V.A. Health Insurance

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Leesbro63
Posts: 6945
Joined: Mon Nov 08, 2010 4:36 pm

V.A. Health Insurance

Post by Leesbro63 »

My cousin got divorced three years ago and went off her husband's employer insurance. She served 3 years in the Air Force in her early 20s (she's 54 now) and has VA health insurance that she's been using since the divorce. So far it's been good for her. My question is this: Is this good insurance? She's been very healthy, but what if she becomes not-so-healthy? To get private coverage on her own, she'd be looking at about $900 per month for a low deductible plan or a bit less for a higher deductible. This VA coverage seems decent, bit I'm wondering what happens if she wakes up with something, has an emergency, chronic illness or acute health crisis? She's asked me what I think and I just don't know. I understand her desire to make this her only insurance, because it's basically free. What can you tell me?
ScubaHogg
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Joined: Sun Nov 06, 2011 3:02 pm

Re: V.A. Health Insurance

Post by ScubaHogg »

No personal experience, and I know what the VA will and won’t do varies based on service history. Your friend is probably better off asking a bunch of questions to the VA. Their local Veteran Service Officer is probably a good starting point

https://nvf.org/veteran-service-officers/
“Unexpected Returns dominate the Expected Returns” - Ken French
Topic Author
Leesbro63
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Joined: Mon Nov 08, 2010 4:36 pm

Re: V.A. Health Insurance

Post by Leesbro63 »

ScubaHogg wrote: Mon Oct 12, 2020 7:01 am No personal experience, and I know what the VA will and won’t do varies based on service history. Your friend is probably better off asking a bunch of questions to the VA. Their local Veteran Service Officer is probably a good starting point

https://nvf.org/veteran-service-officers/
I think hearing real world stories is more important, but thank you fir that link.
ScubaHogg
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Re: V.A. Health Insurance

Post by ScubaHogg »

Leesbro63 wrote: Mon Oct 12, 2020 7:05 am
ScubaHogg wrote: Mon Oct 12, 2020 7:01 am No personal experience, and I know what the VA will and won’t do varies based on service history. Your friend is probably better off asking a bunch of questions to the VA. Their local Veteran Service Officer is probably a good starting point

https://nvf.org/veteran-service-officers/
I think hearing real world stories is more important, but thank you fir that link.
VSOs literally exist to help folks navigate the confusing VA bureaucracy. I encourage your friend to reach out.

The problem with “real world stories” is that the VA covers different things for different people, so any personal responses you get might not be applicable. Does your friend have a service connected disability? Well, they will probably cover that. What if she gets cancer? No idea. 3-4 years of service not in a war zone (guessing) isn’t a “lot” in the VAs eyes. The particulars of her case will likely overwhelm the general responses you get here.
“Unexpected Returns dominate the Expected Returns” - Ken French
dpm321
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Joined: Sun Mar 04, 2012 6:04 pm

Re: V.A. Health Insurance

Post by dpm321 »

I assume when you say “VA Health Insurance” you mean that this person is qualified for VA medical care. The VA does not offer insurance. There are as many opinions of the quality of VA health care as there are patients. I’m qualified as a result of a service connected disability but choose to get my primary health care via other vehicles because the quality at the VA is variable. That said, it is free. The biggest issue that you may have is that the VA has what is referred to as “priority groups” that are used to ration or prioritize care when resources become limited. Because of that, depending upon your group, you run the risk of being denied care when needed. If you have other options I would recommend using the VA as a fallback.
shiftyg
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Re: V.A. Health Insurance

Post by shiftyg »

I use VA Health Care and agree with all said above - there are a lot of different care options depending on your individual situation. When you enroll in VA health care post-military service, they send you a lot of information on the different options, and have a pretty decent online system as well. There are a lot of resources for your cousin to have any questions answered.
In my sample size of one, VA health care has been very good for routine care, including annual exams, lab work, etc. Their optometry has been very good, and I have not used their dental services at all. Their telehealth system has worked okay for specialist consults, about as well as the systems I use for work. And as you said it doesn't cost anything, including prescriptions, so the price is right
If I had more complex issues or needed something beyond outpatient surgery/treatment I would certainly explore my options outside the VA, but that would be true of any provider.
Hope this helps
bmwr1200s
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Re: V.A. Health Insurance

Post by bmwr1200s »

Long time lurker, first time poster. I work as a rehab therapist at one of the largest VA hospitals, plus was in the Marines for 5yrs, so I can provide a little information that may help.

