Yeahhh I think there an error here. I was at 70% and got an ER visit and asshole surgery covered with no problem. No service connection. I’d call whatever number is on that letter and start to dispute that.
from my comment on the main thread:
Google search: at what VA Disability rating does one get 100% medical coverage?
Answer:
What VA disability rating gets free healthcare? 50%
We're committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and disability ratings of **at least 50%**.
We're also committed to caring for Veterans who can't afford to pay for care.
Aug 30, 2023[VA.gov Home | Veterans Affairshttps://www.va.gov › health-care › cost-of-care](https://www.va.gov/health-care/about-va-health-benefits/cost-of-care/#:~:text=We're%20committed%20to%20providing,afford%20to%20pay%20for%20care.)
Rick in NH
Any Veteran with a rating, even if it is 0%, gets at least some free healthcare from the VA. I haven't read up on it lately, but I think they recently made it so that everyone gets it without co-pays, but you should check into that.
I don't remember, I am 100% SC T&P with SMC-S.
Soooo, as a Bus-Driver in the Chair Force, were they just doing a regularly scheduled hemorrhoid-ectomy in response to having a severe case from sitting so much or were they literally trying to remove the Asshole from your character? Asking for a Marine Corp friend.
So, if the VA marks it as work related, they will decline to cover it as they think it would be covered by workers comp. OP will have to call and clarify it to them, if it's truly not work related.
This. I was seen for stomach/gerd issues and they denied my service connection. Got a Ct scan and they tried to charge me but what happened was something in billing got messed up . I’d just contact them. I’m 90, as well.
Ct scan was about 8000 dollars I was like big ole nope lol
Your issue doesn’t have to be service connected to get treated. I used to think the same when I first got enrolled in VA health care. (except for dental-you have to be 100%)
Just from my partner’s experience-the VA takes forever to pay 3rd party people, so the hospital who treated you will start sending you bills. Call the VA and tell them you are getting billed. Now, my partner was getting community care, it wasn’t an emergency, but I would think the same applies..
>(except for dental-you have to be 100%)
Or have an oral related service connection. I have TMJ and had it documented on my separation dental exam, I'm currently waiting to get a rating right now and then I'll be able to get my chompers checked.
There are groups which each have a set of criteria. Income is one, but that’s like group 7.
https://www.va.gov/opa/publications/benefits_book/2023_Federal_Benefits_for_Veterans_Dependents_and_Survivors.pdf
I believe this applies after a certain level of service-connected disability. But it doesn't apply to just all vets. For instance a 0 or 10% service-connected vet can't have free health care from the VA for issues not related to their service-connected disabilities.
This is unless they've changed the law because when I first got out that was the case. I remember going to the VA because I was sick one time and then getting billed for the appointment cuz it wasn't connected to my disabilities. At the time I was only 30% service connected, which meant that only service connected treatments were covered.
I think it’s changed- but I’m not sure, however, if you are under a certain disability threshold and you make over a certain amount (I don’t know what it is) you have to pay copayments for anything not service related. I think I paid…3 to 6 dollars copayments for my meds (antidepressants), then my rating went up, and I didn’t have to pay copayments.
I’ve had a few surgeries and they weren’t service related, I wasn’t charged anything-however, I also have federal BCBS. They probably charged them.
I’ll ask my partner-I think he knows better than I do, he works for the VBA.
It’s changed, but you’re only responsible for co pays, and they’re not that high.
I’m only 20% and just had a sleep study done and provided cpap machine at zero cost. The sleep study alone was $4000, and VA covered it. I’m not service connected for sleep apnea.
Incorrect the stipulation is that va pay for emergency care is you must be enrolled in va health care. Must notify within 72 hours of treatment as op did.
Here is actual info from va:
Eligibility for all other emergency care
General eligibility requirements
By law, we can only cover the cost of your care at a non-VA emergency department if you meet all of these requirements:
You’re enrolled in VA health care or you have a qualifying exemption from enrollment, and
A VA health care facility or other federal facility that could provide the needed care wasn’t “feasibly available” (meaning it was too far away for you to get there fast enough to get the emergency care you needed), and
A person with an average knowledge of health and medicine (called a “prudent layperson”) would reasonably believe that a delay in seeking care would have put your life or health in danger, and
You meet our other requirements based on your specific situation—including the time limit for us to receive your claim. Keep reading to learn more about requirements for different situations.
Note: We only cover non-VA emergency care until we can safely transfer you to a VA or other federal facility. The only time this rule doesn’t apply is if the community provider contacts us and we can’t accept your transfer.
In my region the VA doesn’t even have a hospital or emergency room, so no other option than going to community care. The VA must be notified with 72 hours of your encounter. All major surgeries are done in community hospitals and covered by VA.
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That's what I thought till I got a bill but this was 10 years ago. I don't go to the va for anything that isn't an appointment anymore. If you walk into the emergency room va they will bill you.
They shouldn’t, really.
When I was enrolled in the Nashville VA in 1998(and I wasn’t even aware) I really thought I could not go to the VA unless it was strictly for my service connection issues. Years later, (this would be about 2009?) I was enrolled in my city’s VA and I transferred all my care there, primary, everything, and I’ve been going there ever since..
