Va Healthcare Means Test For Co-pays

[spike]

I get questions all the time, how do they figure if I am to pay a co-pay at the VA Hospital. Well check the chart. Find where you live (State and county)...go over to the right (no in household). If your income is above that you pay. In 2008....look for copays to go up from 8 to 15 for script. Questions please ask.

The chart is too large its at least 74 pages.

Actually go to the link. Right click and open in new tab.

http://www.va.gov/healtheligibility/Library/GMTtips.asp

[tssnave]

Spike,

I am rated 50% - I thought all my meds were free for both my sc disability and any other Rx need I had - is this correct or incorrect?

BTW, the table came in fine.

Thanks,

ts

[Pete53]

TS - 50% is the magic divider between copays and free.

[john999]

If you are 50% you should not have to pay for anything. The VA will bill your insurance for NSC stuff but no co-pay.

[tssnave]

Pete,

Thanks. That's what I thought but it is all theory to me. I just got my rating late Feb and haven't actually done anything with VA healthcare.

John,

When you say "the VA will bill your insurance for NSC meds" are you talking about health insurance through your job or your spouse's job? What if you don't have any Rx coverage on your health insurance or you don't have any other health insurance outside of VA?

Is the VA like Champus in that it is secondary to any other health insurance you have? That would make sense, that any government health insurance program is secondary to a private health insurance program but I am just speculating here. Please clarify.

Thanks,

ts

[sixthscents]

Really good question tssnave,

1st, the medical care and billing under the VA is split into priority groups 1-8 (currently 7 and 8 are closed to new veteran admissions)

If you are rate 10%-40% you will have to pay a copay, for visits, and medication NOT RELATED TO A SERVICE CONNECTED INJURY OR ILLNESS

Thats a biggie, if the doc puts down you need this medicine because of a service-connected injury - no copay

Vets rated 50% or better are priority group a and have no copay or deductible etc.

Now the VA is supposed to bill outside medical whenever possible, with it falling much like Champus, into a secondary insurere role, but truth to tell they have been really sloppy about it in the past. They do NOT bill other governement insurance programs, like Medicare or Medicade

Let me get you a link for reference, the one provided below is for 40% or less... ah heres a good guide:

http://www.va.gov/LEBANONVAMC/Co-Payments_...h_Insurance.asp

Bob Smith

[sixthscents]

Umm... I thought a story that might be important...

I was taking a veteran into the VA to get enrolled into a care gruop and etc.

We got to the front desk and the lady (who wasnt) became very abusive stating that the veteran was not entitled to care. Now we already had an old VA ID card, and his service-connection letter (even though it was a 0% rating)

Well, I and the lady discussed how incredibly wrong she was, and then she shuffled us off to means testing.... at this point I got po'd.... he was a service-connected vet- even at 0%... he wass till service connected

Well I guess the means based guy got a good look at my face becasue the first question is "what's wrong"... I showed him the letter, and theold ID.... within 15 minutes the veteran had aa new ID, a clinic assignment, and an appointment for the same day.

We went thru and he replaced MOST of his civilian prescriptions with VA ones, and even with the copy is saving over $300 a month.... the lady... had the gall to tell us on our way out that she was just following the regulations... I stopped, collected myself.. and asked her "Well when have you read them?"... and walked on...

Thepoint here is even a 0% service-connected veteran is entitled to care - they DO NOT fall under category 7 or 8...

Bob Smith