VA Doctor vs Non VA Doctors

[pinger]

Can you have a primary VA doctor and a private insurance doctor? Is so what are the advantages and disadvantages

[bigjim]

You can but it can be complicated.  Have been seeing the VA for a long time but I am currently pretty pissed, disgusted, and disappointed in the one in Albq. and the one in Memphis. Especially the one in Albq. There is some big problem in the VA system currently I believe and I don't know what can be done about it. After the election I may try to get a congressman or senator involved but I don't expect much from my senators or congressman currently. Especially one senator.

[Kirk W]

3 hours ago, pinger said:

Can you have a primary VA doctor and a private insurance doctor?

I think that it is probably more common for one to have a primary care physician on Medicare and also a doctor with the VA, which is exactly what I have been doing for the past 5 or so years. One of the reasons for that in some cases is to get medicines from the VA as it is "qualified" prescription coverage so one doesn't have to carry a Medicare part D insurance policy. 

It is importaant to remember that not all VA health coverages are the same. Retired military that have Tricare coverage would typically have a co-pay if accepted. Disabled veterans have complete coverage. When you apply for VA healthcare you will be assignied a priority group that determines your coverages and costs. 

I can only tell you what I have done as there are so many different circumstances and situations. I am a Vietnam era veteran in that I served from 1960 - 68 but was never in Vietnam. I am also classed a cold war veteran due to my service in the "41 for Freedom" days. As such I had no military healthcare at the time I left the service but later legslation changed that with the introduction of the priority group system. I fall into priority group 8 so I do have a co-py for everything. I registered with the VA system in 2001, shortly after I retired and went fulltime and was accepted for care in 2011. Initially I was using the VA clinic for my primary care and for prescrtiption coverage, even though I also had Medicare as a backup, but did not carry part D prescription coverage and had no primary care physician. At the time I was located near a VA clinic but at distance from the nearest VA hospital & medical center. I was happy with that situation for about 6 years with only preventive medicine and 1 visit for illness, until I developed a urinary problem that took me to an emergency room and then to the clinic the following day. My VA primary care physician said that I needed to see a urologist and the first appointment they could get me was almost 3 months in the future. After several days of frustration I visited my wife's primary care physician outside of the VA system and she referred me to a uriologist that I saw the following morning. Since that time I have gone back to using Medicare for my primary care physician, with the VA as just a backup system that I visit 1 time each year.  My current costs are somewhat higher than when I had my care completely with the VA and I do have a Medicare supplement that is paid for by my previous employer so it isn't a lot. 

My present VA doctor and my primary care doctor are both fine with the present situation and in fact have communicated a time or two. I have moved since the urinary problem so have a different VA doctor and he is well aware of the shortfalls of the VA system. I have one medication that is not available from the VA as they rarely have the latest medicines until there is a generic available. I share all of my medical records from each medical system with the other. 

 

Edited October 29, 2022 by Kirk W

[RV_]

Are you retired military?

I have both. It is less complicated when you are retired military with a military retired ID card and full privileges. and on Tricare For Life or TFL.

Tricare picks up the copays and Medicare is the primary. But not VA Copays for meds. But those are 100% covered on base.

I am retired USAF and have both a civilian Primary care doctor, and a VA Primary care Nurse Practitioner. They use them here at our clinic. I just returned from the Denver VA to pick up my new hearing aids and there is no issue with my choosing one or the other or both for a second opinion.

I have had more mistakes with my civilian docs over the years than with my VA docs and Practitioners. But I have used the civilian docs most often. Not because they were better but I did not have to wait for appointments as long.

I am 30% disabled with more severe back and cervical issues on active duty and after than folks with 100% disability ratings.

I may go more VA as my civilian ones since I moved here have been pretty sorry doctor but great medical group computer and reception/appointment/support, and now a great doc with terrible communications in the medical group I moved to. The VA clinic in the Springs and the big VA in Denver have been excellent! Still longer waits for appointments.

The key to using both for me has been to share my records back and forth or I set up one or the other for making mistakes. 

So are you a veteran or retired Military? As well are you disabled and rated at a percentage by the VA. The disabled vets, even with less 30% and are service-connected VA approved disabilities wait less time and are prioritized. So that can make a difference.

I hope that helped.

