15 replies to this topic

[Jim Rack]

I recently had a doctor visit at the outpatient clinic in Surprise AZ. I was told by the doctor that the VA no longer paid for emergency care. I questioned her on this as it is contrary to what I had assumed was VA policy. She said it was now policy that the VA will no longer pay for emergency care. . . period. It is up to the individual to pay for hospital care until they get to a VA facility, even if it's a documented emergency. . . heart attack stroke ect.

This still doesn't sound right to me. Has anyone else heard this?

[Brianwl]

The ER visit must be for a life threatening condition and the VA cannot be within a "reasonable" distance (so far it would endanger your life if you were taken to the VA). Once you are at the ER someone needs to call the VA ER and let them know you are there and must call again once you are stabilized and ask the VA if they want you transported to the VA.

If it all possible it is best to be transported to the VA ER in the first place.

I just ran into this problem back in Nov, VA was 70 miles away but the condition was not life threatening. Fortunately I have both Medicare and Tricare because the VA denied the claim even though I followed all previously published procedures.

[DaveM]

Just wish we all knew the correct thing to do. One says this happened another says that happened and there is no set way to know for sure. My take is, if your not dead you better get to the VA ER or your not going to be covered. Unless you do this, do that, maybe do this, maybe do that. Talk about confusing!!!

I'll just demand that I am sent to the VA ER plain n simple. My wife has been told to do just that!! Thing is I have health ins. paid for by my employer until the end of this yr at which time the policy changes and in order to keep what I basicly have now I will need to pay $230.00 a month supplement. This goes for 2 yrs then I am out of health ins. and on medicare I assume. With 100% unemployability I'm guessing the VA is the only smart way. What to do then I have no idea!!

Dave

[Brianwl]

Things must have changed since September. After phoning the emergency room asking if they accepted my VA card as insurance, I had emergency gallbladder surgery at a N. California hospital. Two VA hospitals were 1/1/2 hours away. To date, all bills paid.

Your case was a true emergency by VA standards "emergency gallbladder surgery".

Just wish we all knew the correct thing to do. One says this happened another says that happened and there is no set way to know for sure.

Dave

In this particular case Loose Cannon filled all the squares. Your take of always go to the VA ER is the best choice as for getting the VA to foot the bill, but not always the best option health wise.

In my case, I was not in a life threatening situation, but was in enough pain that I could not drive the 70 miles to the VA and could barely tolerate the 20 miles I had to ride to the nearest medical facility. I could not ask the person that took me there to take me to the VA, in my mind because they were doing me a favor. I guess I learned that next time I'll call for an ambulance and have them take me to the VA. Then the VA can pay 3 times the cost of my ER visit.

[StarDreamers.us]

With all the cuts going on it would be nice to know what to do. Proper procedures. All suggestions appreciated.

Safe Travels!

[Brianwl]

With all the cuts going on it would be nice to know what to do. Proper procedures. All suggestions appreciated.

Safe Travels!

Per the VA when I filed my claim for my ER care.

1. If it is life threatening, go to the nearest ER whether VA or other.
2. Call the VA ER and let them know the Vet is in the other ER. Make sure you have the SSAN of the Vet.
3. Call the VA ER when the Vets condition is stabilized and ask them what they want to do next. If they say the Vet should stay at the other hospital, make sure you get the full name and position of the person you spoke with. If they say they want the Vet transported to the VA, tell the VA to send the transport.

This all assumes the Vet is either rated at 50% disabled by the VA or more. Or, the Vet is in the ER for treatment of a service connected condition.

If the Vet is being seen for a non-service connected condition and is rated less than 50% by the VA, the Vet should have other insurance or the ability to pay out of pocket.

Your best situation in all cases is to get to the nearest VA ER. IF doing so will not endanger the Vet.

[Brianwl]

For whatever reason; many folks on here don't seem to take anything I post seriously, or insist on challenging what I write. So why is it that once again, I post my personal experiences and its questioned? I'll say it again. I have NO DISABLING RATING!
1.) 4 years ago at 3:am I thought I was having a heart attack. Wife phone ambulance and I insisted to be taken to nearest VA hospital since I do not have insurance. Ambulance attendees said "No Way". VA hospital in Jacksonville, FL is 90 miles away. Depending what's wrong, once you're stabilized at the local heart hospital they will have to be the ones that make arrangements to get you to the VA. During my 3 day stay in a private heart Institute I expressed my concerns about not having insurance insisting to be sent to a VA hospital. Long story short; No surgery, No stint. No bill ever showed up.
2.) Look at post #3. Same story but surgery involved. I did phone my local VA to advise them of the situation.

