Lab work at VA

[champ_49]

This is what happened to me just this week at the Pensacola VA Clinic. I'm not sure if I should be upset or accept the fact that yes I am dealing with the VA. To make this as short as possible I will post an email I sent my Primary back in MI. to solve the problem, through My Health Vet. It reads as follows:

 

"I am in Gulf Shores AL and this morning I tried to get some lab work done for my diabetes and the issues we have been dealing with. I have also been working with Bethany Cross on a regular basis and haven't been controlling the sugar like I have been. So I went to Pensacola FL VA Clinic this morning and got registered and was hoping to get the labs done. Because I am not there patient they can't do it without an order being present in my records. I would like to get an order for labs for A1C as I am a diabetic.

I will be returning to MI in March when the weather allows it."

 

They told me that they can't help me because I am not a patient of theirs. There was no order to have labs done but she says I see they been changing your meds around and all, we just can't help you. I have been fighting the blood sugar numbers as of late and we are trying to get them figured out, as I am dealing with the pharmacy. Last I knew I was a patient of the VA for the USA and not with the state of Michigan. All of my records are on computer and with just a little looking into my records they could see it was time for my labs for sugar.

 

Now here's the next problem I have. I sent the above email to my primary that is no longer with the VA as she retired, and I got a reply from the office that they would forward the email to the primary that is covering until they get a new primary at that location. So far, no reply and it has been close to 48 hrs. Also forwarded the message to Bethany Cross the pharmacist I have been working with. No answer from her but it has been less than 24 hrs. since I emailed her.

 

Maybe I am making more of this than I should, but trying to get things done on the road with the VA is becoming a huge hassle. I did learn one thing out of this, have my primary put in an order before I leave the next time for my needed labs, that should cover that problem. I hope!

 

Dave
Thank You

[Chief 62]

Is there a VA hosp. close by? If so go to the ER and tell them you are having problems with your sugar. They will do all the work up you need.

[champ_49]

Chief 62

 

Closest hospital is 90 miles away. It appears I may just have to do this as I got a reply and was told I didn't need labs from a provider that has never seen me. They said we will see you in March and that's it. Doesn't even know I have been working with the pharmacist that I was sent to at all. She said she could make a better decision on the meds with labs.

 

Who knows, I'll just deal with it like we always do.

 

Dave

[bigjim]

If I understand this correctly it is common and is one of the problems in the VA system that should be address by congress/senate/maybe president also. You can register at the nearest VA hospitlal and probably get the blood draw at the closest VA clinic in That hospital system. You can remain in the Mich. system but as a rule they won't coordinate with each other. I am in 2 VA sytems, NM and Memphis,Tn and I say they don't play well together. That creates a problem of it's own especially regarding primary doc's I am on Warfarin and have to have blood test at least monthly maybe more if the level is off. I am monitered by the coumadin clinic out of Albquerque. I get a standing order for my lab that I can take to outside labs near where I am(like Labcorps or Quest or AEL) and they will fax or call the info to the coumadin clinic and usually I get a call the next day reporting the test results asking a couple of questions and adjusting the dosage and test schedule if the level is off or telling me to keep current dosage and go back for retest in 4 weeks on such and such day. ***I have medicare and so far it has picked up all charges***** I CANNOT go to the nearsest VA for the test with that order. This MIGHT work for you with the diabetic tests if you can get your primary in Mich. to work with you and not have to deal with another VA thats great. They usually can but it can be difficult to get them to agree. I get most of my ongoing meds outside the VA through my secondary ins and cheaper for me too. The big problem I have had is getting the perscriptions written for outside the VA and in a way the mail order phamacy will accept and fill correctly. This is only a problem with the changeable/variable coumadin/warfaring one. The big problem there is the primary but they also have VA rules they have to follow. It took me a couple of times to get my old primary " trained" about that script but then it worked great for about 5 years until he retired. I am having some trouble getting the new one " trained" but I think we are getting there as progress has been made.

 

this has been long and run on but I hope my experience might be of use to you.

[RV_]

Dave,
Did you get your temporary card to use if too long a wait? I think you just qualified for VA Paid out of system medical treatment. Dave, go here immediately and call the number in the webpage and get youe tests done that you earned along with the rest of us!

 

http://www.va.gov/opa/choiceact/

[bigjim]

I'm hopefull about RV's suggestion but am also skeptical. I hope it works and it will be interesting to see.