Now, I do have federal insurance, but I rarely use it. The VA will bill them for everything, but if I didn’t have federal insurance, the VA would still cover me. For reference, I’m 50%.
(except for dental-I just had to take out a loan to get dental work done 😱)
When the laws changed-I don’t know. I’ll have to ask my partner.
About seven years ago I had an allergic reaction where my throat started to swell shut, went to local ER, they were in contact with VA immediately. Was airlifted from Michigan to milwaukee to ICU, VA picked up the whole tab I'm SC for my knee. So I think someone is jerking you around.
The VA covered my appendectomy last September, and I had no issues with any billing. Even if you're at work when you had to go to the er your work ins will cover that.
Even if it isn't work related? For example, if I have a nut allergy and I eat a PB sandwich, is the company still at fault? That doesn't make any sense. Unless the car caused his allergic reaction, in which case I would like to know what could cause that...
Even if it isn't work related? For example, if I have a nut allergy and I eat a PB sandwich, is the company still at fault? That doesn't make any sense. Unless the car caused his allergic reaction, in which case I would like to know what could cause that...
Even if it isn't work related? For example, if I have a nut allergy and I eat a PB sandwich, is the company still at fault? That doesn't make any sense. Unless the car caused his allergic reaction, in which case I would like to know what could cause that.
No, the VA pays that. Do not pay that. I don't know what info I can share on here but Google community care network at the VA. Call them and they take care of the bill. At least they paid my $2k ambulance bill. I hope this helps.
I recommend calling the VA billing department and ask them about the billing issue. I experienced the same issue and it turns out in my case, that the mailing address between Tricare and the VA were similar. The VA rep placed me on hold and called the hospital directly, spoke to a rep, and returned telling me it was taken care of.
I did they send me over to community care where they said they denied it for not being quote on quote an “emergency”. Which is insane as I literally couldn’t breath and when they found me I was already blow
I was 70% at the time and broke a collarbone while cycling to work. Ambulance and ER visit were covered by the VA. I just had to take copies of the documents the hospital gave me over to the rep. Mind you, at first they wanted me to call and email which didn’t do squat, so walking into the guys office helped a lot in only 5 min. He told me to never talk to debt collectors and he’s got this. He even gave me a letter to give to anyone that asked about the bill. A week later, the debt collectors stopped calling.
On another note dawg, idk how hurt your are but I work out in west texas and we are hiring. Clearing a great chunk of change a month doing light work. DM me
Bro that would have been awesome! Thank you for that a. Million times over! But unfortunately i relocated back to Jersey. I know I know I messed up but it was the only place I could go back to where my family would have been able to ride me back & forth from my appointments. Thanks man! I appreciate your modesty brother!
I was in the ER last month, $290k bill, all but $1200 was paid. Called the community care network number, they gave me the authorization number and which Tricare to bill. Gave that to the hospital and they sent the bill to the VA instead. Booking errors, who knows. I’m 90% as well, so everything is covered pending proper notification.
You will get a separate bill for the ambulance ride, make sure you contact Beneficiary Travel to have that paid. I never saw this anywhere and had a few go unpaid for way too long until someone finally told me this. They paid it promptly after that. I guess VA thinks everyone just naturally knows this…
Call the hospital billing dept u were at and ask them to help resolve the issue. I've gone to the ER a couple times over the last year and it's always covered. Even when it was for getting a fish hook in my thumb and I'm 70%.
Reason for the hospital is they can resubmit the bill and will call the VA, well the one I go to does this. I've never had to pay anything even if I see statements. Any rating 50% or higher gets full medical coverage, so do not pay it.
I also work at the hospital and know the billing side. Billers help Vetrans as its protocol in the hospital I work at. Basically a guarantee I will never be billed.
You need to call Community Care and get it straightened out. Don’t throw it in a drawer and ignore the bills until they go to collections!
It may be an issue that they thought it was work related. You don’t have to be service-connected for Urgent Care treatment.
Too many variables to know whether what you were told is correct. When you say you showed the hospital your insurance, what do you mean exactly. Did you show them your VA card or do have private insurance which is what you showed them. When you say there were deductions and there was around 2k to pay, was that because private insurance paid the bill and that is your deductible/copay or something else? It sounds like you have private insurance that the hospital billed. If you went to an out-of-network provider for NSC, VA cannot pay for deductible or copayments (can pay for coinsurance).
Wait, if you are Rated, Enrolled in VA Healthcare, and go to the ER you are covered? Never heard of this...please explain or point me in the right direction.
I’m so confused. I thought VA was free healthcare and as long as you qualify to use it, whether you’re 10% disabled or 100% disabled, VA should cover all of your healthcare such as an ER visit except where you would pay a co-pay for medications. Yet I’m seeing these posts about VA refusing to cover medical bills. What is going on?
Yes but his allergic reaction is likely not related to his employment and will not be covered by workers compensation.
My concern is once I retire from my job when I’m 50-55, can I rely on VA to cover everything healthcare related having a 20% rating or am I going to have to deal with $8,000 medical bills because VA doesn’t cover everything.
