Skin Cancer

[christiane41]

Hello there.

 

My primary doctor is concerned about a spot on my face that looks to him very suspicious. He wants to send me to a dermatologist who deals with skin cancer. Is that visit and or any skin cancer treatment covered by ChampVa? 

 

Also my other concern, on my last Dr check up the office coded the visit as an annual physical/exam. ChampVa completely denied the claim. My Dr office is not changing the coding. How can this even be right? We are always talking about preventative care. An annual physical would fall into that category I would think. I am just shocked they will not pay the office visit. 

 

Thank you for any and all answers. 

 

Christiane Bayes

[broncovet]

Did you call Champva and ask them?  Its been my experience that Champva is the best insurance you cant buy. (You have to earn it by having a 100 percent disabled Vet as a spouse.) 

Like other stuff at VA, tho, I usually use the "teenager" method.  If mom says no, ask Dad.  If Mom and Dad say no, ask your teacher.  Essentially, you take advantage of the fact that "mom, dad, and teacher" dont communicate all that well.  This is true among VA employees, times 8.  You are not really "taking advantage" but are getting what you deserve.  It works well when you use it that way, but if you use this in a malicious way, pressuring benefits you dont deserve, then it can backfire.  

In other words call at a different time and ask a new employee, and you are likely to get a Veteran friendly employee this time.   This works because VA is not a "unified body", and, there are few policies that work VA wide that each employee enforces the same.  

[Berta]

Good advice.

I juts realized I did not get my 2020 CHAMPVA handbook, but it is on line ,if you don't have one:

https://www.benefits.gov/benefit/318

You have a right to know why they denied.Did they send you a letter as to the denial?

The Handbook has some contact info in it. 

I only had one problem in decades , and I called a phone number in the section about Pharmacy stuff.

The problem was not with CHAMPVA but with my pharmacist.He told me ,without even checking, that a med my doc advised would not be paid by CHAMPVA. I paid the bill myself. When I got home I looked up the med- he was wrong.The CHAMPVA woman called him immediately and then he called me to tell me that my 53.00 payment was waiting for me. Hve you called CHAMPVA?

There is something about CHAMPVA that CHAMPVA recipients know.

At age 65 a CHAMPVA recipient must apply for Part A and Part B of Medicare.

At that point, Medicare is their prime payer, and CHAMPVA kicks in for the rest of the coverage.

 

 

 

 

 

[Berta]

I almost forgot- years ago my PCP doctor wanted me to get an opinion  on a cyst I had.

A skin specialist examined it and said right away it was nothing to worry about.It was a very common type of cyst.

It was on my back and I had noticed that spring, during yard work that, it was being irritated by a back support I wear for yardwork. I made another Appt with the skin doctor and asked him if he would remove it and check it for cancer.

He did, in his office, and a  test result on it ruled out cancer.

I thought maybe CHAMPVA would consider this as unnecessary cosmetic surgery and maybe not pay for the removal. But they did.

 

 

 

 

[shrekthetank1]

Another point these places normally make a mistake and if someone before them did not do their job correctly they just keep pushing something which should be resolved.  My wife get 3-4 a year she has to call in on because it was covered and they try to not cover it.  She is also the one who will call them prior and make sure it is covered.  it is possible they made a mistake.  

[shrekthetank1]

27 minutes ago, Berta said:

I almost forgot- years ago my PCP doctor wanted me to get an opinion  on a cyst I had.

A skin specialist examined it and said right away it was nothing to worry about.It was a very common type of cyst.

It was on my back and I had noticed that spring, during yard work that, it was being irritated by a back support I wear for yardwork. I made another Appt with the skin doctor and asked him if he would remove it and check it for cancer.

He did, in his office, and a  test result on it ruled out cancer.

I thought maybe CHAMPVA would consider this as unnecessary cosmetic surgery and maybe not pay for the removal. But they did.

 

 

 

 

I have had over 150 removed now and any time you tell them it is painful or uncomfortable it is covered.  I know I don't pay for them anymore, but when I saw a private doctor the nurse told me about this once they code it this way the insurance has to cover the cost.  As for cancer if the doctor has given you a referral because they think something is wrong then 99% of the time this is covered.  Someone could have coded it incorrectly.  

[jennifer1981]

Thanks for the explanation of how ChampVa works. I have this insurance, but I didn’t have the possibility to use it yet because I rarely have health issues. However, recently, I discovered a new mark on my skin, and my doctor suggested removing it because it can develop into cancer. And I don’t know whether this insurance would want to cover the costs. I think they have to because the surgery I will receive is minor and is intended to prevent cancer.
I am currently taking pills from https://www.pillpal.to/anticancer-1828 and hope there’s nothing bad developing in my body right now. It would be really not cool if they refused to pay for the surgery.

Edited December 26, 2022 by jennifer1981 (see edit history)

[john999]

ChampVA will probably pay!  Do you get SSA and ChampVA?  ChampVA is better than most private insurance.  Your doctor should probably say he is removing a cancerous lesion.  This is how you get paid not by speculating about possible cancer or preventing cancer.  My arms are eaten up with pre-cancerous lesions.  You know if a doctor does a biopsy on a mole it is considered surgery.