Just like there's differences between some major medical center hospitals and small rural hospitals, the same is true for the VA. Water Reed (not my Location) will be much better than a VA hospital in Pig's Knuckle Tennessee.... same would be true when comparing John Hopkins to Pig's Knuckle General.

Your concern seems to be for chronic or acute conditions. This is standard business at our hospital. While the processes can be a little frustrating (it's the government after all), if you have something like breast cancer, ALS, Parkinsons, etc...the services available are almost endless. For example, you can no longer get into your bathtub, there's money to replace your tub w/ a roll in shower. Private sector doesn't care if you can't safely get in/out of the tub to bathe. In my role, I can see a patient as long as I want and order whatever equipment I deem appropriate and in the best interest of the patient's care. That definitely doesn't happen in the real world.

Do we get things wrong, yup.... just like any other large organization. The main problem w/ the VA health system is that it is tied to disability ratings. First let me say, if the government injured you then you deserve the appropriate care and compensation. The problem is that too many people try to game the system. The goal is to keep getting your disability rating increased so that you can get paid more money. For example when I see someone w/ shoulder pain and I ask them how it happened, the answer is almost always about some fall they had 30 years ago while in the military, never mind the fact that they worked construction or as a mechanic for the past 25yrs. It's always that one fall they had at the height of their health and vitality. This is the foolishness that clogs up the system for those who really need the care.

So to make a long story l short, if your family member is happy w/ the care then I wouldn't worry.

This was typed on my phone so please excuse any typos.
Topic Author
Leesbro63
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Joined: Mon Nov 08, 2010 4:36 pm

Re: V.A. Health Insurance

Post by Leesbro63 »

bmwr1200s wrote: Mon Oct 12, 2020 8:46 am Long time lurker, first time poster. I work as a rehab therapist at one of the largest VA hospitals, plus was in the Marines for 5yrs, so I can provide a little information that may help.

Just like there's differences between some major medical center hospitals and small rural hospitals, the same is true for the VA. Water Reed (not my Location) will be much better than a VA hospital in Pig's Knuckle Tennessee.... same would be true when comparing John Hopkins to Pig's Knuckle General.

Your concern seems to be for chronic or acute conditions. This is standard business at our hospital. While the processes can be a little frustrating (it's the government after all), if you have something like breast cancer, ALS, Parkinsons, etc...the services available are almost endless. For example, you can no longer get into your bathtub, there's money to replace your tub w/ a roll in shower. Private sector doesn't care if you can't safely get in/out of the tub to bathe. In my role, I can see a patient as long as I want and order whatever equipment I deem appropriate and in the best interest of the patient's care. That definitely doesn't happen in the real world.

Do we get things wrong, yup.... just like any other large organization. The main problem w/ the VA health system is that it is tied to disability ratings. First let me say, if the government injured you then you deserve the appropriate care and compensation. The problem is that too many people try to game the system. The goal is to keep getting your disability rating increased so that you can get paid more money. For example when I see someone w/ shoulder pain and I ask them how it happened, the answer is almost always about some fall they had 30 years ago while in the military, never mind the fact that they worked construction or as a mechanic for the past 25yrs. It's always that one fall they had at the height of their health and vitality. This is the foolishness that clogs up the system for those who really need the care.

So to make a long story l short, if your family member is happy w/ the care then I wouldn't worry.

This was typed on my phone so please excuse any typos.
Great info; thank you for replying. She lives near a great VA facility in the Pittsburgh area. And they’ve been great so far.
Tuxedo
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Re: V.A. Health Insurance

Post by Tuxedo »

Leesbro63 wrote: Mon Oct 12, 2020 6:33 am She served 3 years in the Air Force in her early 20s (she's 54 now) and has VA health insurance that she's been using since the divorce.
Does she have a service-connected disability?