I don't really give a hoot who believes me or not any longer. In fact, my wife keeps telling me how the negativity on this forum is unhealthy. I now agree with her. So long suckers I wish you all the best.

Who's not believing you? Both cases you stated are/were true "emergencies".

[Ron and Laine]

No where did I see where anyone didn't believe Loose Cannon's post and he came with that last post. Maybe he is a Loose Cannnon.

[acker1]

I'll just demand that I am sent to the VA ER plain n simple. My wife has been told to do just that!! Thing is I have health ins. paid for by my employer until the end of this yr at which time the policy changes and in order to keep what I basicly have now I will need to pay $230.00 a month supplement. This goes for 2 yrs then I am out of health ins. and on medicare I assume. With 100% unemployability I'm guessing the VA is the only smart way. What to do then I have no idea!!

Dave

If you are 100% unemployable by the VA you should be eligible for SS disability and that would entitle you to Medicare. Then get a supplement policy to go along with medicare. SS will probably turn you down on your first application. If so, go to a SS lawyer and consult with him/her. They can help and are limited as to what they can charge.

DICK

[Jim Rack]

For whatever reason; many folks on here don't seem to take anything I post seriously, or insist on challenging what I write. So why is it that once again, I post my personal experiences and its questioned? I'll say it again. I have NO DISABLING RATING!
1.) 4 years ago at 3:am I thought I was having a heart attack. Wife phone ambulance and I insisted to be taken to nearest VA hospital since I do not have insurance. Ambulance attendees said "No Way". VA hospital in Jacksonville, FL is 90 miles away. Depending what's wrong, once you're stabilized at the local heart hospital they will have to be the ones that make arrangements to get you to the VA. During my 3 day stay in a private heart Institute I expressed my concerns about not having insurance insisting to be sent to a VA hospital. Long story short; No surgery, No stint. No bill ever showed up.
2.) Look at post #3. Same story but surgery involved. I did phone my local VA to advise them of the situation.

I don't really give a hoot who believes me or not any longer. In fact, my wife keeps telling me how the negativity on this forum is unhealthy. I now agree with her. So long suckers I wish you all the best.

Now, now, there's no need to get upset. I was simply asking a question. You may find this hard to believe but I don't follow all your posts. It just seems to me that there has been a policy change at the VA regarding emergencies and I wanted to see if anyone had any info on it. I'm glad all worked out well for you medical wise and I hope you don't quit posting.

[Rover]

Jim Rack ; I have no clue to the new regs.; have not heard anything about them. Loose Cannon; I just came back from TJ Samson hospital on 4/6/12, admitted through the ER with Heart failure symptoms 3/30/12. Called the Hospital on Monday 4/9/12 about VA coverage for care and the hospital financial officer claims it has been approved for payment of care. Will update later if this is correct. And Yes; I believe what you stated in your post.

Edited by Rover, 11 April 2012 - 06:24 PM.

[ChiefJohn]

Per the VA when I filed my claim for my ER care.

1. If it is life threatening, go to the nearest ER whether VA or other.
2. Call the VA ER and let them know the Vet is in the other ER. Make sure you have the SSAN of the Vet.
3. Call the VA ER when the Vets condition is stabilized and ask them what they want to do next. If they say the Vet should stay at the other hospital, make sure you get the full name and position of the person you spoke with. If they say they want the Vet transported to the VA, tell the VA to send the transport.

This all assumes the Vet is either rated at 50% disabled by the VA or more. Or, the Vet is in the ER for treatment of a service connected condition.

If the Vet is being seen for a non-service connected condition and is rated less than 50% by the VA, the Vet should have other insurance or the ability to pay out of pocket.

Your best situation in all cases is to get to the nearest VA ER. IF doing so will not endanger the Vet.

Brian, appreciate the more accurate response to obtaining non-VA emergency care. For all the various options/requirements for non-VA care, visit the VA web site at Non VA Care

Edited by ChiefJohn, 18 April 2012 - 05:41 AM.

[Brianwl]

Thanks John.

[1puf]

We go to South Tx for the winter..Mid December, I woke up in the night with serious pain in my lower belly area. Went to Valley Babtist Hospital in Harlingen Tx. They went thru tests and found that I was passing a kidney stone.. I had informed them at admission that I had VA care.. They billed the VA and just the other day I received a letter that the VA had paid the bill in full. Past history had 5 way bypass, prostate cancer, Abdominal aortic annurasim (sp).. This may have effected the decision to pay the bill.. Sorry for the mis-spellings..