Edited October 30, 2022 by RV_

[Dutch_12078]

I have both VA and a Medicare Advantage plan coverage. I keep the VA coverage available as a backup to my primary care. That requires an annual physical to stay active, although I do use nearby CBOC's for some shots that my private carrier doesn't cover in full. I have my annual VA physical scheduled 6 months apart from my private coverage physical, but I must say my private coverage physical is much more thorough than my VA physical. It probably helps that my wife doesn't hesitate to tell or ask our doctor about things I may have forgotten to bring up during the exam.

Edited October 30, 2022 by Dutch_12078
typo

[NDBirdman]

I'm straight 100% VA so really can't say much about other Drs.  I get referred to civilian Drs when I ask but every thing is covered.  I have used civilian hosp. Urgent care a few times, mostly for stitches and VA has always payed.  I can't use Tri-care as they for some reason dropped me when I went on VA health-care.  But, they left my wife alone, she's on Tri-care for life even though she's in the VA system also.  She likes her Drs and would prefer to stay out of the VA clinics/hospitals.

[pinger]

22 hours ago, RV_ said:

Are you retired military?

I have both. It is less complicated when you are retired military with a military retired ID card and full privileges. and on Tricare For Life or TFL.

Tricare picks up the copays and Medicare is the primary. But not VA Copays for meds. But those are 100% covered on base.

I am retired USAF and have both a civilian Primary care doctor, and a VA Primary care Nurse Practitioner. They use them here at our clinic. I just returned from the Denver VA to pick up my new hearing aids and there is no issue with my choosing one or the other or both for a second opinion.

I have had more mistakes with my civilian docs over the years than with my VA docs and Practitioners. But I have used the civilian docs most often. Not because they were better but I did not have to wait for appointments as long.

I am 30% disabled with more severe back and cervical issues on active duty and after than folks with 100% disability ratings.

I may go more VA as my civilian ones since I moved here have been pretty sorry doctor but great medical group computer and reception/appointment/support, and now a great doc with terrible communications in the medical group I moved to. The VA clinic in the Springs and the big VA in Denver have been excellent! Still longer waits for appointments.

The key to using both for me has been to share my records back and forth or I set up one or the other for making mistakes. 

So are you a veteran or retired Military? As well are you disabled and rated at a percentage by the VA. The disabled vets, even with less 30% and are service-connected VA approved disabilities wait less time and are prioritized. So that can make a difference.

I hope that helped.

Veteran 50% service connected priority 1 Navy Aircrewman SAR and Sonar operator in Helicopters The reason I asked was that my private  insurance(KAISER) keeps going up One of my kids is a CRNA at Kaiser and said that when I go to the VA that the VA bills Kaiser.. is this true?

[Kirk W]

3 hours ago, pinger said:

One of my kids is a CRNA at Kaiser and said that when I go to the VA that the VA bills Kaiser.. is this true?

The answer is yes.  The following quote comes from the VA healthcare website.

Quote

Why does VA require me to provide information on my health insurance coverage (including coverage under a spouse’s plan)?

We ask for this information because we have to bill your private health insurance provider for any care, supplies, or medicine we provide to treat your non-service-connected conditions (illnesses or injuries that aren’t related to your military service).

We don’t bill Medicare or Medicaid, but we may bill Medicare supplemental health insurance for covered services.

 

[RV_]

Expand Kirk's post. That is why I asked about service connected.

That section quoted also includes:

 

"What if my health insurance provider doesn’t cover all the non-service-connected care that VA bills them for?

You won’t have to pay any unpaid balance not covered by your health insurance provider. But, depending on your assigned priority group, you may have a copay for non-service-connected care.
Learn more about eligibility priority groups

Does my current health insurance status affect whether I can get VA health care benefits?

No. Whether or not you have health insurance coverage doesn’t affect the VA health care benefits you can get."

 

I would check with the VA and take a look at what Co pays you would have for non service connected treatments, you may be able to use VA alone. But also check for minimum/maximum income levels for co-pays. Make an appointment with a benefits counselor to explore your options.

[pinger]

6 hours ago, RV_ said:

Expand Kirk's post. That is why I asked about service connected.

That section quoted also includes:

 

"What if my health insurance provider doesn’t cover all the non-service-connected care that VA bills them for?