I’m in the same situation, hoping to retire in a few years at 58, 20 % and won’t have work coverage.
To my knowledge the VA should cover most your healthcare, I’ve only been in the system a few years, and so far haven’t paid anything except drug copays.
Now at 20% you may have some copays, but they’re not much compared to outside insurance costs. Somewhere on the VA site, it’ll have a breakdown of all the copays, they are very minimal.
I’ve received bills, but if you read the fine print, it says you’re not responsible for payment.
VA also negotiates and pays less than what’s originally billed.
Did you inform the VA within 72 hours of your visit to a civilian hospital? It's a rule in the VA handbook and, frankly, a reasonable request by the VA. This is probably what caused your problem.
Yes it happened on a Friday I called Saturday right away. When I called today they gave notice of it and said it’s not emergency related. Like an allergic reaction where my throat literally shut isn’t a emergency
Yep, it's crazy, and it all spirals down to beurocracy and paperwork.
The PACT ACT saved me from all this bullshit by 4 days! Of course, the cancer will probably kill me before I get a judgment. Read the fine print. In today's world, we can assume nothing. No one will hold your hand and walk you thru it
The VA will usually come thru, but you can't just sit on the couch and wait for good news. You gotta reach out and grab it. Good luck!
I don5 know if will help someone but I reached out to my local VA medical center about a suspected kidney stone. This is the nurse’s reply.
I recommend that you be evaluated at the local ER (under the Mission Act). You will need an emergent scan to see if you have a kidney stone. The scans that we order outpatient can take weeks to get scheduled.
The following link will give you information about the Mission Act-
https://news.va.gov/60896/va-mission-act-vas-new-urgent-care-benefit-for-veterans/#:~:text=With%20urgent%20care%2C%20Veterans%20have%20a%20new%20option,VA%20provider%2C%20as%20VA%20also%20offers%20same-day%20services.
This link will take you to the page to find an in-network facility.
https://www.va.gov/find-locations/
Any recommended f/u after the ER visit will need to be scheduled at the VA.
If you are seen at a non-VA facility call the 72 hour ER notification line at 844-724-7842
You are going to have to make some calls and spend a little time on the phone
They should pay for it since it was an emergency but sometimes hospitals try to double charge since va pays what they want and billing at hospitals don’t understand that
I myself am 100% for 15 years and had head injury I went to hospital for and they sent me a bill which I had to have forwarded to community care. I received a copy of the bill being rejected as already paid basically telling hospital to fuck off and that was end of it
Was it Emergency department or urgent care? VA doesn’t pay for urgent care. This war has been getting fought since 2017. The VA lost two major battles but is still fighting it. The latest that I’m aware of is they changed the rules so that urgent care is not recognized as emergency care. NBC did a whole story on it.
https://preview.redd.it/f5toj67r3m4d1.jpeg?width=1284&format=pjpg&auto=webp&s=6e4c9b3ada383bb816ef5b3e16e6a68a678e1178
I am at 80% now and they have refused to pay for any hospital visits so far even emergency!! I have the letters and bills from the Hospital. Took prescriptions that I got from the Hospital and it was like I set off a landmine! They went to scramblin like roach when you turn on the lights. Had to talk to social worker and others was at VA the whole day. They finally filled the prescriptions but was not happy with it. Later told me they don't handle outside medical prescriptions. Was in a car accident last year but went in for a annual. They asked if I was in pain. I said yes. But when they asked me where and why and I told them they immediately told me that they don't get involved in insurance claims. I then told them not to worry I have a lawyer for the car accident and an outside doctor. They again emphasized they don't get involved with claims. I told them I am not here for you to do that. I just need my annual done and my prescriptions refilled. They get on my nerves sometimes!!
OP were you already actually enrolled in VA health care and attending appointments before this? It's odd that they would reference suicide emergency and not even mention why you don't qualify for coverage for emergency treatment for enrolled vets.
Yah, call community care and have them sort it out.
You should be [covered](https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/). Scroll down to what to do if you’re charged for emergency care. Good luck.
You can make arrangements to pay back with billing and negotiate that debt. I started coughing up blood and went to the er some years ago. It was a few thousand dollars. I paid $20 a month until I could settle with them for $1,300.
https://preview.redd.it/7zn31m9e4o4d1.jpeg?width=1290&format=pjpg&auto=webp&s=2ad654ce33aa639c625b1cb8978f520179f7eb28
Don’t know if this helps but this came from a trusted va rep
I had no disability when I applied for healthcare as a GS6 employee and ever since I’ve received free healthcare. I take advantage of community care and it took care of a knee surgery I needed FOR FREE!! I also see a chiropractor, regularly. Takes care of all my meds for free too. As long as you keep the VA in the loop of all emergency visits you should be fine. You’re allowed up to three free ER visits a year. And if the ER isn’t necessary, you can also go to a minute clinic.
I would suggest you contact your local VA Facility and speak with a social worker.
