Can I file a claim for my out of pocket expenses for medical care performed by outside medical providers for my service connected disabilities?

[63Charlie]

 If yes, can someone provide a link, or information on how to proceed?

The deductibles I'm paying have placed a financial burden on my family.

Thanks for helping.

 

[pacmanx1]

12 minutes ago, 63Charlie said:

If yes, can someone provide a link, or information on how to proceed?

The deductibles I'm paying have placed a financial burden on my family.

Thanks for helping.

Contact your local VAMC Business Office, they have the authority to Approve or Deny this type of claim. 

[brokensoldier244th]

If it's under community Care there shouldn't be deductibles

[Buck52]

If your meaning will the VA PAY YOUR MEDS  THAT YOU PAID FOR BEFORE BEING SERVICE CONNECTED?  THEY WILL AS LONG AS THE SERVICE CONNECTION IS 30% OR HIGHER.  You need the receipts that what you paid out of pocket. as your proof.

IF YOUR MEANING  WILL VA PAY YOUR MEDICAL EXPENSE IF YOU CHOOES TO GO TO THE PRIVATE SECTOR?

THEY WILL BUT YOU NEED TO HAVE IT OKED WITH THE VA First & THROUGH YOUR VA PCP  for the mission Act.  THEY WILL CALL YOU AND LET YOU KNOW.  SO BE SURE TO CONFIRME IT.

[DSIG]

If the services you are receiving meet the criteria for being covered through Community Care it will cost less out of pocket and would be limited to the VA deductible. You will need to submit a consult request with your primary care doctor at the VA and then the VA community care office will authorize a referral which will be used to bill the VA. The only issue with community care is it cannot be used indefinitely.  It has a beginning and end defined as an episode of care, which varies for whatever healthcare service you are authorized to receive. 

[Berta]

I might need to look into this for my neighbor, as last night  he was rushed to a major non VA  hospital, with ALS aboard the ambulance ,as he had COVID symptoms, but I understand today they think it was a heart attack.

He is only 10% SC and for many years he asked me to file for TDIU for him based on his SSDI award - he had to get SSDI because he was under FERS at that time,( he said he gets SSDI solely for his VA 10% back strain)  But I have never seen his SSDI award and he still has a local POA.

 

I guess my question is ( he says he has Medicare Part A and B)but that will probably not cover all of his medical expenses- and maybe not ALS.....and maybe he can still get any  prescriptions he needs for whatever the hospital diagnoses, from the local VAMC, when he is released and recovering......I dont know and will look for a link to Community Care.

I jut saw Mercy flight helicopter going from northwest to east- I wonder if they are transferring him from Rochester  to a different and closer hospital.

I hope I hear more soon on his condition, two friends of his are staying at a motel, near the hosp. because without a COVID diagnosis, maybe he can have visitors.

 

 

 

 

 

 

[DSIG]

Berta,

Here is the procedure for urgent care; the video is helpful https://www.va.gov/COMMUNITYCARE/providers/info_UrgentCare.asp

And here is the link for the network of providers 

https://provider.vacommunitycare.com/tpa-ap-web/?navDeepDive=VACCN publicProviderHomeDefaultContent
 

For emergency care notify the VA regional community care office immediately that the veteran was hospitalized and ask what is the procedure to have his expenses covered through community care.  If the veteran has myhealthvet they can send a secure message to the community care office but you would need to follow up with a call.

The VA understands there will be emergencies where a veteran can’t get to a VA facility.  With proper communication the VA will understand and will work with the veteran.