You won’t have to pay any unpaid balance not covered by your health insurance provider. But, depending on your assigned priority group, you may have a copay for non-service-connected care.
Learn more about eligibility priority groups

Does my current health insurance status affect whether I can get VA health care benefits?

No. Whether or not you have health insurance coverage doesn’t affect the VA health care benefits you can get.

I would check with the VA and take a look at what Co pays you would have for non service connected treatments, you may be able to use VA alone. But also check for minimum/maximum income levels for co-pays. Make an appointment with a benefits counselor to explore your options.

I think that I'll just keep my private insurance

[Kirk W]

13 minutes ago, pinger said:

I think that I'll just keep my private insurance

Have you registered with the VA and if so, which priority group are you in? Even if you have Medicare it is nice to have as a reserve, just in case. 

[bigjim]

On 10/29/2022 at 3:38 PM, RV_ said:

share my records back and forth or I set up one or the other for making mistakes. 

How are you doing that. I may need to do that soon I hope.

I called a particular va office in Albq. last Mon. Got a recording saying they had 72 hours to respond. I gave them a whole week in case they are short staffed or something. Never heard from them. Called again today and got the recording and left another msg and also said the time and date I had first called. I am giving them until 11:30 tomorrow then I hope I don't get arrested when I go in. I have a number of years ago got some results using  a patient advocate but it has not worked this time.  There is something wrong here and not just for me. Anyone have any insight on who  else I could talk to in the system that might do something and tell me the truth?

For reference I am a 2 service active member and VN vet in the Marine Corps. Disablities but not service connected. On the Agent Orange list and the Camp Lajuene list. I have co-insurance that is billed and pays a small portion of my copay.  I am not even bitching about my copays.  I have had good care here in the past.

Btw. There is a law that even the VA is stuck with that requires them to bill to try and recover funds owed to the government. That is part of the reason I got stuck with a 1 cent overdue with a $15. surcharge and would have gone to collections next. The insurance had paid all but the 1 cent and for some reason I did not get the bill in time to know.  My next lowest bill was for 4 cents. I offered to put up a $25. amount each year to keep this from happening but that was a no go.  I have gotten a bill and paid it to be safe then a couple of weeks later received a refund as the insurance cover part.  This all goes back to some Congressman trying to show how tough he is in recovering funds owed the  government. A good idea in theory of course but they did a poor job of setting the system up.   Surprise surprise

Edited November 1, 2022 by bigjim
more info

[bigjim]

th

11 hours ago, pinger said:

I think that I'll just keep my private insurance

I think in most cases that is wise, especially if you are not a provable  service disabled vet.

That is based on the information at hand and of course everything can change at anytime, even as soon as we all click off the forum.🙂

 

 

 

 

[Kirk W]

On 10/29/2022 at 4:38 PM, RV_ said:

The key to using both for me has been to share my records back and forth

9 hours ago, bigjim said:

How are you doing that. I may need to do that soon I hope.

I can't speak for RV but I do that same thing and with the electronic medical records you should be able to do the same. If you sign into My Healthy Vet site and look under Health Records, there is an option for records sharing. The website of your doctors and medical facilities should have something similar. With that set up the records from each should be automatically shared with the other.  You can also download a .pdf copy of the records of either and then upload a copy to the other. 

 

Edited November 1, 2022 by Kirk W

[RV_]

My VA required me to sign a disclosure permission form but it is likely online today.

It is not either/or. You do not drop your civilian doc or insurance unless you want to. I have EARNED all three since I have TFL which is military and Medicare, as well as the VA. I have no other insurance and non needed since I retired coming up on a quarter century ago. My Primary Care Doc is a civilian but is paid for by TFL.

Regardless of whether you decide to keep your civilian doc you should go ahead and register with the VA and get ratings on your disabilities. If your disabilities appeared during active duty or as a result of on duty injuries they are service connected if they are in your military medical records during the time you were serving on active duty.

That is the best I can explain it and you would do well to schedule an appointment with a state VA representative. I had one in Louisiana but I have not tried to find one here yet until I re-approach my VA ratings, and I will. If you just search for VA state or county counselors you may find a dud or a great rep as I have found. They are not online you have to meet in person.

