VA Health Care

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rocket
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VA Health Care

Post by rocket » Sun Jun 26, 2011 6:23 pm

Would you drop your BCBS insurance ?
Do you think VA health care is good ?

I have had the option of using the VA for my health care for about 2 years. I am 20% disabled from side effects of protate cancer surgery from sleeping in Agent Orange. I also have BC/BS insurance. My co-pay for BCBS or VA for doctors appointment or prescriptions are approximately the same cost. I could switch to VA only and quit my BCBS and save around $175 per month insurance fee. I am relunctant to use VA physicians. If I ever drop BCBS insurance, I can NEVER get BCBS again. I only use the VA for prescriptions for very expensive pills. I go to my non-VA physician for everything else.

p_qrs_t
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Post by p_qrs_t » Sun Jun 26, 2011 6:57 pm

Rocket,

I can not answer this question for you perfectly. I would be reluctant to encourage you to give up insurance that you will never again be able to obtain, especially for $175/month which is a relatively paltry sum when it comes to health care co pays.

I would suggest looking into whether an academic center runs the VA you frequent. Besides having access to the best national medical records system, it will then also use physicians from the academic center.

I work at a University Hospital, which provides the physicians for the VA. I am tremendously proud of taking care of vets, and I make d**n certain that my patients get the same care that they would at the University. My friends who are active duty expect no less.

Anuj

dhodson
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Post by dhodson » Sun Jun 26, 2011 6:59 pm

If you are that uncomfortable with va physicians then keep your bcbs. The va does some things well and others not as well. I am not agreeing with your assessment but given your feelings, I'd keep the bcbs

dhodson
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Post by dhodson » Sun Jun 26, 2011 7:03 pm

I've used multiple EMRs and I can't say ahlta or vista is the best.

fishndoc
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Post by fishndoc » Sun Jun 26, 2011 7:34 pm

I am relunctant to use VA physicians. If I ever drop BCBS insurance, I can NEVER get BCBS again
I believe you answered your question yourself.

Another point to consider, and I don't know the answer: has the VA facilities and capabilities increased to care for the influx of new patients and injuries/illnesses associated with our long mid-East wars?
I know when I worked at the VA as a resident (long ago), the wait for elective surgery was measured in months.
" Successful investing involves doing just a few things right, and avoiding serious mistakes." - J. Bogle

rocket
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Post by rocket » Sun Jun 26, 2011 7:57 pm

dhodson wrote:I've used multiple EMRs and I can't say ahlta or vista is the best.
What is EMR ?
What is AHLTA ?
What is Vista ?

dhodson
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Post by dhodson » Sun Jun 26, 2011 8:10 pm

Electronic medical record

The name for the active duty and va programs

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norookie
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Post by norookie » Sun Jun 26, 2011 8:18 pm

:D I'd equate that to dumping private sector quality on .gov sector 1 size fits all. My mind works in odd ways. :? Drs seem more accommodating to BCBS, than .gov payment %'s for services payments.
" Wealth usually leads to excess " Cicero 55 b.c

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johnoutk
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Post by johnoutk » Sun Jun 26, 2011 9:36 pm

I would keep your BCBS. Only see the VA for the expensive refills. Keep your regular doctor. Speaking from inside experience, the VA is not good healthcare.

Penguin
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Post by Penguin » Sun Jun 26, 2011 10:28 pm

Some patients with prostate cancer from agent orange are eligible for more than 20 % service connected disability. Often if you appeal and can raise the service connected disability to 50% or more (this may be prostate cancer plus diabetes, PTSD or other service connected diagnoses) you can get all your medical care at the VA for free. If you wish to appeal you should contact your local vet center which provides services to veterans who have been in combat theater in or DAV center. Sometimes it is necessary to be persistent to find someone to help you appeal.
The quality of care varies from VA to VA. You are eligible to go to any VA that you choose.
Jon

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White Coat Investor
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Re: VA Health Care

Post by White Coat Investor » Sun Jun 26, 2011 10:48 pm

rocket wrote:Would you drop your BCBS insurance ?
Do you think VA health care is good ?

I have had the option of using the VA for my health care for about 2 years. I am 20% disabled from side effects of protate cancer surgery from sleeping in Agent Orange. I also have BC/BS insurance. My co-pay for BCBS or VA for doctors appointment or prescriptions are approximately the same cost. I could switch to VA only and quit my BCBS and save around $175 per month insurance fee. I am relunctant to use VA physicians. If I ever drop BCBS insurance, I can NEVER get BCBS again. I only use the VA for prescriptions for very expensive pills. I go to my non-VA physician for everything else.
I wouldn't have included your second question in this thread since it will soon be locked as it is against forum policies. I'll answer anyway as far as my opinion.

First, VA docs are fine. But you often don't get a doc for your primary care. IMHO their mid-levels, like military mid-levels, are undersupervised. So I wouldn't recommend you see a VA NP for your primary care for instance. VA health care tends to be no frills. The buildings aren't that nice, there is no piano in the lobby, you tend to get less expensive drugs, there is less incentive to do more tests (for better or for worse), and there is less access to specialists. That said, you generally get what you need in my experience.