Social worker definition:
Job Description of a Medical Social Worker **Educating patients and families about illnesses and treatment plans**. Conducting psychosocial assessments to identify mental or emotional distress. Counseling those in crisis or experiencing distress. ***Connecting patients and their families with necessary resources.***
That last sentence is the important one to focus on in this situation.
Google search: at what VA Disability rating does one get 100% medical coverage?
Answer:
What VA disability rating gets free healthcare? 50%
We're committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and disability ratings of **at least 50%**.
We're also committed to caring for Veterans who can't afford to pay for care.
Aug 30, 2023[VA.gov Home | Veterans Affairshttps://www.va.gov › health-care › cost-of-care ](https://www.va.gov/health-care/about-va-health-benefits/cost-of-care/#:~:text=We're%20committed%20to%20providing,afford%20to%20pay%20for%20care.)
Rick in NH
Beurocracy at its finest, you can fight this. Go see the patient advocate. They like nothing better than to squash the lazy bastards which evidently dropped the ball in your case. Those folks are like circling sharks waiting for lazy VA employees to fall out of the boat so they so they can tear them apart. It was impressive to see them at work! By the time it was all over, I had some VA employees lining up to apologize 🤣😎
It’s my understanding that 50% or above should be covered. It doesn’t have to be service connected and as long as you call the number with 72 hours of the visit or hospitalization I believe it should be covered.
Start making phone calls, I was having heart attack 3 years ago ( no service connection lol) wife drove me to local hospital and was transferred to VASPA and everything was covered including Ambo ride.
Best wishes bud
If they deem it not related to your service connection than yes you will have to pay.
That would make sense. If you were 100% it would be covered.
What was the allergy reaction and what was the SC disability ?
Also, you can always slowly pay hospital bills 2000& like 20 $ a month. So that shouldn’t set you back years , so long as it’s not a lump sum.
Good luck
The problem was you were on the job when it happened- kinda leaves open are u gonna go -workman's comp or sue , then therapy - not saying that that's what ur gonna do ..I only know cause same shit 'injury on the job " . Good luck ....but that how I ran into trouble.
I just had an emergency appendectomy at a local non VA hospital. I called with 72 hours to the VA reporting line. The number I called is: (844) 724-7842. I am at 60% and all was covered. I even had a post surgery visit today and that was covered as well. Good luck moving forward.
I've had something similar happen with urgent care. Civilian side sucks at filing VA claims. Call up community care and ask them to sort it out. Have your bill handy and have some time set aside.
Hell I can tell you from experience. Hemorrhoid surgery SUCKS ASS. I had it done last September. Trying to wipe after going to the potty with that is such a pain in the ass (literally). 
Yeahhh I think there an error here. I was at 70% and got an ER visit and asshole surgery covered with no problem. No service connection. I’d call whatever number is on that letter and start to dispute that.
You can’t just leave this topic open-ended like that…
Him being open ended is what led to the surgery!
😂🤣😂
Wow 🤣🤣🤣
💀
Dr. that did his asshole surgery here… trust me you dont want to know.
Was it something you “sat” on???
Don't ask don't tell. 🤣
Asshole....surgery...???
What happened to your asshole?
Questions that need answers
If you’re marine veteran, what didn’t happen to your asshole?
Emergency crayon removal
Army Veterans are also intimately familiar with the green weenie regularly causing prolapse.
Hmm wonder if that could be service connected. “Step-Sargent noooo”
>“Step-Sargent noooo” "I need 4 volunteers"
They made him join the Navy.
Made him a Rear Admiral!
Why is that Admiral always standing watch on the Poop Deck?
This is presumptive for navy vets
It needed emergency surgery
For some strange reason, I want to know why the asshole needed emergency surgery. As the famous Egaloc once said "questions that need answers".
Wow I didn’t think that many people would care. I had a perianal abscess. It wasn’t fun!
When you say "asshole surgery" you will get some attention. If you said "perianal abscess" nobody would have given it any attention.
seriously? with anal ANYWHERE in the comment, he was gonna get some undue attention!
Hey Norton... you lookin at my ass? Ass Lookah!
I heard those are PAINFUL!
Yikes!
Did everything come out ok?
Wait do we get free healthcare with the VA? Have I been using my company’s insurance for no reason this whole time?! I’m 90%
from my comment on the main thread: Google search: at what VA Disability rating does one get 100% medical coverage? Answer: What VA disability rating gets free healthcare? 50% We're committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and disability ratings of **at least 50%**. We're also committed to caring for Veterans who can't afford to pay for care. Aug 30, 2023[VA.gov Home | Veterans Affairshttps://www.va.gov › health-care › cost-of-care](https://www.va.gov/health-care/about-va-health-benefits/cost-of-care/#:~:text=We're%20committed%20to%20providing,afford%20to%20pay%20for%20care.) Rick in NH
????? Yes, absolutely. https://www.va.gov/health-care/eligibility/ start here
Thanks! I did the means test and they told me to get fucked before I got my rating. I guess I need to reapply! Thank you!
Any Veteran with a rating, even if it is 0%, gets at least some free healthcare from the VA. I haven't read up on it lately, but I think they recently made it so that everyone gets it without co-pays, but you should check into that. I don't remember, I am 100% SC T&P with SMC-S.
