Author Topic: Experiences with VA health care?  (Read 868 times)

NorCal

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Experiences with VA health care?
« on: November 02, 2019, 07:17:12 AM »
Does anyone here have experience with VA health care? 

While I served in the Army, I never had any service related disabilities or financial hardships, so I assumed I wouldn't qualify.  I recently learned that I do qualify, but at the absolute bottom of the VA priority list.  I live close to a VA hospital.

I'm considering leaving my job to be a SAHD, so I'm reviewing my options.  Kids would stay on my wife's insurance.

My health care needs are pretty basic.  I'm a 39y/o male, and I need
-Theoretically an annual checkup, but realistically a checkup every 2-3 years
-Coverage for emergencies.
-A flu shot whenever my wife guilts me into it.

From the VA website, I see:
1. Routine checkups are included at a VA hospital
2. I can use the VA emergency room or urgent care facilities
3. Emergency room at non-VA facilities is covered at 70% of medicare rates.  This seems to be a big financial risk.
4. Coverage outside the US is non-existent.  I don't have plans for foreign travel, but I'd have to figure out other options if I ever do plan to travel.

What are people's practical experience with the VA, good and bad?  Specifically, have you run into billing issues or payment challenges related to emergency care?  Is availability and access to primary care decent?  Anything else I should know while researching this?



FatFI2025

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Re: Experiences with VA health care?
« Reply #1 on: November 02, 2019, 10:16:11 AM »
Why wouldn't you just go on wife's insurance? I don't have any experience with the VA health system...because it's known to be so atrocious I stay away.

freya

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Re: Experiences with VA health care?
« Reply #2 on: November 02, 2019, 11:10:01 AM »
Most physicians have rotated through VA hospitals, so anyone with medical training will be able to tell you...

...that you probably don't want to rely on getting care at a VA.   I could tell you stories that would set your hair on fire.  The conditions can vary though.  Some medical schools have attending staff rotating through VAs, and those are likely to be better than average.  Otherwise, you are looking at the worst of the worst.   Many people use them only to get good prices on prescriptions.

If you're looking to save money for a period of time and you're healthy enough that you don't anticipate needing care, it might be worth taking a chance.  Wouldn't consider it for long term though.

tomorrowsomewherenew

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Re: Experiences with VA health care?
« Reply #3 on: November 02, 2019, 03:35:41 PM »
My husband's experience with VA healthcare has been excellent. The care he receives is far better than what I receive in the civilian marketplace. And, he never has to deal with insurance f@ck ups like I do. However, since it's sounds like you're priority group 7, you need insurance. That doesn't mean I wouldn't utilize the VA if they have space for you though. I would go to the VA over a civilian medical facility any day.

FatFI2025

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Re: Experiences with VA health care?
« Reply #4 on: November 03, 2019, 05:55:04 AM »
My husband's experience with VA healthcare has been excellent. The care he receives is far better than what I receive in the civilian marketplace. And, he never has to deal with insurance f@ck ups like I do. However, since it's sounds like you're priority group 7, you need insurance. That doesn't mean I wouldn't utilize the VA if they have space for you though. I would go to the VA over a civilian medical facility any day.

Wow, this is a surprising departure from what you normally hear!

FL_MM

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Re: Experiences with VA health care?
« Reply #5 on: November 03, 2019, 06:25:24 AM »
My husband has VA care. Weíve been very impressed.

NorCal

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Re: Experiences with VA health care?
« Reply #6 on: November 03, 2019, 06:30:03 AM »
Why wouldn't you just go on wife's insurance? I don't have any experience with the VA health system...because it's known to be so atrocious I stay away.

One important point I forgot to mention:
1. VA Health Care = Nearly free, other than some minor copays
2. Wife's insurance = $1,100 per month + copays and random $100+ bills from every medical visit because insurance doesn't fully reimburse.

Like everyone else, I hear the VA horror stories, but I don't know how much of that is real vs. complaints designed to increase funding, or complaints without the context of how bad health insurance is everywhere else.

I had never considered looking into it previously, as I had heard the same stories.  I recently found out about it when a friend started using the VA system and had an excellent experience.  I'm very interested in hearing more first or second hand accounts.

NorCal

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Re: Experiences with VA health care?
« Reply #7 on: November 03, 2019, 06:35:37 AM »
My husband's experience with VA healthcare has been excellent. The care he receives is far better than what I receive in the civilian marketplace. And, he never has to deal with insurance f@ck ups like I do. However, since it's sounds like you're priority group 7, you need insurance. That doesn't mean I wouldn't utilize the VA if they have space for you though. I would go to the VA over a civilian medical facility any day.