[champ_49]

Derek thanks for the link. Not sure as of yet if I have got the letter. My mail has been building at the mail forwarding service and I should receive my mail today. I have some letters and a package from the VA. Hoping this letter is here today.

 

Thanks again!

[Pieere]

You earned it! The VA said if you are more than 40 miles from their facilities you can get care from a civilian health facility. You do need to call for prep authorization. Derek said it best!

[champ_49]

Thanks for the heads up guys. Got my mail yesterday and my card is in there. Will make the call Monday and get things setup. Appreciate it.

 

Dave

[Pieere]

Good to hear, Brother!

[RV_]

How'd it go Dave? Did you get qualified?

[patty98311]

Dave,

Did you get your temporary card to use if too long a wait? I think you just qualified for VA Paid out of system medical treatment. Dave, go here immediately and call the number in the webpage and get youe tests done that you earned along with the rest of us!

 

http://www.va.gov/opa/choiceact/

I dont' know if ou have called this number but it is totally useless, i have called repeatedly and have gotten no answers. I have been told repeatedly to call back next week as the system is no caught up yet.(7 weeks of calls so far) i live 65 miles from the closest va / clinic.

[RV_]

OK,

Seems the VA is having trouble standing this program up. I decided to try the number just now, at almost 10:30 local (central) time, and see why they are having issues. I got the recording, answered that I was a vet and punched in my Zip code and was connected to Charles, a vet himself manning the call center in Alexandria Louisiana. He told me that the vet needs to call or go to the nearest VA and verify that the docs can't see them. Or that some vets may have to go to the VA once to start the process. I did find out that enrollment can take 7-10 days.

 

He told me they are opening new call centers and the training takes 7 days before they are certified or something. I wasn't too clear on it but I can say they are there, and at least tonight, here, answered and were ready to serve vets. So keep trying in your area. Charles has been working at the call center for several months here. the number I called was 866-606-8198 from the webpage.

 

Keep trying. he said they were open from 8-12 midnight. Perhaps calling at night?

[champ_49]

Well Derek this is the end result. No I don't qualify for the Dr out of VA. As was stated to me only about a 100 people have been granted this option here in MI. Yes here in MI. With all the problems I have had I ended up coming back to MI to get my problems solved. Here in MI I had just transferred to what I thought was the closest VA which was 43 miles away for a clinic. After she told me the criteria isn't as easy as it seems and that only 100 people have qualified, I told her not to worry about it as if it was that hard, I wouldn't try to take a spot that another Vet less fortunate than myself. I told her I'm retired, have a good vehicle, and perfectly capable of making the drive. Just give the Vet that needs it a lot more than I do. After talking with her some more I then found out there is a clinic only 28 miles away, but the hospital where most of the work is done as you all know is still close to 100 miles away. So I am now transferring to that clinic.

 

I have 3 Dr's appt. in the next 2 weeks. One with the VA and two with a Dr out of the VA. I will get this resolved one way or another. Thanks for all the help, much appreciated.

[RV_]

Dave while it didn't work out for you, thanks for coming back and letting us know for vets who may need it, that indeed they are answering the phones and there is a program.

 

I have about the same situation here with Overton Brooks VA facility, a giant regional hospital. But I prefer my own docs with Tricare. I can walk in and be seen within an hour by my primary care guy with no appointment if it is emergent but can wait.

 

It is a cheaper to use the VA but I have the Tricare system as a retiree.

[champ_49]

Ok I have a question as a follow up. What do you all do when your Dr out of the VA gives you a prescription for drugs as far as filling it with the VA. Its my understanding that a VA Dr has to prescribe to get the drug. Anyone else found a way around this?

 

Dave

[bigjim]

A VA Dr. can write a perscription that you can have filled outside the VA but some do not know they can or will sometimes resist doing so because it is a little more trouble for them. It could vary from dr to dr and different va systems. I have coinsurance that requires I get ongoing meds through their mail order. The co-pay for those are cheaper for me than my med copay at the va. I have 5 on going medications. I probably save around $400+ per year this way. If this is only a one time perscription I just get it through the VA. If it is narcotic medications it is more complicated. The Dr's at the VA in Memphis and Albuquerque input the perscriptions through the computer for the ones to be filled at the VA. For outside one they have to provide a written script. Usually it will say on it "For VA Use Only" which they will usually line through. As long as it is written properly I have never had a problem getting it filled.

