VA To Offer Health Care to Previously Ineligible Veterans

[quadvet]

VA To Offer Health Care to Previously Ineligible Veterans

http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1641

January 8, 2009

WASHINGTON – The Department of Veterans Affairs (VA) announced today plans to re-open enrollment in its health care system by July 2009 to about 265,000 veterans whose incomes exceed current limits.

"We’re pleased to be able to offer what has been called ‘the best care anywhere’ to many more new veterans," said Dr. James B. Peake, Secretary of Veterans Affairs. "We’ll be able to provide these newly enrolled veterans with the kind of timely, high quality health care veterans who already use our system are accustomed to."

The change affects veterans whose incomes exceed the current VA means test and geographic means test income thresholds by 10 percent or less. Congress provided funds in VA’s fiscal year 2009 budget to support the new enrollment.

In 1996, Congress established a priority-based enrollment system for VA and a uniform package of medical benefits for all enrollees. The legislation opened enrollment in VA’s health care system to all eligible veterans and required that each year the Secretary of Veterans Affairs assess veterans’ demand for services and determine if the necessary resources are available to provide timely, quality care to all enrollees.

Enrollment for the lowest priority of the eight groups—veterans who are not being compensated for a military-related disability and who have incomes above a set threshold—was suspended on January 18, 2003, although veterans in that priority group who were already enrolled for care were permitted to remain enrolled.

VA originally suspended enrollment for Priority 8 veterans because it was unable to provide all enrolled veterans with timely access to its health care due to a tremendous growth in the number of veterans then seeking enrollment. VA now plans to reopen enrollment for a portion of these veterans without compromising the Department’s ability to provide high quality health care services to all enrolled veterans who are eligible for care.

VA’s computer systems are being modified to accommodate the changes, and the Department is preparing communication and education materials to ensure that Congress, veterans service organizations, and the public are aware of the coming changes.

"The rule will take effect by June 30, 2009, if the regulatory process proceeds smoothly," Peake said. "We look forward to welcoming these newly eligible veterans into the VA system. VA will continue to monitor wait times to ensure the quality of care is not adversely affected."

[skippy13]

I'm category one and it doesnt mean diddly squat. I still have wait times up to a month for a regular appointment, and several months for an MRI or other type test. I cant see that adding more people into the system will do anything but slow down the system. The people at my local clinic seem to be pretty busy already. No slackers there.

I do feel that everyone who is qualified should get care if no other resource is available.

[Veteran Advisor]

I'm category one and it doesnt mean diddly squat. I still have wait times up to a month for a regular appointment, and several months for an MRI or other type test. I cant see that adding more people into the system will do anything but slow down the system. The people at my local clinic seem to be pretty busy already. No slackers there.

I do feel that everyone who is qualified should get care if no other resource is available.

This debate about expanding VA care (some argue that it's nothing but socialized medicine in sheep's clothing) has been going on for some time. It's sad that it's come to a veteran-versus-veteran situation. I do know quite a few vets who are over the income limit and not service connected but badly need some help with health care costs. The question is whether this falls within Lincoln's promise "to care for him who shall have born the battle."

[skippy13]

I hope I didn't imply a vet vs. vet attitude. I dont mean to. I dont know how I feel about it yet. I do know that unless the system is expanded to accommodate all vets, it will have to have an impact on services as they are now. They are stretched pretty thin already. I have a feeling that it is going to be required that any vet eligible for medicare/medicaid use those services as a first resource. How else can the system avoid getting overloaded?

[Sue Pendleton]

This debate about expanding VA care (some argue that it's nothing but socialized medicine in sheep's clothing) has been going on for some time. It's sad that it's come to a veteran-versus-veteran situation. I do know quite a few vets who are over the income limit and not service connected but badly need some help with health care costs. The question is whether this falls within Lincoln's promise "to care for him who shall have born the battle."

When you say "not service connected" do you mean injured while serving but off duty and doing something stupid or hurt by crime, etc? Or do you mean people injured after they have left the service? If the second and the injury is not connected to service like the Agent Orange vets than we have cared for those who bore the battle and they should look for civilian care.

I was injured 7 years after I ets'd and I shouldn't receive care at VA hospitals or clinics. I do receive Space A at military hospitals, clinics and have TRICARE For Life as the spouse of an Army Retiree. And yes, I'm trying to get him to have his hearing tested. His retirement physical showed significant loss in one ear and if it gets worse than he'd get either more retirement pay or a small VA pension. A year of mortars going off all around you in VN kills hearing faster than marriage. :D

[Veteran Advisor]

When you say "not service connected" do you mean injured while serving but off duty and doing something stupid or hurt by crime, etc? Or do you mean people injured after they have left the service?