If yes, what is her disability rating?
Soon2BXProgrammer
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Joined: Mon Nov 24, 2014 11:30 pm

Re: V.A. Health Insurance

Post by Soon2BXProgrammer »

Leesbro63 wrote: Mon Oct 12, 2020 6:33 am My cousin got divorced three years ago and went off her husband's employer insurance. She served 3 years in the Air Force in her early 20s (she's 54 now) and has VA health insurance that she's been using since the divorce. So far it's been good for her. My question is this: Is this good insurance? She's been very healthy, but what if she becomes not-so-healthy? To get private coverage on her own, she'd be looking at about $900 per month for a low deductible plan or a bit less for a higher deductible. This VA coverage seems decent, bit I'm wondering what happens if she wakes up with something, has an emergency, chronic illness or acute health crisis? She's asked me what I think and I just don't know. I understand her desire to make this her only insurance, because it's basically free. What can you tell me?
The VA has been pretty good for me besides having to "deal with the VA".

A couple things to be aware of... Depending on the priority group, for the lowest priority group 8's there isn't a guarantee of funding
https://www.va.gov/health-care/eligibil ... ty-groups/
There is risk that for the lowest priority groups that funding will continue. The VA already has congressional authority to only service high priority groups in areas where they are budget/capacity strained.
https://www.cbo.gov/budget-options/2018/54782

VA Healthcare is NOT insurance. The has community outpatient urgent care, but it is very important to go to those locations. I am not sure about true "emergency" care. While i have used the VA helathcare extensively, i have had other insurance as I must insure my family. Therefore, i'm not sure what someone does with only VA healthcare.

It would be worth investigating with the VA how emergency care works. (both in and out of your local area).
Topic Author
Leesbro63
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Joined: Mon Nov 08, 2010 4:36 pm

Re: V.A. Health Insurance

Post by Leesbro63 »

Tuxedo wrote: Mon Oct 12, 2020 10:43 am
Leesbro63 wrote: Mon Oct 12, 2020 6:33 am She served 3 years in the Air Force in her early 20s (she's 54 now) and has VA health insurance that she's been using since the divorce.
Does she have a service-connected disability?

If yes, what is her disability rating?
I’m not sure of her disability status but will check.
Last edited by Leesbro63 on Mon Oct 12, 2020 7:35 pm, edited 1 time in total.
John88
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Re: V.A. Health Insurance

Post by John88 »

I used the VA system while I was out of work about 12 years ago and used it for about 3-4 years. For me the care was outstanding and proactive certainly better than Kaiser. For example they contacted me to set up 6 month check ups. I had to tell them once a year is ok with me. As opposed to Kaiser where you need to reach out to them for routine appointments.

I also had a colonoscopy at the VA and was treated for elbow tendinitis by physical therapists. All excellent care.
Oilcans
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Joined: Tue Mar 27, 2018 12:50 pm

Re: V.A. Health Insurance

Post by Oilcans »

Lot's of great comments here. Don't know that I can offer any specific advise. I am a disabled vet who has used the VA some as well as medical services outside the VA. I have been quite satisfied with the VA especially with dental care. I would recommend 1) listening to all the good advice here, (2) contact your closest Veteran Service Officer (don't know if they are taking appointment now with the virus), (3) go to Hadit.com where you may get some good advice.
Katietsu
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Re: V.A. Health Insurance

Post by Katietsu »

Leesbro63 wrote: Mon Oct 12, 2020 9:15 am
Great info; thank you for replying. She lives near a great VA facility in the Pittsburgh area. And they’ve been great so far.
If she is comfortable going to Oakland for specialty care, if needed, then I suspect she will be happy with her options. It is an excellent facility. I believe many of the specialty physicians are UPMC faculty, fellows and residents.

She will need to talk to someone at the VA to understand her potential costs. As others have said, vets are put into different priority groups that can have different copays.
Rudy Tooty
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Re: V.A. Health Insurance

Post by Rudy Tooty »

The VA saved my life. Twice. I've been in community hospitals too. When it comes to patient care - the VA Medical Center wins hands down.

No complaints here. I thank my lucky stars.
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