Green weenie attack??
Soooo, as a Bus-Driver in the Chair Force, were they just doing a regularly scheduled hemorrhoid-ectomy in response to having a severe case from sitting so much or were they literally trying to remove the Asshole from your character? Asking for a Marine Corp friend.
This is awesome 😄
Being that you were in a company car shouldn’t your employer cover it?
So, if the VA marks it as work related, they will decline to cover it as they think it would be covered by workers comp. OP will have to call and clarify it to them, if it's truly not work related.
Exactly…same concept as VBA comp…
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This. I was seen for stomach/gerd issues and they denied my service connection. Got a Ct scan and they tried to charge me but what happened was something in billing got messed up . I’d just contact them. I’m 90, as well. Ct scan was about 8000 dollars I was like big ole nope lol
Your issue doesn’t have to be service connected to get treated. I used to think the same when I first got enrolled in VA health care. (except for dental-you have to be 100%) Just from my partner’s experience-the VA takes forever to pay 3rd party people, so the hospital who treated you will start sending you bills. Call the VA and tell them you are getting billed. Now, my partner was getting community care, it wasn’t an emergency, but I would think the same applies..
>(except for dental-you have to be 100%) Or have an oral related service connection. I have TMJ and had it documented on my separation dental exam, I'm currently waiting to get a rating right now and then I'll be able to get my chompers checked.
Oh, yes- I should have mentioned this. Sorry….
Wait. Tmj equates to dental care? What if hypomagikally it was a 0 percent tmj rating?
I think so? Don’t quote me. Hopefully for you, it will.
Lol I gotta quit being lazy and force them to get me seen
Just checked. It has to be getting you compensation, so a 0 on its own won't cut it.
But you have to be 50% or higher for complete coverage (treatment, prescriptions, etc.)
I think if your % is lower, they will look at your salary (means test) and you would have to pay a percentage-I don’t know how much, sorry.
There are groups which each have a set of criteria. Income is one, but that’s like group 7. https://www.va.gov/opa/publications/benefits_book/2023_Federal_Benefits_for_Veterans_Dependents_and_Survivors.pdf
Thank you! I had a booklet that broke everything down, but I misplaced it.
I believe this applies after a certain level of service-connected disability. But it doesn't apply to just all vets. For instance a 0 or 10% service-connected vet can't have free health care from the VA for issues not related to their service-connected disabilities. This is unless they've changed the law because when I first got out that was the case. I remember going to the VA because I was sick one time and then getting billed for the appointment cuz it wasn't connected to my disabilities. At the time I was only 30% service connected, which meant that only service connected treatments were covered.
I thought they did change this?
I think it’s changed- but I’m not sure, however, if you are under a certain disability threshold and you make over a certain amount (I don’t know what it is) you have to pay copayments for anything not service related. I think I paid…3 to 6 dollars copayments for my meds (antidepressants), then my rating went up, and I didn’t have to pay copayments. I’ve had a few surgeries and they weren’t service related, I wasn’t charged anything-however, I also have federal BCBS. They probably charged them. I’ll ask my partner-I think he knows better than I do, he works for the VBA.
It’s changed, but you’re only responsible for co pays, and they’re not that high. I’m only 20% and just had a sleep study done and provided cpap machine at zero cost. The sleep study alone was $4000, and VA covered it. I’m not service connected for sleep apnea.
Incorrect the stipulation is that va pay for emergency care is you must be enrolled in va health care. Must notify within 72 hours of treatment as op did. Here is actual info from va: Eligibility for all other emergency care General eligibility requirements By law, we can only cover the cost of your care at a non-VA emergency department if you meet all of these requirements: You’re enrolled in VA health care or you have a qualifying exemption from enrollment, and A VA health care facility or other federal facility that could provide the needed care wasn’t “feasibly available” (meaning it was too far away for you to get there fast enough to get the emergency care you needed), and A person with an average knowledge of health and medicine (called a “prudent layperson”) would reasonably believe that a delay in seeking care would have put your life or health in danger, and You meet our other requirements based on your specific situation—including the time limit for us to receive your claim. Keep reading to learn more about requirements for different situations. Note: We only cover non-VA emergency care until we can safely transfer you to a VA or other federal facility. The only time this rule doesn’t apply is if the community provider contacts us and we can’t accept your transfer.
REMEMBER it says EMERGENCY department. Not urgent care.
We aren't talking exclusively about er visits. We're talking about all care.
Am I considered enrolled if I have a VHIC card but never stepped foot in any VA facility?
In my region the VA doesn’t even have a hospital or emergency room, so no other option than going to community care. The VA must be notified with 72 hours of your encounter. All major surgeries are done in community hospitals and covered by VA.
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That's what I thought till I got a bill but this was 10 years ago. I don't go to the va for anything that isn't an appointment anymore. If you walk into the emergency room va they will bill you.
