VA HEALTH CARE OVERVIEW AND ELIGIBILITY

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1 VA HEALTH CARE OVERVIEW AND ELIGIBILITY NATIONAL OVERVIEW 5.3 Million Veterans enrolled in health care 152 Medical Centers 971 Community Based Outreach Clinics (CBOC) 133 Community Living Centers 98 Domiciliary Rehabilitation Treatment Programs 300 Readjustment Counseling Centers 140 Comprehensive home care programs 1

2 LOCAL OVERVIEW VA Montana serves nearly 40,000 Veterans state wide. Fort Harrison is only VA Hospital in Montana 12 Community Based Outreach Clinics (CBOC). Miles City Community Living Center Only VA funded Veteran s home in Montana. State Veteran Homes Glendive and Columbia Falls ELIGIBILITY ACTIVE DUTY SERVICE MEMBERS Must serve 24 months of consecutive service after Sept. 7 th, Combat tour is not required. Must have an Honorable Discharge as noted on the DD214. Have a Service Connected Disability or separated from the Armed Forces due to a disability. If service time is less than 24 months, separation must be for convenience of the government or force reduction, and this must be specifically stated on the DD214. 2

3 ELIGIBILITY RESERVE/NATIONAL GUARD Must have been federally ordered to Active Duty Must have deployed to a Combat Theater or have deployed in support of Combat Operations. Must be Honorably Discharged as noted on DD214. SERVICE CONNECTED DISABILITY Definition: Any injury, illness or disease, that was was incurred or aggravated while on Active Duty. Disability does not have to be Combat related. Disability is annotated in 10% increments, starting with 0%. Disability claims are adjudicated through the Veterans Benefits Administration (VBA). 3

4 ENROLLMENT PRIORITY GROUPS Group 1 Service Connected 50% to 100%. Free health care and travel pay. Group 2 Service Connected 30% or 40%. Free health care and travel pay. Possibility of medication copayment for Non Service Connected medications. Group 3 Service Connected 10% or 20%. Free health care, travel pay paid for service connected visits, otherwise based on income. Possibility of medication copayment for Non Service Connected medications. Group 4 Aid and Attendance or Catastrophically Disabled. Free health care including medications. Travel Pay based on income. ENROLLMENT PRIORITY GROUPS Group 5 Non Service Connected. Free health care, medications copay status and Travel Pay based on income. Group 6 Combat Veterans. Copay for services and visits. Group 7 Asset Based Enrollment. Threshold is $80,000. Copay for services and visits. Group 8 (a,c,d,e,g) Income Based Enrollment. Income exceeds thresholds associated with Group 5. Copay for services and visits. 8e and 8g Not Eligible. 4

5 COPAYMENTS Primary Care Provider $15.00 Specialized Service or Appointment $50.00 Medications $8 and $9 for a 30 day supply. Inpatient Care»Day 1 through day 90 $1132»Day 91 through day 180 $566»Day 181 through day 365 Free DENTAL ELIGIBILTY Service Connected 100% with Permanent and Total clause. Be Service Connected for a Dental issue. Service Connected 60% or greater with an Individual Un employability clause. Enrolled in a VA sponsored Vocational Rehabilitation program. Homeless Veteran 5

6 MATERNITY CARE Requires enrollment in VA Healthcare. Complete Maternity care to include pre natal and post natal care. Includes new born enrollment for 7 days. Most services are Fee Based to private sector providers. TRAVEL PAY Available for Groups 1 and 2 and Veterans with income below the Non Service Connected Pension threshold. Available when attending Compensation and Pension medical appointments Paid at per diem rate of $.415 cents per mile Electronic Funds Transfer or Debit Card will be only form of payment in the near future. 6

7 VETERANS HEALTH IDENTIFICATION CARD (VHIC) VHIC is a Health Care Card; you must be enrolled in VA Health Care to receive the card. Cards can be processed Fort Harrison and at every clinic. Veteran friendly businesses provide discounts when in possession of the card (Home Depot, Lowes, Applebee s, etc ) 7

8 Online Prescription Refills 8

9 Online Prescription Refills Track Labs and Tests with MHV 9

10 Track Labs and Tests with MHV Secure Messaging with your Health Care Team 10

11 WEBSITES Covers all facets of the VA including health care, benefits, disability, education, VA home loans, etc Form 10 10EZ is the application for health benefits. Health Care Marketplace provides insurance packages meeting ACA requirements. Requests for Military Service Records; Replacement of lost Medals and Awards. My HealtheVet 11

12 Questions? 12