Second, I'd be pretty cautious dropping BC/BS. I don't think I would. Good luck with your decision.
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ataloss
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Post by ataloss » Mon Jun 27, 2011 5:47 am

f I ever drop BCBS insurance, I can NEVER get BCBS again.
won't this change in 2014?

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semperlux
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Post by semperlux » Mon Jun 27, 2011 6:24 am

Another vote for NOT dropping your BC/BS insurance. Working in an emergency room, let's just say that most veterans who could afford private insurance will not use the VA system unless it's a last resort. And most veterans who use the VA are the ones who cannot afford private insurance. This is only my personal observation and not pulled from any official statistic.

Because of forum rules, I cannot explain the details of why this is without getting the thread locked. But let's just say it has nothing to do with the quality of the people working in the VA system, but rather the system itself and it's access to emergency care and specialists.

Disclaimer: one of my immediate family member is a veteran and we looked into both options for her before deciding to stick to private insurance. She also worked at the VA in Manhattan for a few years, and I worked at the VA in Long Island, NY for a few years as well.

dhodson
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Post by dhodson » Mon Jun 27, 2011 8:03 am

thats not exactly true. actually the studies done on VA centers show a very high degree of satisfaction. With that said, i wouldn't deny that there are problems. I mostly agree with ERdoc on the VA system. OP it sounds like you are not enamored with the VA system so i wouldn't give up what you have for that small monthly premium.

tjwolf
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Post by tjwolf » Mon Jun 27, 2011 8:59 am

I find the local (Minnesota) VA center better than my previous private practice group. If I could spend ten minutes with my previous doctor, I felt lucky.

Have had two different doctors as my VA assigned physicians, and both were excellent. They claim that they only average 12-13 patients a day, and can therefore spend time to properly access a person's problems.

Tests within the system and referrals to outside specialists have been excellent. Excellent follow-up, prompt appointments, and caring personnel!

I could not be happier with the system. I do however, carry additional coverage for both health and pharmacy, even though I have not used them in years.
Tom

gkaplan
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Post by gkaplan » Mon Jun 27, 2011 2:15 pm

It probably depends on the VA center. I heard the one in Portland (Oregon) is quite good.
Gordon

fishndoc
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Post by fishndoc » Mon Jun 27, 2011 9:07 pm

dhodson wrote:thats not exactly true. actually the studies done on VA centers show a very high degree of satisfaction.
Perhaps the dissatisfied patients don't go go the VA (& can't be interviewed)?
As stated, the quaality of care seems to vary greatly among VA's

My favorite VA story: when I was a resident, the wait for elective surgery was ridculously long for out-patients (months), but somewhat more reasonable for in-patients (weeks). The residents solution? Admit anyone really needing their elective surgery, so they could get on the OR schedule. We would have a ward full of otherwise healthy patients waiting (usually happily) to get their hernia repaired. :roll:

So yes, I would definitely keep my BCBS, and the options it gives you.
" Successful investing involves doing just a few things right, and avoiding serious mistakes." - J. Bogle

dhodson
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Post by dhodson » Mon Jun 27, 2011 9:45 pm

No I am talking about actual studies that attempt to reduce bias. Given the OPs position, I would agree he should keep his bcbs.

billw
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Post by billw » Tue Jun 28, 2011 11:37 am

Would not give up BCBS, VAMC/Op clinics that I have received tx at in Mississippi have been lacking in quality care. Will use only basic primary care, med refills, etc, and no surgery. Plus they will not entertain PTSD issue unless you proceed with Claims&Pensions. Sometimes I wonder if it's worth the hassel and time.

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fandango
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Post by fandango » Tue Jun 28, 2011 1:52 pm

I used to live in a small town that had a large VA facility.

I can tell you that it was not very highly regarded by the local physicians.
They say that they often see former VA patients and spend a lot of time correcting "misdiagnoses".

My personal observation is that most of the new physicians that they hired were "washouts" from local practices who could not find any other employment.

Keep your BC/BS and use the VA only for refilling you Rx's.

Calum
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Re: VA Health Care

Post by Calum » Tue Jun 28, 2011 4:48 pm

EmergDoc wrote:VA health care tends to be no frills. The buildings aren't that nice, there is no piano in the lobby, you tend to get less expensive drugs, there is less incentive to do more tests (for better or for worse), and there is less access to specialists. That said, you generally get what you need in my experience.
As a CS & SPD vendor I'll contribute that the VA seems to put more money into back-end infrastructure than a typical private hospital. For better or worse they also have significantly more rules and policies to navigate. YMMV and of course this is only my experience. I wouldn't hesitate to have a surgery at a VA facility.

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celia
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Re: VA Health Care

Post by celia » Tue Jun 28, 2011 5:05 pm

rocket wrote:If I ever drop BCBS insurance, I can NEVER get BCBS again.
If you move to some place where there is no VA center or don't like the care received at the VA or the VA does not have a specialist you need, what will you do?

I understand that the VA only covers service-related disabilities. When someone I know goes to the VA for non-service-related care, the VA bills BCBS.

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