Veterans' Health Care Eligibility Reform Act, the rule that hurt veterans

Just because they serve the country, that does not mean they get free healthcare. The only way to get free care is to have a service connected disability and a rating from the VA or being flat broke for longer than a year.

Some vets being denied health care

Health care is a hot topic, especially when it comes to those who have served our country. A local veteran seeking surgery reported to the VA Hospital in Fayetteville says he was turned away over money.

Roddie Jones has been suffering with a hernia for weeks.

As a Navy veteran, he figured he would go to the Veterans Medical Hospital in Fayetteville for treatment, or so he thought.

“They are denying me treatment at the veterans hospital and I never thought for once that a veteran would be denied service at a veterans hospital,” Jones said.

At the hospital, Jones says he was turned away because he wasn't eligible for care.

His income level from 2008 exceeded the threshold to receive treatment at a reduced cost.

"That's why I joined the military, so that I would have benefits later on in life when I needed them,” Jones said.

He needs surgery now more than ever since he lost his job back in September.
read more here
http://www.wwaytv3.com/some_vets_being_denied_health_care/08/2009

This is what I keep talking about. Without a service connected rating from the VA, they have to pay for care. This means that even if they really do have something wrong with them needing medical care because they served the nation, they have to pay for it until their claim is approved.

Understanding Veteran Health Care
In October 1996, Congress passed the Veterans' Health Care Eligibility Reform Act, paving the way for the Medical Benefits Package plan, available to all enrolled veterans. The Medical Benefits Package emphasizes preventive and primary care, offering a full range of outpatient and inpatient services.

In addition combat veterans returning from active military service may be eligible to receive free health care services and nursing home care for up to two years, beginning on the date of separation from active military service. This benefit covers all illnesses and injuries except those clearly unrelated to military service (common colds, injuries from accidents that occurred after discharge, disorders that existed before joining the military). Dental services are not included. If you want treatment for health conditions you claim are related to combat operations, you will be physically examined.

This section will help you to understand your VA health care benefits eligibility, enrollment requirements, and specialized programs.

Means Testing
Certain nonservice-connected and 0% noncompensable service-connected veterans are required to fill out the financial worksheet, which we refer to as the "Means Test." A means test is a gathering of financial information by which VA determines your priority group for enrollment, and whether or not you are required to make copayments for the service you receive. The means test is based on prior year income and net worth. However, you can apply for an exemption from paying those copayments to avoid a hardship if projections of your income for the current year will be substantially below the applicable income threshold.

Should you decline to complete the Financial Worksheet, you must agree to pay the applicable copayment unless you are otherwise eligible for VA care. We would be unable to determine your priority and therefore could not offer you enrollment. It is possible, if you do not want to complete the Financial Worksheet, to declare yourself as a Discretionary Veteran. This means that you would accept placement in priority group 8 for enrollment and if enrolled you would be accepting responsibility for making the required copayments.

Service-connected veterans rated 50% or more, service-connected veterans receiving medications for a service-connected condition, or nonservice-connected veterans who meet the low-income criteria are exempt from the prescription copayment. This income threshold changes annually.

Hardship Determination
A Hardship Determination is a process by which veterans enrolled in Priority Group 7 & 8 may request a change in their enrollment priority group if their projected income for the current year will be substantially lower than their income from the previous year. Circumstances that might warrant hardship determination would be the loss of employment, business bankruptcy, or out-of-pocket medical expenses.

Veteran Health Insurance
Whether or not you have insurance does not effect your eligibility for VA health care benefits.

If you are receiving care for a nonservice-connected condition and have health insurance, your insurance carrier will be billed. VA does not bill your health insurance carrier for VA-adjudicated service-connected disabilities. An adjudicated service-connected disability is one that VA has determined was incurred or aggravated in the line of active duty. The law requires VA to bill private health insurance companies for all nonservice-connected care a veteran receives. VA’s budget and your future care could depend on the amount VA is able to collect from private health insurance carriers. By not giving us insurance information you may be limiting your future care and that of many other veterans. Additionally, if you are a veteran who is subject to a copayment and are receiving care for your non service connected disability, providing VA your insurance information enables VA to submit a claim to your health insurance company. Any payment received from your insurance will be applied to your outstanding copayment debt. This may satisfy all or part of your copayment responsibility.

You will NOT be responsible for any unpaid balance that the insurance carrier does not pay except for VA copayments. In addition, many insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.

http://www.military.com/benefits/veterans-health-care/cost-and-co-payments