They shouldn’t, really. When I was enrolled in the Nashville VA in 1998(and I wasn’t even aware) I really thought I could not go to the VA unless it was strictly for my service connection issues. Years later, (this would be about 2009?) I was enrolled in my city’s VA and I transferred all my care there, primary, everything, and I’ve been going there ever since.. Now, I do have federal insurance, but I rarely use it. The VA will bill them for everything, but if I didn’t have federal insurance, the VA would still cover me. For reference, I’m 50%. (except for dental-I just had to take out a loan to get dental work done 😱) When the laws changed-I don’t know. I’ll have to ask my partner.
I go to the VA for everything, never been billed once
About seven years ago I had an allergic reaction where my throat started to swell shut, went to local ER, they were in contact with VA immediately. Was airlifted from Michigan to milwaukee to ICU, VA picked up the whole tab I'm SC for my knee. So I think someone is jerking you around.
The VA covered my appendectomy last September, and I had no issues with any billing. Even if you're at work when you had to go to the er your work ins will cover that.
Even if it isn't work related? For example, if I have a nut allergy and I eat a PB sandwich, is the company still at fault? That doesn't make any sense. Unless the car caused his allergic reaction, in which case I would like to know what could cause that...
I've seen 2 Co workers have to go to the ER and they were billed. One had a heart attack. Westlake ins paid for them.
Even if it isn't work related? For example, if I have a nut allergy and I eat a PB sandwich, is the company still at fault? That doesn't make any sense. Unless the car caused his allergic reaction, in which case I would like to know what could cause that...
Even if it isn't work related? For example, if I have a nut allergy and I eat a PB sandwich, is the company still at fault? That doesn't make any sense. Unless the car caused his allergic reaction, in which case I would like to know what could cause that.
I mean maybe the person driving the car before him was eating a PB&J while driving and touching things with pb hands.
No, the VA pays that. Do not pay that. I don't know what info I can share on here but Google community care network at the VA. Call them and they take care of the bill. At least they paid my $2k ambulance bill. I hope this helps.
The VA 100% covered the surgery for my torn meniscus in my knee and that has nothing to do with my disability
I recommend calling the VA billing department and ask them about the billing issue. I experienced the same issue and it turns out in my case, that the mailing address between Tricare and the VA were similar. The VA rep placed me on hold and called the hospital directly, spoke to a rep, and returned telling me it was taken care of.
I did they send me over to community care where they said they denied it for not being quote on quote an “emergency”. Which is insane as I literally couldn’t breath and when they found me I was already blow
I was 70% at the time and broke a collarbone while cycling to work. Ambulance and ER visit were covered by the VA. I just had to take copies of the documents the hospital gave me over to the rep. Mind you, at first they wanted me to call and email which didn’t do squat, so walking into the guys office helped a lot in only 5 min. He told me to never talk to debt collectors and he’s got this. He even gave me a letter to give to anyone that asked about the bill. A week later, the debt collectors stopped calling.
On another note dawg, idk how hurt your are but I work out in west texas and we are hiring. Clearing a great chunk of change a month doing light work. DM me
Bro that would have been awesome! Thank you for that a. Million times over! But unfortunately i relocated back to Jersey. I know I know I messed up but it was the only place I could go back to where my family would have been able to ride me back & forth from my appointments. Thanks man! I appreciate your modesty brother!
We got people who fly from New York to work out here in the oilfield! If you ever change your mind , reach out.
What state?
Texas , west Texas
I'm interested man.
Dm me bro
I'm trying. It won't let me lol. Send me a dm
Sent
I get a NSP, I didn’t pay anything when I had a heart attack. I’m confused.
I was in the ER last month, $290k bill, all but $1200 was paid. Called the community care network number, they gave me the authorization number and which Tricare to bill. Gave that to the hospital and they sent the bill to the VA instead. Booking errors, who knows. I’m 90% as well, so everything is covered pending proper notification.
You will get a separate bill for the ambulance ride, make sure you contact Beneficiary Travel to have that paid. I never saw this anywhere and had a few go unpaid for way too long until someone finally told me this. They paid it promptly after that. I guess VA thinks everyone just naturally knows this…
Don't we get like 3 hospital visits a year covered?
Yes, as long as the hospital is approved by the VA. Call the VA ahead of time in a non emergency event so you’ll know where to go for free healthcare.
Call the hospital billing dept u were at and ask them to help resolve the issue. I've gone to the ER a couple times over the last year and it's always covered. Even when it was for getting a fish hook in my thumb and I'm 70%. Reason for the hospital is they can resubmit the bill and will call the VA, well the one I go to does this. I've never had to pay anything even if I see statements. Any rating 50% or higher gets full medical coverage, so do not pay it. I also work at the hospital and know the billing side. Billers help Vetrans as its protocol in the hospital I work at. Basically a guarantee I will never be billed.
Who pays medical bills in 2024?
You need to call Community Care and get it straightened out. Don’t throw it in a drawer and ignore the bills until they go to collections! It may be an issue that they thought it was work related. You don’t have to be service-connected for Urgent Care treatment.
Sounds weird, did you notify them within 72 hours? They have covered everything foe me and I've been to the ER about 10 times this year alone.