 

I have had an issue with the wording of my Coumadin perscription as the dosage can vary based on blood tests and their monitering by the Coumadin clinic.

[RV_]

Dave,

My local VA will only honor scripts written by their doctors or their affiliates. Here is an excerpt of their Pharmacy FAQs with your question among them.

 

Excerpt:

 

"Prescriptions FAQ

Order only the medications you need. If you do not want a medication filled at the VA pharmacy (including over-the-counter medications), BE SURE to tell your doctor not to order it. Medications received by the patient CANNOT be returned for credit of copayment.

 

Why do I have to talk to a pharmacist first in order to pick up a prescription at the Pharmacy window?

Due to the large number of prescriptions received by Pharmacy Service each day, prescriptions written during your clinic visit will be processed and mailed to you unless you first speak with a pharmacist. This provides us with an opportunity to educate you on your medicine and lets us know that you want to pick up your new prescription that day. If you are a patient in the Red, White, or Blue Primary Care Clinics or 5 WEST Specialty Care Clinics, a pharmacist is available to talk with you.

 

What if I am not a patient in one of those clinics or the pharmacist is not available?

You may speak to a pharmacist at the prescription intake window at 1 EAST 96. First take a number and be seated in the lobby. When your number is displayed, you can speak to a pharmacist at the designated window.

 

How soon should I request my prescription refills?

Please request your next supply of medications at least two weeks before you need them, although you may request a refill as soon as you receive your prescription in the mail. This allows time for processing and mailing. You may order your refills through the automated telephone refill system, by internet, or by mail. All refills will be processed by mail.

 

Why do I receive a refill when I didn’t ask for one?

Pharmacy does NOT automatically refill your prescriptions. Please inform your provider and pharmacist if you have an adequate supply of medicine at home so that a new prescription can be placed on hold by the pharmacist until you need it.

Question IconWhat is a formulary?

The VA pharmacy does not stock all medications. The VA has developed a comprehensive list of medications (also known as a formulary) to meet the needs of our veterans. This list is often updated and new drugs are added while some are removed. You may view this formulary listing by clicking HERE.

 

Can I get medication not on the formulary?

Your doctor must first prescribe a formulary medicine to treat your condition. In the event that formulary medicines do not produce the desired results, your doctor may request special approval to prescribe a medicine not on the VA formulary.

 

Can I get prescriptions from my private physician filled at a VA pharmacy?

No. In order to receive medication from the VA, a VA health care provider must treat you and prescribe your medication.

 

Will the VA pay for a prescription filled at a non-VA pharmacy?

No. The VA is not responsible for payment for outside medications. You or your private insurance company are responsible for these costs.

Question IconWhat is the prescription co-payment?

A co-payment charge may be incurred for medication prescribed for outpatient treatment. The current prescription co-payment rates are as follows:
•1 to 30 day supply of a drug = $ 8.00 co-pay
•31 to 60 day supply of a drug = $16.00 co-pay
•61 to 90 day supply of a drug = $24.00 co-pay

 

Veterans enrolled in priority groups 2-6 will to have a $960 cap on the amount that they can be charged for medication each year. This means that veterans in Priority Groups 2-6 will not pay more than $960 annually for medicine they receive on an outpatient basis. As in the past, there is no cap on annual co-payment amounts for outpatient medications provided to veterans in Priority Groups 7 and 8.

 

Prescription co-payment charges do not apply to former Prisoners of War (POW) or those covered by other exceptions as set by law.

 

There are additional times when a prescription co-payment will not be charged for your medicine.

 

That FAQ is on the Overton Brooks VA Medical Center Shreveport, LA webpage here: http://www.shreveport.va.gov/faq/RX_FAQ.asp

[champ_49]

Thanks guys, as I thought. I'm trying to get my care outside of the VA even though I am 100% disabled. Its 28 miles to see my primary Dr in the VA at a clinic, and almost a 100 miles to the VA hospital. Also when I am traveling I don't want to depend on the VA as they aren't very helpful if your not there patient, even if you do register with them. This also depends on the particular VA you are going to.

So I have Medicare, and a supplement to pick up what Medicare don't pay. But I don't carry the Plan D prescription and that is where I'm running into a bit of a problem. Will be checking into the plan D a little further.

Thanks for your time all.
Dave

[RV_]

Thanks for the update, keep us posted for the others that use the VA.