Non-service connected in this context means any vet with a disability that has no in-service nexus or was due to willfil misconduct. There are a number of disabilities presumptively connected to service long after discharge (MS in a 7 year period, ALS at any time, etc.), in which case the nexus is established by statute.

[Veteran Advisor]

I hope I didn't imply a vet vs. vet attitude. I dont mean to.

That comment wasn't specifically directed at your post. But I've seen firsthand how the discussion often revolves around a "rob Peter to pay Paul" scenario that pits veteran segments against each other, including those on active duty who have a catastrophic injury and are pending discharge. An easy example is the dental backlog.

[SCI-Nurse]

Keep in mind also that if you have a SCI, you nearly always will qualify as a Category IV priority veteran, regardless of your income, so it would be rare that someone who is a NSC veteran with a SCI should not already qualify for VA care without this new ruling. Unfortunately we still run into veterans who don't know this, and eligiblity offices who don't properly rate the veteran when they apply.

Sue, as you know, you are eligible for VA care. If you choose to get your care elsewhere, that is your decision. Many veterans do not have other options, or choose the qualify of the VA SCI System of care in spite of having other insurance.

(KLD)

[Sue Pendleton]

Keep in mind also that if you have a SCI, you nearly always will qualify as a Category IV priority veteran, regardless of your income, so it would be rare that someone who is a NSC veteran with a SCI should not already qualify for VA care without this new ruling. Unfortunately we still run into veterans who don't know this, and eligiblity offices who don't properly rate the veteran when they apply.

Sue, as you know, you are eligible for VA care. If you choose to get your care elsewhere, that is your decision. Many veterans do not have other options, or choose the qualify of the VA SCI System of care in spite of having other insurance.

(KLD)

I'm well aware of my VA eligability. The guys at the Am. Legion practically came to get me to sign up when I just wanted, and didn't get, their support for the state SCI cure bill.

My problem with NSC vets, excepting the Agent O, MS, ALS and some PTSD is this is quickly adding vets who should be carried for the same as non-vets. It's a start to universal healthcare and I know too many who are waiting for VA appointments for long periods and longer for needed equipment. For those who have other insurance as NSC vets does the VA bill their other insurance for any services? When I see my physiatrist at Walter Reed there is a flat $100 billed to our FEP insurance. Tests and labs or inpatient stays are free but regular office visits are billed only if you have other insurance.

I'm not a vet against vet type. I am against universal healthcare. Guarenteed insurance yes but lower standards for all? No.

[SCI-Nurse]

Yes, if you have other non-federal insurance we bill them for your care at the VA for NSC conditions, but you get the same care even if they don't pay. Of course the reality is that the vast majority of those with SCI don't have private insurance, and right now we are not allowed to bill Tricare (except for active duty under certain MOUs), Medicare, or Medicaid.

In addition, Category 7 & 8 (and sometimes 6) veterans often have a co-payment for their care, both inpatient and outpatient. The ruling above does not remove the co-payment requirement, it only allows us to start enrolling category 8 veterans again, which has been prohibited for the last few years.

There are many differences in the non-medical care benefits between NSC and SC, but we don't provide lower quality care to NSC veterans...that would be extremely unethical. The differences are much more in things like pension, and some of the specialty prosthetics coverage (such as home modifications) and housing modification grants.

(KLD)

[quadvet]

What's the ratio of NSC veterans versus SC veterans that use VA SCI services? What's the chronicled history of that number? How much has the the overall number of those using SCI services increased over the years? How has funding kept up? ETA: What has the VA SCI system done to accommodate these increased numbers?

Those would be my questions.

[Sue Pendleton]

Exactly. It wasn't that long ago that the PVA had to fight to keep beds in Tampa's SCI Unit reserved for vets with SCIs. The place was continually filled with able bodied vets.

What's the ratio of NSC veterans versus SC veterans that use VA SCI services? What's the chronicled history of that number? How much has the the overall number of those using SCI services increased over the years? How has funding kept up? ETA: What has the VA SCI system done to accommodate these increased numbers?

Those would be my questions.

[SCI-Nurse]

Do you have proof of this? As a polytrauma center, Tampa might have to take non-SCI injured OEF/OIF veterans into their SCI Center if they have empty SCI beds, but we have to do that too if the hospital as a whole is very busy. If we are not full, and the med-surg units are, we sometimes have to take a "boarder" med-surg patient. How can we turn patients away when the hospital as a whole has beds???? This would also not be acceptable or ethical. When a med-surg bed opens up, we move them back in order to free up the bed for SCI patients as needed.

(KLD)