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AliBoBali Asked April 2014

Is there any reason I cannot take my Dad out of VA and into Medicare/Medicaid for PCP?

My father rec'd letter from IL Dept of Veterans' Affairs that states:

"Our interagency records indicate that you may be receiving state benefits when by law you should instead be receiving more robust federal veteran benefits. In light of this, you are required to call Veteran Service Officer (lists name and number, I did try to call, recording says "mailbox is full") to assess your veteran benefits by May 16, 2014. … If it is determined you may qualify for additional federal benefits, you will be given the contact info of a local VSO in your area. The local VSO will assist you with filing any necessary paperwork to the US Department of Veterans' Affairs, provide guidance concerning your claim, and assist you by interpreting any information you receive from the VA."

First of all, when I can't even get through to telephone number they provided because mailbox is full, it reinforces everything I've, unfortunately, experienced with VA. It is so disconnected and discombobulated, and main facility I have to take my father to is an hour drive each way up into the massive city of Chicago. And, again, I just spent this morning calling back and forth to variety of VA offices trying to figure out why my father's catheter nurse - that was ordered by doctor and confirmed through Health Nurse Coordinator - has never called or shown up and its been 8 weeks since this was supposed to happen. I'm beyond sick and tired of dealing with VA inefficiency and running me around. I want to take my dad to local PCP and get a comprehensive and local primary doc to oversee his health care. Any reasons I can't or shouldn't do this? Thanks for any input.

runragged Feb 2015
IF (big IF) you want to stay with VA care, this might complicate things more, but there has been a lot of press lately about the "Veterans Choice Cards" which your dad likely received in the mail within the last few months. Don't know if this is something that would help you or not. Also don't know if a VA outpatient clinic closer to where you live might be an option. Any kind of specialist visit would likely have you driving to Chicago, but are you getting travel reimbursed? At least that's something for your trouble.

We completely agree that the veterans support organization from the county government up through the federal government can be disjointed if not completely broken. In general, we have found that the VA at the federal level has good and caring people, but you often get what you pay for when you accept "free medical care." What happens at the state and county/local level is completely up for grabs. We recommend leaving the state Veterans Service Organization alone and doing what Pam Stegman suggested...talk to the pros at VFW, DAV, AL, etc.

At present, you need what works for you and your dad, not what works for the local, state, or federal government. There is, at this point, you have no obligation to use the VA unless you want the VA to continue paying for a particular kind of care or support. And even that does not stop you from obtaining all or almost all of your care through Medicare so long as you make the minimum required visits and provide records.

AliBoBali Feb 2015
Just bookmarking the answer here on this question I asked.

The answer: No, there is no reason I cannot use Medicaid coverage that my father has and take him to local geriatrician and specialists. Doing this has cut down expense of taking him to the main VA facility which is an hour away. My father was once getting all of his medical care through VA and is now getting all of it mostly from regular medical sector.

My father retains all of his VA medical benefits to use in the future if he wants to do that.

So far Medicare/Medicaid has paid the entire bill for a dozen primary care doctor visits, referrals to specialists, a month and a half of hospitalization and rehab, and physical therapist/home nurse visits. I wish I had stopped using VA exclusively sooner in our particular situation.

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AliBoBali May 2014
I agree, cap, that Indy VA is top notch. I've taken my dad there a few times for emergency cath changes and its a cakewalk compared to Jesse Brown VA facility in Chicago's Health District. BUT… until I can convince my father to relocate to Indy, I'm going to get him a Primary Care doc close to his far south Chicago neighborhood. I've been warned to expect a copay but I still want to give it a shot.

And I can't say enough about how pleasant and patient the people are that I interact with at VA here. It just seems the machine is too large and inefficient. It takes months and years to accomplish simple things (like outpatient surgery for skin cancer removal) and I just can't stay on their long, drawn-out time schedule anymore. :-)

pamstegma May 2014
You could switch to Medicare/Medicaid, BUT you will have out-of-pocket expenses that you don't have with the VA. If he belongs to a local VFW or American Legion, the local officers often know more about these benefits than the person on the phone. Check there if you can.

gladimhere May 2014
Huge problems with VA here, it is making news almost nightly.

anonymous158299 May 2014
ive seen people from the chicago area come to indy for better service. when other va's screw up its indy who sends technicians to fix it. they are top notch . they dropped this new hepc tx on me of their own accord. i would choose indy va over any health care in the world , given the choice..
your va is only as good as its local labor pool .

AliBoBali May 2014
Just wanted to post follow up for the archives:

I took this letter into Patient Advocate at local VA. He said "everyone" received one in light of the changes made to Medicaid this year. So it would seem that anyone receiving state Medicaid benefits - which as of June 1st, 2014 will be changed over to "health plans" - received this letter.

AliBoBali Apr 2014
My biggest concern at the moment is just to find a way to ascertain I am not going to somehow "counterfeit" my father's eligibility for VA OR Medicare/Medicaid benefits/services in the future because of the immediate need to get him a local PCP. I'm confused about how this letter was worded - "Our interagency records indicate that you may be receiving state benefits when by law you should instead be receiving more robust federal veteran benefits." It implies that he cannot do both Medicare/Medicaid and VA? I'm sure there are others who do indeed use both…?

gladimhere Apr 2014
Allison,
I certainly would try to use Medicare/Medicaid instead of the VA for just the drive time alone. Last year sometime there was a special on tv about problems with VA administration of health care. I have been looking for it, if I find it I will let you know. Probably an issue of not using the right words to search, you know like wedge? ;-)

vstefans Apr 2014
On the other hand, the Aid and Attendance and support for nursing home care if it is ever wanted or needed can be a positive. A lot depends on the quality of the individual VA system nursing home though - there were some serious concerns with that here in Arkansas.

vstefans Apr 2014
Hmmm...theoretically better benefits you can't access, versus decent ones that you can. You could go in person to a VA facility I guess, but this is a POC. I remember working some at VA Lakeside when I was a resident and it was a real pit. A lot of employees truly did not care one whit about anyone, only about keeping their job, which was pretty easy to do. Incompetence was pretty major and at times resulted or could have resulted in loss of life, typically without repercussions, and the paperwork and administrative barriers to getting people's needs met were enormous.

I would document/log each call you've made. I would consider talking to a state senator or congressperson. It is very politically unpopular to defend mistreatment of veterans these days, though not enough to actually stop the mistreatment.

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