he is rated and SC'd it will be his first.

I hope this helps.

Jangrin

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Brandy,

What happened is I got a notice from the federal government that they were going to attach my husband SSD to pay for veterans copays and office visit payments. When my husband was diagnosed with all his stuff he could no longer work. During that time he had so many doctor appt and prescriptions with the VA that we had a very large bill. He was not working so we couldn't pay.

However, with all this going on he filed "new" financial paperwork with the VAMC, because we had NO income as my husband was self employed. So he had no disability or unemployment. You don't have that when you are self employeed. So the VA changed his status at the time he filed the not working no income.

Well, I guess it finally got credited to the account because when I called about making payment or what we could do to keep the federal government from deducting from his SSD, the VA financial gal told me that the account had been audited and we only owed about $110.00 instead of the $1700.00. I'm sure if we had been able to pay all along we would have been refunded instead of credited.

My husband has never been rated as service connected yet. He has a claim for DMII and many many secondarys we were told it is at the rating board. When we hear something, if he is rated and SC'd it will be his first.

I hope this helps.

Jangrin

Jangrin,

We just got a letter from the VA and they want to deduct co-pays from my husband's monthly VA check. I will call them and ask for "Hardship" as I have with the RO. Our claim has been there for about a year. He takes about 25 or more different med's. Most for nsc conditions that we have claimed as service-connected. He only gets a couple of sc med's for his DMI. We are having difficulty keeping up with monthly expenses. Mortgage, utilities, etc.

Well see what they say.....

Thanks,

Brandy

Edited by Brandy (see edit history)
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