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    Advise on where to start...

    I was hoping the regulars here could help me with some basics....

    We have some older family friends who have been lovely to my Dad since his injury. They are in the 80's/90's. He is a WWII veteran who flew many missions in Japan. Surprising to me, he has never taken advantage of any VA benefits. He had no idea he had any! I only discovered this because they are going through a rough time right now and I am trying to help them sort through some medical/insurance paperwork. I was surprised to see that he wasn't using VA benefits (?Tricare) as a supplement to his Medicare, as I assumed he had them.

    I would love to somehow get them into the VA system, once things stabilized.... just to see if there are some benefits that would help them. They are actually somewhat satisfied with their current doctors, but they could use some help as he is declining and has more home health needs. There is a decent VA hospital near to where they live (Hines VA, just West of Chicago).

    What would be the best, first step for them?

    Thanks.

    #2
    They would not have TriCare unless they are military retirees (ie, put in their 20+ years) or medically retired, and signed up for Tricare.

    They should be eligible for VA care though. Here is the on-line site where they can get more information about eligibility, and fill out an eligiblity form on-line. They will need to provide a copy of their DD214 (discharge papers) if at all possible. While this can be electronically confirmed as well, that can delay the process for some time.

    http://www.va.gov/healthbenefits/apply/

    Here is information about eligibility:

    http://www.va.gov/HEALTHBENEFITS/apply/veterans.asp

    They can also enroll at the Member Services office of their local VA hospital; again, will need to fill out the form, provide a copy of their DD214, and some form of current picture ID (like a driver's license).

    Depending on their income level, they may have a copayment if they have no service connected conditions, but the copayment is significantly lower than similar Medicare or private insurance copayments.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      If they prefer a person to help, first step is to visit the Medical Center's Eligibility Office. They will guide him through it all.

      On the left side of this page, enter your zip code to find a nearby location. Here's my search for 60155.

      My dad is a 91 Yr old WWII vet (Guadalcanal) and has never used VA Healthcare either, even though he knows I love it. I don't get it. His choice though.
      Last edited by chasmengr; 26 Aug 2014, 8:14 PM.
      Chas
      TiLite TR3
      Dual-Axle TR3 with RioMobility DragonFly
      I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

      "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
      <
      UNKNOWN AUTHOR>

      Comment


        #4
        Thanks so much for this information. Really helpful.

        My friend is 92... maybe he knew your Dad!

        I'll try to get an appointment for them with Member Services etc... They would like a little hand holding. I think his respiratory issues will be considered service connected. He spent a lot of time flying over Japan after the bomb... it's amazing to me that he is still alive today, actually.

        They were recently talking about wanting to change their car insurance etc... are they eligible for the USAA plans or are those only for active military/"military retirees"?

        Any other benefits they should ask about, that come to mind?

        Comment


          #5
          I don't beiieve VA has any connection to USAA. Here's a VA site to start looking for other VA benefits.
          Chas
          TiLite TR3
          Dual-Axle TR3 with RioMobility DragonFly
          I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

          "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
          <
          UNKNOWN AUTHOR>

          Comment


            #6
            USAA is rather flexible on who they accept now but veterans who are not totally insane drivers are accepted. We have both car and home owners with them.

            Once you get your Dad into the VA System ask to have his name added to any waiting lists for assisted or nursing homes run by the VA. They have very long waiting lines. Your Dad may qualify for the Nuclear Vets program. Turns out my oldest Uncle who sailed into Tokyo Bay aboard the USS Witchita right after the bombs was characterized as one very late in life. It covered more of his care close to home.
            Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

            Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

            Comment


              #7
              Thanks for your input as well Sue. I'm actually researching for a family friend. My Dad isn't a Vet.

              I am going to try to set up an appointment for him and his wife at our local VA to start the application process for Health Benefits. It looks like he will be at the worst, a Priority Group 6 for his radiation exposure in WW2, but maybe even higher if they decide his lung problems are service connected. He is also pretty housebound now with his oxygen use.

              If he wants to keep his local doctors who are outside of the VA system, it still looks like the prescription drug benefit would be good for him. Am I right to understand that he would need to have a doctor at the VA to be eligible for getting the cheap meds through the VA program?

              Also, is his wife eligible as a dependent for these health benefits, or only the veteran?

