Medication Pay for Military Sexual Truama?

[MKAH]

I was recently an inpatient a VA medical center BH-ICU lock down unit for Suicidal Ideation with multiple actionable plans and means to complete. Based on my non service connected (yet) but currently VA treated PTSD- Military Sexual Trauma for 7 full days.  During this inpatient visit, I was given at least 6 individual pills per,  day ranging from panic, sleep, mood, more different panic,  different sleep ect..ect... each day until they found the best fit for me. 

Currently I am service connected for 20% hearing loss & 10% tinnitus = 30%.  That makes me a  a priority group 2 and I pay $8.00 per prescription (from 30 day supply down to 1 pill).  $ 8 bucks. Pretty simple.
Based on my inpatient BH-ICU stay, that would total up to (6pills per day $8 each = $56 cost per day X 7 Days = $392). 

I have not worked since Jan 4th 2016 and am burning thru my savings and retirement money to support my family of four.

Since getting VA treatment for PTSD-MTS in November of last year 2015 and filing a claim shortly afterwards with a VSO, I have paid for all of my medical co-pays at $8 which were significant but nothing like the 7 day inpatient amount will be.

 

However, I did see this article on a VA website:

Basic Business Rule
No extended care copayment when income is below pension single rate threshold.
*Copayment Free Care and Medication for treatment of Service-Connected (SC) disabilities, SC 50% or more, former POWs, Catastrophically Disabled Veterans, VA pensioners,
and those under Special Authorities (e.g. PG 6, military sexual trauma, nasopharyngeal radium irradiation)

Since getting treatment for PTSD-MTS in November of last year 2015 and filing a claim shortly afterwards with a VSO, I have paid for all of my medical co-pays and am waiting for the big bill from inpatient medications & maybe hospital care as well?

What is my best option at this point...... I am a wreck emotionally and am having trouble sorting thru thius mess?

I am grateful for the care I get and the support of the forum members.  Especially TBird.Mark
Combat Medic 1983-1986
30 Hearing loss SC
PTSD-MTS pending VA RO

[Vync]

If you have not yet received a detailed bill for your co-pays, I would start there so you know exactly what may have been billed:
http://www.va.gov/health/NewsFeatures/2013/April/An-Easier-to-Understand-Billing-Statement.asp

Next, if they have billed you for the MST-related visits, contest the bills as you mentioned above. In my case, this is the billing link for my VAMC and it includes a toll-free number to call. If I am not mistaken, they have consolidated the billing departments. http://www.birmingham.va.gov/patients/billing.asp

The VA is really famous for trying to bill veterans despite the information you posted above.  I'm 100% and still receive bills in the mail for co-pays and they also continue to try to bill my insurance for SC conditions. I'm on the phone with the billing team at least a few times a year.

In addition, if you have paid any co-pays to your VAMC related to your PTSD/MST-related treatment, if your PTSD/MST claim is approved, they are supposed to refund what you paid for said treatment.

I'm not sure if the co-pays are like my private non-VA medical insurance co-pays. With my private insurance, if the cost of the medication is less than the co-pay, then I pay the lesser of the two. I'm not sure if the VA does that or just bills you the full co-pay amount regardless. It's worth looking into.

I hope this helps

[MKAH]

Vync,

As usual, you have provided me the exact information I needed. 

Also, my VSO has submitted an application for temporary compensation based on unemployability.  I am not sure if I qualify though?

However, my VA psychiatrist has filled out the state of Ca. SDI forms for severe mental illness (she did not say military sexual truama on this form, but is is most certainly in her weekly treatment forms that I can see on Blue Button download).

Ive been off work for this condition since 1/6/2016, and saw a VA regulation somewhere that if my non-service related unemployable is related to MST, that I may possibly qualify for Temp 100% thru the VA?

What do you think?

 

 

Thank you very much....

 

Mark Nicholson Former Army, Combat Medic - 1983-1986 1/94 FA MLRS C-BTY, Federal Republic of Germany

 

[Tbird]

mark -

good to see you. ca state disability will be a help, no one will state mst as your disability. mst is not a diagnosis, they will say ptsd or ptsd and mdd or some other combination. you will be compensated for the ptsd or the depression. it may say ptsd/mst on some va stuff. don't worry to much about what the forms say. ptsd, depression it's all paid at the same rate.

it gets confusing because to your doctors and for your treatment plan mst will have an impact on those things. but as far as your claim is concerned the award will be for the ptsd or depression or whatever they decide on.

mine says ptsd/mdd. remember to pace yourself you are going to have a lot of information to go through so don't let it overwhelm you.

you may qualify for tdiu, unemployable due to a service connected disabilities. it means they would have to rate you for the ptsd and then if that did not get you to 100 you would go the tdiu route.

i applied for tdiu but they gave 100 schedular and the tdiu became moot. i hope this isn't to confusing, i'm drowsy today.