Here's the offices here:

"Veterans Services

El Paso County / Justice Services / Veterans Services

The El Paso County Veterans Service Office is responsible for assisting residents of the State of Colorado who served honorably in the United States Army, Air Force, Coast Guard, Navy, Marine Corps or any other armed service of the nation.

The El Paso County Veterans Service Office was established by State law to advise and assist veterans, their dependents, and their survivors concerning any Veterans Affairs (VA) benefits which such person may be, or may have been, entitled to receive under the laws of the United States or the State of Colorado. The office is not a part of the Department of Veterans Affairs, which is a Federal government agency, but serves as a liaison between the claimant and the VA.

The primary purpose of the office is to provide personalized local service to veterans and other claimants, and to assist them in cutting through the maze of red tape frequently involved in direct dealings with government agencies.

• Veteran Benefits
• Services
• Community Resources
• Contact Veterans Services

Source:

https://justiceservices.elpasoco.com/veterans-services/#1511209255765-534b869a-d1d9

 

The important part is that they, like the one in Shreveport LA, are not part of the VA. They are part of our state insuring the federal government is kept honest in regards to earned benefits not charity. And you are getting any state services you may need or want that you EARNED.

 

You Earned your benefits, they are not being on any dole. And yes when you go in most of the folks look old and grizzled. Ever look in a mirror? 😮🖖

 

The wait times here are about the same as for a specialist. But I can get in for routine appointments within a day or two with my civilian doc. But I can actually get appointments for specialists with the VA about the same as civilian specialists.

 

My advice is to go and get registered despite a bit of hurry up and wait. If you make too much for free services your co-pays with the VA may still be substantially less than your insurance AND co-pay costs.

 

Regardless you have nothing to lose but a few hours buddy. Because you are my service buddy regardless of how long or short your service was. And you earned it, just like I did. If your bank account earns interest do you decline it because it is a handout? Heck no! You earned it by depositing your hard earned monies into their system. Just as you gave your country a blank check for any amount of your life for a set period, like a CD, an amount up to and including life and limbs.

 

For those who have fought for it, freedom has a taste the protected will never know. And for those willing, a camaraderie, like family, that few who never served can understand.

I essentially do not use them for anything but hearing aids at this point. But I am registered and in the system. I really like the folks here and at the Denver VA. I use them if I want to, not if I don't.

Make an informed decision, go see what you've earned. Have it as a back up, that costs nothing but the few hours it takes to get registered and evaluated for disability rating. Then you can ignore it unless you need it.

 

Edited November 2, 2022 by RV_

[pinger]

On 11/1/2022 at 10:53 AM, RV_ said:

My VA required me to sign a disclosure permission form but it is likely online today.

It is not either/or. You do not drop your civilian doc or insurance unless you want to. I have EARNED all three since I have TFL which is military and Medicare, as well as the VA. I have no other insurance and non needed since I retired coming up on a quarter century ago. My Primary Care Doc is a civilian but is paid for by TFL.

Regardless of whether you decide to keep your civilian doc you should go ahead and register with the VA and get ratings on your disabilities. If your disabilities appeared during active duty or as a result of on duty injuries they are service connected if they are in your military medical records during the time you were serving on active duty.

That is the best I can explain it and you would do well to schedule an appointment with a state VA representative. I had one in Louisiana but I have not tried to find one here yet until I re-approach my VA ratings, and I will. If you just search for VA state or county counselors you may find a dud or a great rep as I have found. They are not online you have to meet in person.

Here's the offices here:

"Veterans Services

El Paso County / Justice Services / Veterans Services

The El Paso County Veterans Service Office is responsible for assisting residents of the State of Colorado who served honorably in the United States Army, Air Force, Coast Guard, Navy, Marine Corps or any other armed service of the nation.

The El Paso County Veterans Service Office was established by State law to advise and assist veterans, their dependents, and their survivors concerning any Veterans Affairs (VA) benefits which such person may be, or may have been, entitled to receive under the laws of the United States or the State of Colorado. The office is not a part of the Department of Veterans Affairs, which is a Federal government agency, but serves as a liaison between the claimant and the VA.

The primary purpose of the office is to provide personalized local service to veterans and other claimants, and to assist them in cutting through the maze of red tape frequently involved in direct dealings with government agencies.