              Comment


                #8
                Only the Veteran is eligible for health care through the VA. He would have had to be military retired and kept his TriCare coverage for both himself and his wife to have coverage for her related to his service (with a very few exceptions), and that would not be at the VA, but at a TriCare clinic or authorized physician on the outside.

                He should really work with a NSO (national service officer) from a chartered service organization such as DAV, VFW, etc. to get his benefits properly established. They can act as his agent and advocate with the VA to be sure he is properly rated, and that he gets eligibility properly established. Getting service connected this long after the fact can take a LOT of work and effort, and the NSO can push the application process along. For example, he would not have to pay a co-payment for something he is service connected for, but will have a co-payment for medications for other conditions if he ends up being Category 6.

                Any meds obtained through the VA must be prescribed by a VA employed physician. He and his wife should be discussing the option of "co-managed care" with the PCP he is assigned to at the VA, as this is the program that has his non-VA and VA-physician work together on medication management (and other aspects of his care as well).

                (KLD)
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                Comment


                  #9
                  This is so helpful. Thank you KLD.

                  I was able to find a local office as well that would look into all benefits, but I will review your recs.

                  Comment


                    #10
                    Make sure you go through a veteran service organization regarding benefits such as Compensation for service connected conditions or a Pension which your dad might qualify because he has wartime service. The pension is income based but you need to work with someone who could help you with this. Income levels can be adjusted with medical costs such as caregivers, Medicare Part B, and copays. There are other issues that you might want to get him help with. Remember he is from another generation where PTSD didn't exist or was never talked about. Respiratory issues from the fire bombing could be an argument but you will need a medical opinion in order to make that fly.

                    Comment


                      #11
                      Quick follow-up.... I am finally taking my friend to the VA tomorrow to try to get medical benefits. His wife submitted an application to the VA already by mail, and claims that they stated he is ineligible due to "high income". I haven't seen the rejection letter yet, and suspect there is an error. As best as I can tell, he is Category 6 due to his radiation exposure. His only major medical problem is advanced COPD. Is it true that Category 6 folks do not get ANY benefits if their income is above the eligibility threshold? Our friends have little assets, but their combined pensions are a bit over the local VA "income threshold" of $50k. But this year they have more that $15k in out of pocket medical expenses. Their uncovered dental/vision/hearing aids/oxygen/dme etc... costs are killing them. It is really a shame if they don't qualify for VA benefits, but I am hoping their application wasn't assessed properly.

                      We'll try going to their VA offices tomorrow, and if unsuccessful, will see the local VFW office (which has a longer wait than the VA).

                      Thanks.
                      Last edited by hlh; 23 Feb 2015, 8:20 PM.

                      Comment


                        #12
                        If the VA doesn't welcome him with open arms, go to your congressman, senator. They will be glad to straighten things out for you. You might call The Tribune and TV. They would love to do a story about a WWII vet getting grief from the VA.

                        Comment


                          #13
                          Good news. We went to the VA today and spoke to the guy in charge of the VA applications. He agreed that the rejection letter was a mistake, and he qualified for VA benefits. He was quite apologetic, admitting that some of their employees weren't as careful as they should be..... He qualified as category 6 for his combat time and for the radiation exposure in Japan. So now all the paperwork is corrected. He said it would take 3 to 6 months to determine if there is a service connection, once we get that process started...... Less hopeful about that. Because of their income level, there will be modest co-pays. They are hoping for help getting a rollator, wheelchair and hearing aids. He has his first VA doctor appointment next Monday.

                          Comment


                            #14
                            Great news!!

                            I am cat7, am not service connected, and have modest copays; the VA has provided (with no copay) my hearing aids, wheelchair, wheelchair lift for our car, and modular ramp for our house.

                            Note that the VA charges only one copay per day, so try to group as many appointments on the same day as possible. I have had as many as four appts the same day, and been billed only one copay.

                            See the 1173.## series of VHA Handbooks for more info.
                            Last edited by chasmengr; 25 Feb 2015, 2:26 AM.
                            Chas
                            TiLite TR3
                            Dual-Axle TR3 with RioMobility DragonFly
                            I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

                            "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
                            <
                            UNKNOWN AUTHOR>

                            Comment


                              #15
                              I really appreciate this info. His wife is so happy they will cover hearing aids. He wouldn't have gotten them otherwise, as they are too expensive. I didn't realize they might not even have a co-pay for dme. Nice...

                              Interesting about the "one copay per day". Thanks again. I'll check out the links.

                              Comment

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