Thank you for sharing!  This is very helpful.  I'd actually be priority group 8g (the true bottom of the list).

Do you have any knowledge about what type of insurance would make sense to pair with the VA care?  I'm just starting to research this, and not finding much that is useful.  I'd love to find some type of emergency-only insurance since that's the biggest gap I see in the VA coverage (if something happens when you're not near the VA).

Peach

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Re: Experiences with VA health care?
« Reply #8 on: November 03, 2019, 08:21:00 AM »
My husband has been using the VA solely for many years, but he is classified as priority 1.  For the most part, he has had great care.  On the downside, sometimes the wait time for appointments is a little long.  Now he's old enough for Medicare Part B and although he's signed up, he has never had to use it.  We both are very grateful and feel fortunate that the VA has been there to take good care of him.

He has been hospitalized at the VA many times with major operations and the care varies by location.  He's never really had anything to complain about, though.  He's had some extremely good doctors and other just adequate doctors -- just like in the real world.  One thing I like is that they are never in a big hurry to kick him out of the hospital like they are in civilian hospitals.  He's also had to use the emergency room on a few occasions, and they are never as crowded as civilian hospitals. 

I can't speak to what you may face as priority 8.  I have the same feeling as "tomorrowsomewherenew" in that hubby's VA healthcare is less of a hassle than mine.


spartana

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Re: Experiences with VA health care?
« Reply #9 on: November 03, 2019, 08:46:17 AM »
I use the VA. I used it for many years just for my service-connected injuries s but started using it for all my medical once I FIREd and the ACA was enacted. Im in Priority Group 2 so only have to pay co-pays for meds. $5 for 30 day generic and $15 for non-generic.

If you are in a the last 2 Priority Groups (7and 8 I believe) you will not only have co-pay for meds but all so all your care. You can look on the VA website under co-pays and see how much they will be but they seem to be inline with non-VA care. $25/doctor visit. $50/specialist. Etc. I believe the in-patient hospitalization was the highest around $100/day or more but no sure. Could get pretty pricey but you'll pay no premium so that off sets cost a lot.

The other thing is potential budget cuts. The priority group's are more about the VA's annual budget then they are about how soon you'll get an appointment. If the budget is cut then the lower Priority Groups are cut. Obama reinstated the last group but that could change.

The other thing to 've concerned about is emergency care at a non-VA hospital. While technically the VA can and does reimburse a non-VA hospital for your emergency care, I have read of some stories that people had hard time getting them to do it and are strapped with having to pay those costs 100%.

You can also combi e the VA with other medical insurance. You can have the VA and Medicaid,  Medicare, private insurance thru your job or an ACA plan. The VA usually will fill in the gaps of your private insurance out of pocket costs (or vice versa so you pay no VA co-pays if using a VA hospital and have both VA and private insurance). I had both for all my civilian working years and then when on COBRA and a private plan. The only thing you can't get is subsidies if using the ACA even if you qualify for them. Gotta pay full cost for your ACA private insurance premiums.

Also the VA has (or had) a program where you could use a private doctor if you couldn't get an appointment at the VA within a month. They would pay 100% of that but I'm not sure if that includes the lowest Priority Group. Same with sending you to a non-VA provider for specialized testing or treatment. There are probably more things Im forgetting  but maybe @Nords can chime in.

As far as my personal experience using the VA it's be great. They are very pro-active about getting lots of stuff done - almost the point of getting naggy about it. I have always gotten appointments within a couple of weeks or less (much sooner then I ever have with my private insurance) and they have always spent a lot of time going over everything with me. No rush to move you along asap. It has been a much better experience then anything I've had in the private world. I also like that it's easily transportable and I can use any VA hospital or clinic anywhere. 

ETA Im a woman and the VA has started having Women's  Clinics at their hospitals now an they are great. Since their are fewer women vets using the VA it definitely speeds up getting an appointment.
« Last Edit: November 03, 2019, 09:08:13 AM by spartana »

NorCal

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Re: Experiences with VA health care?
« Reply #10 on: November 03, 2019, 11:40:59 AM »
Peach and Spartana:  Thank you so much for your responses!  I'm glad to hear you've had some good experiences. 

I'm honestly entirely fed up with our PPO plan (mostly the structure of the healthcare market in general) that I want to try something new.

I've also been taking my kids to a hospital that supposedly all the "best of the best" doctors go to.  I've actually been pretty unimpressed.  All the doctors are clearly well qualified, but they're so specialized that they're not prepared for any questions outside their very narrow expertise.  This isn't to say there isn't a difference.  I just strongly suspect that patient satisfaction and care has a low correlation with the "premier" hospitals.