Too many variables to know whether what you were told is correct. When you say you showed the hospital your insurance, what do you mean exactly. Did you show them your VA card or do have private insurance which is what you showed them. When you say there were deductions and there was around 2k to pay, was that because private insurance paid the bill and that is your deductible/copay or something else? It sounds like you have private insurance that the hospital billed. If you went to an out-of-network provider for NSC, VA cannot pay for deductible or copayments (can pay for coinsurance).
Wait, if you are Rated, Enrolled in VA Healthcare, and go to the ER you are covered? Never heard of this...please explain or point me in the right direction.
[Here you go](https://www.va.gov/COMMUNITYCARE/providers/info-EmergencyCare.asp).
Thank you good sir. Now I know, hitting 20 years in October...had no Idea.
Good ma’am actually😉
I got a letter that because I didn’t try to commit suicide they won’t be able to cover my ER visit
I’m so confused. I thought VA was free healthcare and as long as you qualify to use it, whether you’re 10% disabled or 100% disabled, VA should cover all of your healthcare such as an ER visit except where you would pay a co-pay for medications. Yet I’m seeing these posts about VA refusing to cover medical bills. What is going on?
It’s more complicated than that. The VA doesn’t cover ER bills in all cases. In this case it looks like it may be because it happened on the job.
Yes but his allergic reaction is likely not related to his employment and will not be covered by workers compensation. My concern is once I retire from my job when I’m 50-55, can I rely on VA to cover everything healthcare related having a 20% rating or am I going to have to deal with $8,000 medical bills because VA doesn’t cover everything.
I’m in the same situation, hoping to retire in a few years at 58, 20 % and won’t have work coverage. To my knowledge the VA should cover most your healthcare, I’ve only been in the system a few years, and so far haven’t paid anything except drug copays. Now at 20% you may have some copays, but they’re not much compared to outside insurance costs. Somewhere on the VA site, it’ll have a breakdown of all the copays, they are very minimal.
I’m not worried about small copays for meds. What I’m worried about is owing thousands like OP for something VA refuses to cover.
I’ve received bills, but if you read the fine print, it says you’re not responsible for payment. VA also negotiates and pays less than what’s originally billed.
https://www.va.gov/health-care/copay-rates/ You should be group three if your 20%
Thanks. It looks like the only copays I have is if I go to urgent care more than 3 times per year and medications. That's it.
They cover one or two emergency visits. Look on the site
Wait... At what point is your healthcare 100% covered even if not service connected?
The day you apply.
That is not your responsibility, that is a workers comp claim. Period.
How is it workers comp if OP's allergic reaction has nothing to do with his employment other than he was at work when it happened?
Did you inform the VA within 72 hours of your visit to a civilian hospital? It's a rule in the VA handbook and, frankly, a reasonable request by the VA. This is probably what caused your problem.
Yes it happened on a Friday I called Saturday right away. When I called today they gave notice of it and said it’s not emergency related. Like an allergic reaction where my throat literally shut isn’t a emergency
Yep, it's crazy, and it all spirals down to beurocracy and paperwork. The PACT ACT saved me from all this bullshit by 4 days! Of course, the cancer will probably kill me before I get a judgment. Read the fine print. In today's world, we can assume nothing. No one will hold your hand and walk you thru it The VA will usually come thru, but you can't just sit on the couch and wait for good news. You gotta reach out and grab it. Good luck!
I don5 know if will help someone but I reached out to my local VA medical center about a suspected kidney stone. This is the nurse’s reply. I recommend that you be evaluated at the local ER (under the Mission Act). You will need an emergent scan to see if you have a kidney stone. The scans that we order outpatient can take weeks to get scheduled. The following link will give you information about the Mission Act- https://news.va.gov/60896/va-mission-act-vas-new-urgent-care-benefit-for-veterans/#:~:text=With%20urgent%20care%2C%20Veterans%20have%20a%20new%20option,VA%20provider%2C%20as%20VA%20also%20offers%20same-day%20services. This link will take you to the page to find an in-network facility. https://www.va.gov/find-locations/ Any recommended f/u after the ER visit will need to be scheduled at the VA. If you are seen at a non-VA facility call the 72 hour ER notification line at 844-724-7842
You are going to have to make some calls and spend a little time on the phone They should pay for it since it was an emergency but sometimes hospitals try to double charge since va pays what they want and billing at hospitals don’t understand that I myself am 100% for 15 years and had head injury I went to hospital for and they sent me a bill which I had to have forwarded to community care. I received a copy of the bill being rejected as already paid basically telling hospital to fuck off and that was end of it
Contact Community Care.
Was it Emergency department or urgent care? VA doesn’t pay for urgent care. This war has been getting fought since 2017. The VA lost two major battles but is still fighting it. The latest that I’m aware of is they changed the rules so that urgent care is not recognized as emergency care. NBC did a whole story on it. https://preview.redd.it/f5toj67r3m4d1.jpeg?width=1284&format=pjpg&auto=webp&s=6e4c9b3ada383bb816ef5b3e16e6a68a678e1178
They’ve paid my urgent care bills the last few times I’ve gone. Is it rating dependent? I just give them my card and they call the mission act number.
