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Will my family lose CHAMPVA


mclevela726

Question

Hello all,

If I disenroll (cancel) from care at VA will my family lose CHAMPVA.

I ask because I have private insurance (required by my employer to opt into) and I want to see a private doctor.

Thanks.

MCleve

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  • HadIt.com Elder

why can't you have both VA and private at the same time? Many do. I use the VA for most of everything I do except for my eye doc. Kinda my back-up plan in case I have something that I don't think the VA will handle properly. It costs me $130 a month but to me, it's worth having that security blanket. But the point is you don't have to chose one or the other; you can have both. I have several friends that do the same who have heart conditions, etc. They want the same private doc for their continued care. You can split also. Be sure you go for at least your annual check up and I would suggest that if you are prescribed meds, have the VA provide at least one or two at a minimum. 

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I dont recommend "disenrolling" from VAMC.  Its unnecessary, and burns down bridges you may want to cross in the future, perhaps rendering it more difficult to re enroll later, should you so decide.    If you so desire, simply use your private insurance instead.  Then, if things go south with your company, or you retire, you can still use the VAMC.  I see no reason to burn that bridge down, you can be enrolled in VA health care and use your private insurance elsewhere, they are not mutually exclusive. 

"It sounds like" you are receiving VA benefits.  If you like, you can inform VA you are seeking private care treatments for your SC conditions, but Im not sure even it is required you inform VA.  If the VA calls you to schedule an appointment, you can decline to set the next appointment, informing them "if you like" that you are seeking treatment in the private sector, and do not need an appointment at this time. 

It seems like I recall that the VAMC (VHA) "may" disenroll you automatically "if" you dont seek treatment there for a period, probably about 3 years or more, and have not moved and sought treatment in another VAMC.  However,  when I was young, I sometimes went  10 years or more and not see a doc, and I had no problem checking into a VAMC ER if I cut my hand and needed treatment, for example. 

If you like McDonalds, and hate Arby's, it is not necessary for you to go to Arby's to inform them you plan on eating at their competititor the rest of your life, McDonalds.  Instead, you may change your tastes and desire Roast Beef or Roast Turkey, so you dont need to inform Arby's you no longer plan to eat there.  In the future, your boss or new girlfriend my LOVE Arby's, and offer to meet you there.  You are not required to go into a rant about how much you hate Arby's, you can just show up, and maybe even try their food, again, even if you had a bad experience in the past with them. 

"If" VA tries to reduce your benefits, such as PTSD, alleging you "actually improved under ordinary conditions of life", citing that you have not received VAMC treatment for 2 years, then you can write VA and tell them you are seeking medical treatment for your conditions in the private sector.  You could even send them your most recent private sector medical exam report at that time if you choose.  If you read the rules for rating reductions, it does NOT say its mandantory to have treatment in a VA facility or lose your benefits.  Here is what it does say, instead:

  https://www.law.cornell.edu/cfr/text/38/3.344

Edited by broncovet
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Thank you all for your comments.

I am approaching this from a continuity of care standpoint. I do not feel that I get the level of care at local VA that I get from my private care physician nor do I feel that I am being allowed to be a part of my care. For example, local VA doc has prescribed medication inappropriate for a diabetic, because it is known and well documented to cause a rise in blood sugar (My credentials include a degree in nutrition with an emphasis in dietetics as well as having been registered with the Academy of Nutrition and Dietetics). As such, I have experienced a fasting blood sugar that has gone from around 126 mg/dL to over 300 mg/dL. And while I have asked to be changed to a medication from the same class and that is appropriate for a diabetic, VA doctor refuses to do so.

As far as compensation, I am 100% T & P with the VA stating that "no other exams will be scheduled".

I agree with the VA as a back-up plan. However, how might I approach this is a manner that I am not being double treated for the same thing without "burning bridges" with VA?

Thanks again for your time.

Edited by mclevela726
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The primary care doctors at my VAMC aren't very good. Plus, I like to be able to choose my own doctors and if I don't like a certain doctor, I can leave that doctor and pick another one. My VAMC is also 45 minutes from my house and I hate driving there and there is no CBOC closer to me. 

I tried moving all of my care from private doctors to the VAMC several years ago and I wasn't pleased with the primary care doctors at all. The last primary care doctor I had at the VAMC was very rude and basically lectured me each time I was there. At my last appointment, I had finally had enough so I got up and walked out. She followed me all the way to the elevator yelling at me. I do use the VAMC for dental, optometry, allergy and sleep clinic. 

I definitely wouldn't disenroll from the VAMC because there's really no benefit. You may not always have private insurance. 

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  • HadIt.com Elder

Mclevelan726  You said"I agree with the VA as a back-up plan. However, how might I approach this is a manner that I am not being double treated for the same thing without "burning bridges" with VA?" I thought I answered that but quite simply, you pick and chose. If you have a heart condition, for example, and you want your private doc to handle it, he doesn't handle SOME of it, he does all the cardiology issues. You don't share the responsibility with the VA right? So, if you have a hearing problem, maybe arthritis , and a foot problem, you may chose to use the VA for those. If your VA foot doc doesn't seem to be hitting it off, you either drop him and request a new VA pediatrist or, go private. It might be difficult to get back with the VA care on that foot problem if you change your mind later. Certainly, they would not put you at the front of the line in terms of service if you came back. I don't know or care what disabilities you have; you just make your decisions all the same way.

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On 11/1/2020 at 10:02 AM, mclevela726 said:

Thank you all for your comments.

I am approaching this from a continuity of care standpoint. I do not feel that I get the level of care at local VA that I get from my private care physician nor do I feel that I am being allowed to be a part of my care. For example, local VA doc has prescribed medication inappropriate for a diabetic, because it is known and well documented to cause a rise in blood sugar (My credentials include a degree in nutrition with an emphasis in dietetics as well as having been registered with the Academy of Nutrition and Dietetics). As such, I have experienced a fasting blood sugar that has gone from around 126 mg/dL to over 300 mg/dL. And while I have asked to be changed to a medication from the same class and that is appropriate for a diabetic, VA doctor refuses to do so.

As far as compensation, I am 100% T & P with the VA stating that "no other exams will be scheduled".

I agree with the VA as a back-up plan. However, how might I approach this is a manner that I am not being double treated for the same thing without "burning bridges" with VA?

Thanks again for your time.

i am sad you have this experience! my primary at my local va is the best! but hasnt always been. I have had 3 great primary care doctors who either retired or moved on to other medicine in the va system. my previous Primary care was like the one you describe. i requested a change because of a very similar situation on medication where he refused to discuss the medications with me. at one point i was given a prescription without even being told. they just showed up in the mail and i had no idea what they were or what they were for. HE GOT THE AX. 

my doctor now talks over everything with me. she is the best! i really hope she sticks around for a while!

 

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