Won claim!. Insurance and SS questions

[nancygail]

Hello!

Not been on for a while but we just received notice my husband won his claim. The VA called and  scheduled  "meeting"  with him next month to go over the  decision. I've been searching the forum but what I've found is older so I'm unsure if its accurate so I hope I can get some clarity here. I have several questions but I'll start with these.  Below is a screenshot of his proof letter. 70% for combined eval and 100% for unemployability. 

 

HEALTH CARE

1. As his wife will I get insurance?
2. Will there be a cost? 
3. Will his health care change or does he still have to go to the VA hospital as always. 

SOCIAL SECURITY

He can get SS retirement this year. Does that impact anything?

 

Thanks so much!

Nancy Ü

 

 

 

 

[GBArmy]

nancygail His disability income is not taxable income. Whether it is counted as "income" for SSI purposes, I do not know but you should check with SS and confirm. You make the choice on insurance, but most people would choose CHAMPVA. Don't take opinions for fact; you should verify any info to see it it should apply to you. And, as already suggested, you should check on state and local benefits, especially taxes. All states have a State sponsored VSO organization to ask about benefits. Often they are state employees, like state of "x" dept. of veteran affairs.Their job is to know and advise about veteran benefits for state residents. Be sure to find out from your town or county about property tax exemptions as well. Congrats on a well deserved win!

[nancygail]

16 hours ago, GBArmy said:

nancygail His disability income is not taxable income. Whether it is counted as "income" for SSI purposes, I do not know but you should check with SS and confirm. You make the choice on insurance, but most people would choose CHAMPVA. Don't take opinions for fact; you should verify any info to see it it should apply to you. And, as already suggested, you should check on state and local benefits, especially taxes. All states have a State sponsored VSO organization to ask about benefits. Often they are state employees, like state of "x" dept. of veteran affairs.Their job is to know and advise about veteran benefits for state residents. Be sure to find out from your town or county about property tax exemptions as well. Congrats on a well deserved win!

Thank you so much. Ü

[nancygail]

UPDATE:

ChampVA:  My husband made a couple calls and was told ChampVA can be my first or secondary insurance. If its first it costs me copays plus a 3k year deductible. I currently have medicaid and he was told I can keep that and use ChampVA as my secondary... which I have no idea what that really means. My Medicaid pays 100% though I struggle to find doctors who take what I have.  They are sending him paperwork since it didn't come in his VA packet.

WORK: He was also told due to being TDUI  he can't do any single extra "job" that pays more than 1k in a month if he'll get a w-9 for it. Which kinda sucks as he's an entertainer and though he's had to cut WAY back due to his health worsening he still gets shows now and then which he can sometimes do.  But they pay more than 1k. Last year he only had a couple of gigs. So the yearly income was under poverty level. But from what he was told they go by the month not the yearly income. If he was 100% by the VA alone I guess its different and he can "work".  He has not been able to hold a job for 20 years. He went into entertainment due to some circumstances that allowed it and because he can set his own schedule and its basically singing. 

GOING FOR 100%: I saw an article on here about how he should always pursue claims and appeals. It if he was 100% by the VA alone I guess it changes everything and he's considered retired. But he's only 70% with the TDUI giving him 100. So I take he we can try to get that but he was told it could take up to 3 years since he already has TDIU.

I find it all very confusing.

 

 

[Berta]

CHAMPVA is wonderful- I am glad you have it-

I have a $50 annual co pay for my meds, but if I choose to have the VA fill my Prescription  (it is called Meds by Mail) I would have no PX co pay.

I only take  one low dose statin med twice a week so I prefer the Co pay-and can avoid dealing with the local VAMC.

However my shingles shot cost 240 and I only paid 59, under CHAMPVA and also the boosters shots had a pharmacy fee, and also I think my tetanus shot did too.

Other than that between Medicare A & B, and CHAMPVA I have had plenty of tsts etc etc and never had a bill.

 

 

 

 

 

 

 

[broncovet]

Yes, its the VA's goal to keep Veterans confused.  They do it well.  

Champva is the best insurance you can get.  I recommend you do NOT get medicare prescription coverage.  Why?  Because Champva will do "meds by mail" but only if you do not have other (prescription) insurance.  No copays or deductables for meds by mail.  This is always a better deal than paying copays or deductables.  Champva is more widely accepted than medicare.  Only drawback is people confuse Tricare with Champva.  Tricare and Champva are similar but are mutually exclusive of each other.  Tricare is for retirees of the military, Champva is for disabled Vets.  

I always cringe when I hear "he was told"....  TDIU keeps track of annual income, not monthly.  If he earns less than the poverty level, then he does not have "substantial" gainfull employment, using VA's defination.  If his earings are less than 12,000 per year, you should be ok.  But, use this to be more precise, since I dont know how many dependents you have.  

https://militarybenefits.info/veterans-pension-rate-table/

Yes, I know the article which says to "keep going" even if you are 100 percent.  While I do agree it has some validity, (It was done by Chris Attig, attorney), its not for everyone.  Im tired of dealing with VA and want to get on with my life after dealing with Va for 17 years, so Im not applying for any new benefits unless stuff changes. (Im 100 percent plus SMC S.)  It makes zero sense to me to apply for more benefits when it wont change my benefit amount.  In other words, if I applied and got arthritis of the knee for an additonal 50 percent, it changes my compensation zero, and Im not going to do it, even tho I broke my leg in service and have a total knee replacement.  

EXCEPTION:  You need to understand DIC (widows benefits).  You should get DIC when the Veteran dies "provided that" he dies either from:

1.  Any service connected condition.  OR

2.  He dies for any reason AFTER he has been service connected 100 percent for 10 years.  

     The DIC is important to me, to take care of my wife, but I have been 100 percent for over 10 years, so my cause of death wont matter.  She should get about 1500 per month when I die with DIC...if she knows to apply.  

[GBArmy]

NancyGail Don't discount the work issue; He is TDIU; about $3100 a month BECAUSE he is being paid for not being able to work. If he earns over the max, they will find out and reduce his ratings. They are tied into SS and IRS so understand what the risks are. Maybe he could do some "volunteer" gigs that don't pay but would be important to him?