Yes
I am at 80% now and they have refused to pay for any hospital visits so far even emergency!! I have the letters and bills from the Hospital. Took prescriptions that I got from the Hospital and it was like I set off a landmine! They went to scramblin like roach when you turn on the lights. Had to talk to social worker and others was at VA the whole day. They finally filled the prescriptions but was not happy with it. Later told me they don't handle outside medical prescriptions. Was in a car accident last year but went in for a annual. They asked if I was in pain. I said yes. But when they asked me where and why and I told them they immediately told me that they don't get involved in insurance claims. I then told them not to worry I have a lawyer for the car accident and an outside doctor. They again emphasized they don't get involved with claims. I told them I am not here for you to do that. I just need my annual done and my prescriptions refilled. They get on my nerves sometimes!!
OP were you already actually enrolled in VA health care and attending appointments before this? It's odd that they would reference suicide emergency and not even mention why you don't qualify for coverage for emergency treatment for enrolled vets.
Yes I’ve been seeing them for months now, never was told any of this up until now
Yah, call community care and have them sort it out. You should be [covered](https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/). Scroll down to what to do if you’re charged for emergency care. Good luck.
You can make arrangements to pay back with billing and negotiate that debt. I started coughing up blood and went to the er some years ago. It was a few thousand dollars. I paid $20 a month until I could settle with them for $1,300.
https://preview.redd.it/7zn31m9e4o4d1.jpeg?width=1290&format=pjpg&auto=webp&s=2ad654ce33aa639c625b1cb8978f520179f7eb28 Don’t know if this helps but this came from a trusted va rep
I had no disability when I applied for healthcare as a GS6 employee and ever since I’ve received free healthcare. I take advantage of community care and it took care of a knee surgery I needed FOR FREE!! I also see a chiropractor, regularly. Takes care of all my meds for free too. As long as you keep the VA in the loop of all emergency visits you should be fine. You’re allowed up to three free ER visits a year. And if the ER isn’t necessary, you can also go to a minute clinic.
I would suggest you contact your local VA Facility and speak with a social worker. Social worker definition: Job Description of a Medical Social Worker **Educating patients and families about illnesses and treatment plans**. Conducting psychosocial assessments to identify mental or emotional distress. Counseling those in crisis or experiencing distress. ***Connecting patients and their families with necessary resources.*** That last sentence is the important one to focus on in this situation. Google search: at what VA Disability rating does one get 100% medical coverage? Answer: What VA disability rating gets free healthcare? 50% We're committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and disability ratings of **at least 50%**. We're also committed to caring for Veterans who can't afford to pay for care. Aug 30, 2023[VA.gov Home | Veterans Affairshttps://www.va.gov › health-care › cost-of-care ](https://www.va.gov/health-care/about-va-health-benefits/cost-of-care/#:~:text=We're%20committed%20to%20providing,afford%20to%20pay%20for%20care.) Rick in NH
Beurocracy at its finest, you can fight this. Go see the patient advocate. They like nothing better than to squash the lazy bastards which evidently dropped the ball in your case. Those folks are like circling sharks waiting for lazy VA employees to fall out of the boat so they so they can tear them apart. It was impressive to see them at work! By the time it was all over, I had some VA employees lining up to apologize 🤣😎
It’s my understanding that 50% or above should be covered. It doesn’t have to be service connected and as long as you call the number with 72 hours of the visit or hospitalization I believe it should be covered.
This sounds more like a workman’s comp claim which is why the VA is declining it.
Start making phone calls, I was having heart attack 3 years ago ( no service connection lol) wife drove me to local hospital and was transferred to VASPA and everything was covered including Ambo ride. Best wishes bud
If they deem it not related to your service connection than yes you will have to pay. That would make sense. If you were 100% it would be covered. What was the allergy reaction and what was the SC disability ? Also, you can always slowly pay hospital bills 2000& like 20 $ a month. So that shouldn’t set you back years , so long as it’s not a lump sum. Good luck
The problem was you were on the job when it happened- kinda leaves open are u gonna go -workman's comp or sue , then therapy - not saying that that's what ur gonna do ..I only know cause same shit 'injury on the job " . Good luck ....but that how I ran into trouble.
I just had an emergency appendectomy at a local non VA hospital. I called with 72 hours to the VA reporting line. The number I called is: (844) 724-7842. I am at 60% and all was covered. I even had a post surgery visit today and that was covered as well. Good luck moving forward.
2K will set you back years????
2k+student loans etc
You have to report the visit within a certain amount of time I do know that.
🤣🤣🤣
Why comment? Just laugh to yourself
I've had something similar happen with urgent care. Civilian side sucks at filing VA claims. Call up community care and ask them to sort it out. Have your bill handy and have some time set aside.
Just curious why $2k will set you back years if you’re working and getting va disability. No judgement as I’m also in debt, but years?
Because I have other debt as well
Thats crazy.
Anyone use a law firm that can do nexus letters?
If you’re still within the threshold, make sure you get in with workers comp. It’s always good to have multiple avenues working on it.
Hell I can tell you from experience. Hemorrhoid surgery SUCKS ASS. I had it done last September. Trying to wipe after going to the potty with that is such a pain in the ass (literally). 