• Veteran Benefits
• Services
• Community Resources
• Contact Veterans Services

Source:

https://justiceservices.elpasoco.com/veterans-services/#1511209255765-534b869a-d1d9

 

The important part is that they, like the one in Shreveport LA, are not part of the VA. They are part of our state insuring the federal government is kept honest in regards to earned benefits not charity. And you are getting any state services you may need or want that you EARNED.

 

You Earned your benefits, they are not being on any dole. And yes when you go in most of the folks look old and grizzled. Ever look in a mirror? 😮🖖

 

The wait times here are about the same as for a specialist. But I can get in for routine appointments within a day or two with my civilian doc. But I can actually get appointments for specialists with the VA about the same as civilian specialists.

 

My advice is to go and get registered despite a bit of hurry up and wait. If you make too much for free services your co-pays with the VA may still be substantially less than your insurance AND co-pay costs.

 

Regardless you have nothing to lose but a few hours buddy. Because you are my service buddy regardless of how long or short your service was. And you earned it, just like I did. If your bank account earns interest do you decline it because it is a handout? Heck no! You earned it by depositing your hard earned monies into their system. Just as you gave your country a blank check for any amount of your life for a set period, like a CD, an amount up to and including life and limbs.

 

For those who have fought for it, freedom has a taste the protected will never know. And for those willing, a camaraderie, like family, that few who never served can understand.

I essentially do not use them for anything but hearing aids at this point. But I am registered and in the system. I really like the folks here and at the Denver VA. I use them if I want to, not if I don't.

Make an informed decision, go see what you've earned. Have it as a back up, that costs nothing but the few hours it takes to get registered and evaluated for disability rating. Then you can ignore it unless you need it.

 

Thats all I use the VA for is hearing aids and the tumor in my ear to get MRI's every 6months to see if the tumor is growing. I'm 50% service connected disability in priority one for some time but I do get my yearly physical at the VA to stay in the system.            

[Kirk W]

1 hour ago, pinger said:

Thats all I use the VA for is hearing aids and the tumor in my ear to get MRI's every 6months to see if the tumor is growing.

If you need glasses, I suggest that you consider them for that as well as it saves considerable money even with a copay. 

[bigjim]

Kirk and RV stated the case and facts much better than me and while I would still consider what I said but follow what they said more.  I sure I am biased at the moment as I am angry, and disappointed to say the least.  My situation may be getting more interesting pretty quick as I spoke to the office person that deals with the VA for a local congress person.  He said that they have had similar complaints lately and they have spoken to the 2 senators' representatives and they relate to getting some of the same complaints. I believe they may all be contacting the VA.

[Kirk W]

One of the biggest issues for most VA facilities is that they are innundated with patients and so have a big shortage of available facilities and personel. For my last eye exam I went to the Dallas VA Medical Center and the main problem was in finding a parking spot. I drove around for more than 20 minutes witing for someone to leave so that I could find a space in a parking lot that must be more than a city block in size, perhaps 2 or 3 blocks. 

[RV_]

Parking has been like that for the Overton Brooks VA Medical center in Shreveport LA since I retired in 1997. They have off site overflow and a shuttle bus to and from that parking area now too and it is full up much of the time in 2019 when we moved out of the South.

[bigjim]

I can tell you that the Albq. VA and Memphis VA are much the same. They recently fiinished a parrking garage at Memphis.   Dallas has been like that as long as I can remember.  I try for the first appt. of the day. It helps avoid some traffic going in  and I normally get there early enough to grab a spot then a cup of coffee.  I  have noticed also towards the end of the appointments a lot of people have had there appointment and left and spots are more readily available. I can't imagine Dallas now. It has been over 20 plus years since I was there.

[Kirk W]

10 hours ago, bigjim said:

I can't imagine Dallas now. It has been over 20 plus years since I was there.

Dallas now has a second facility, having taken over the old Baylor Hospital in Garland. They are doing some major remodeling and so it isn't nearly completely open as yet but it is where my VA doctor is and also the lab where I get most related things done. They say that eventually they will have most of the facilities offered in the main Dallas VA Medical Center but thus far it is pretty limited with no optometrists or opthamologist or other specialty facilities and no hospital except for a Covid wing that they opened. Being small yet the parking there is ample since they also have most of the Baylor parkinglot.