I really wish I could find some type of supplemental plan that would fill in some of the gaps in VA care.  I think using a VA doctor and planning to use a VA emergency room (when appropriate) is a great primary plan.  Right now, all I see is a VA-only plan, or adding my wife's $1,100 per month PPO plan on top of it. 

Maybe there's some middle ground I'm missing?

Nords

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Re: Experiences with VA health care?
« Reply #11 on: November 03, 2019, 02:50:02 PM »
Thanks for the tag, Spartana!

While I served in the Army, I never had any service related disabilities or financial hardships, so I assumed I wouldn't qualify. 
You donít explicitly say, NorCal, so let me ask:  have you filed a VA disability claim and gone through the Compensation & Pension screening exam by doctors to obtain a VA disability rating?  Even if that rating is 0%?

If you have not gone through the claims process then you should.  Itís not just for your benefit but to help your family claim all of the benefits for which youíve already paid the price:
https://the-military-guide.com/file-veterans-disability-claim-not-just/

Your VA disability rating qualifies you for free treatment of your service-connected disability issues.  It also enables the VA to pay for your treatment (for service-connected issues) at emergency rooms.  This is not much help if your service-connected disability is knee damage and you break your arm.  However itís essential for those vets who have diabetes caused by exposure to Agent Orange and require both maintenance insulin as well as occasional emergency treatment.

I recently learned that I do qualify, but at the absolute bottom of the VA priority list.  I live close to a VA hospital.
Again, you might have already done this, but let me mention it:  please register at your local VA hospital or clinic and have them formally classify you at the priority 8 level.  When you register in their service area then they get credit for having another military vet in their region, which helps them get their fair share of funding.  That funding flows directly to hiring more doctors & staff.

Does anyone here have experience with VA health care? 
As youíve noted from the other comments, the quality of the VAís healthcare is unevenly distributed.  If you have a good hospital or clinic in your area then use it as long as youíre happy with it.

-A flu shot whenever my wife guilts me into it.
Apparently itís been a while since youíve had a case of the flu.

If the potential pain (and small risk of respiratory damage) isnít enough to persuade you to get an annual flu shot, then at least consider getting one to avoid passing the virus to your kids.  The younger & more reactive your immune system, the more likely the flu virus is to cause complications. 

Iíve been getting annual flu shots since 1978 and Iíve still had the flu.  (And bronchitis.  And pneumonia.)  I canít imagine how much worse it wouldíve been if Iíd not made the time for the shot.

What are people's practical experience with the VA, good and bad?  Specifically, have you run into billing issues or payment challenges related to emergency care?  Is availability and access to primary care decent?  Anything else I should know while researching this?
Iíd start by chatting with a Veteran Service Officer from a local chapter of the Veterans of Foreign Wars, or the Disabled American Veterans, or the American Legion, or even MOAA.  You can find more info here:
https://www.benefits.va.gov/vso/

Hereís a directory:
https://www.benefits.va.gov/vso/varo.asp

Theyíre not just for helping you file a VA disability claim, but also for figuring out whether you can be treated at your local VA clinic or hospital.  (If they have the experience, they might also suggest why you wouldnít want to be treated there.)  Theyíll  be able to go over all of the cost shares and co-pays.

You can also try talking to your state Veterans Affairs office.  (Depending on the size of the state there may be an office in a city near you.)  They can also help you figure out what state options you might be eligible for.

By the way, if "NorCal" implies that you're a California resident, then your VA disability rating makes your kids eligible for the state's university scholarships:
http://gubmints.com/2016/09/05/the-122k-mistake-i-made-leaving-active-duty/#.XbN6hbJlDmo

NorCal

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Re: Experiences with VA health care?
« Reply #12 on: November 04, 2019, 06:56:01 AM »
Thank you Nords!

I finished the application for VA health care yesterday, so I'll get their packet in the mail shortly.  I wouldn't have anything to claim for a disability rating.

In regards to the flu, I don't get hit hard by the flu itself (and only catch it infrequently), but the symptoms of the flu shot hit me harder than being sick.  I've been begrudgingly getting it the last few years since I have young kids.  For some reason, I also got billed $84 for getting the shot this year.  Now I get the fun of deciding whether it's worth $84 to start a fight with my insurance company (part of the reason I'm sick of PPO's).

I used to live in California, but I'm now in Colorado.  I actually live about 2 miles from the huge VA hospital in Aurora.  It gets a good review from the one person I know who goes there.  Thank you for the links for local resources.  I will check those out.