Friday, February 22, 2008


HEALTH INSURANCE. Many people assume that Veterans receive free health care based solely on their status as Veterans. Nothing could be further from the truth.

Let's start by saying that Noah has received the best and most compassionate care imaginable from the two VA Medical Centers at which he has received care since his discharge (except for the truly uncaring imbecile woman who makes his appointments in Phoenix -- but I'll save that for another post.) However, the VA Health Care system has an
enrollment "priority" system -- from 50% or greater service-connected disability (Priority Group 1) to Group 8 for "higher income" veterans (income must be less than $36,000 for Vets with 2 dependents... here's the chart). And that's gross income, not net.

However, because so many vets enrolled in the VA system between 1996 (after passage of the Veterans Health Care Eligibility Reform Act) and 2002, the VA was ordered in 2003 to stop enrolling Veterans in Group 8 (with it's 4 subcategories). So even people like my husband who was promised "free health care for life" if he made the military a career (he did -- 25 years) and served two deployments to Vietnam but was not wounded, is not eligible for enrollment in the VA Health Care system.

Here's what my research and some new Veterans have told me: Veterans of the current conflicts in Iraq and Afghanistan who are medically unable to continue in the service but receive less than a 10% disability from their service branch, receive no medical insurance once they separate. For those with service-connected disability ratings of 10 or 20% (ratings are 0% or greater in 10% increments), they receive UP TO 12 months of medical insurance (Tricare) for themselves and their families after separation; for 10% and 20% ratings it is typically 6 months but can be 9 or 12 months depending on the medical condition. If a service member receives a disability rating of 30% or greater from the service branch (a medical retirement), medical insurance for themselves and their families continue at no cost to them FOR LIFE.

Remember: 90% of Soldiers, 83% of Marines, 73% of Airmen and 64% of Sailors who were injured, wounded or became chronically ill while in the service received a disability rating of 20% or less. Unless they were covered by an employer or can afford other insurance within say 6-9 months after their discharge, they and their families have no health insurance coverage.

Here are some (appalling) numbers:

Army soldiers approved for permanent retirement disability (30% or greater rating) in 2001 (2 years BEFORE OIF): 642

Army soldiers approved for permanent retirement disability in 2005 (2 years into OIF): 209 (hmmm... 2/3 less while at war...)

Army soldiers receiving medical discharge (20% disability or less), 2001: 4,544
Army soldiers receiving medical discharge, 2005: 4,468 (hmmm... fewer while at war...)
(wounded and not returned to duty within 72 hours: 7,988 in 2004; 5,598 in '05)

Percentage wounded/injured soldiers receiving disability retirement (30% or greater rating), 2001 (BEFORE OIF): 10%

Percentage wounded/injured soldiers receiving disability retirement, 2005 (2 years into OIF): 3% (hmmm... fewer while at war...)

I know this has been covered (perhaps ad nauseum) in many publications in the past, but in case you hadn't read anything on this (or you forgot), these soldiers are then shifted out of the military medical system and into the VA... keeping in mind that the service branches only are required by law to compensate a member for the single condition (or combination of conditions) that make him unable to continue his military service, while the VA is mandated to compensate all injuries and conditions which were received during military service.

Note that annuities paid by the services (DoD) for medically retired individuals are charged to the services; "moving" a disabled member to the VA system shifts the financial burden to the VA. For example, we know of one Veteran who received a "does not meet retention standards" but a 0% rating from the Army for his burns and injuries received in a tank fire; the VA rated that same condition at 40%. Another Veteran was determined fit for duty even after a serious shrapnel wound to his thigh that his Navy physician determined should make him unfit and which the VA rated after his end-of-service discharge at 30%. Another veteran received a 10% disability rating from the Army for severe PTSD, and the VA rated that condition at 50% disability. The two soldiers medically discharged received the exact same lump sum severance payment when they left the Army (which both are reimbursing from their VA benefits) and none of these soldiers now has health insurance. (I know that now the military services and the VA are supposed to be using the same schedules and interpretations of those schedules, but that doesn't help previously discharged Wounded Warriors.)

Veterans can enroll for temporary health care coverage under the "
Continued Health Care Benefit Plan" within 60 days of losing their military health care -- at a cost for family coverage of $665 per month -- a little out of reach if you're trying to go to school full time on the GI Bill AND the government is taking 50% of your VA disability benefit (for the next 17 months!!) to pay back the Army (or Marines, Navy, AF or CG) -- even if your wife went back to work three weeks after the birth of your child to help pay bills (you know -- things like rent, food, gas, utilities...)

As Noah quickly discovered, there is some less expensive health care insurance ("less expensive" being a relative term when you have no money), but when he put in an application with an insurance agent, the agent said, "Let me get this straight: you were wounded in combat and have shrapnel in your skull and chest, you had a neck and spinal injury, a fractured elbow, you have a torn ACL in one knee, a possible torn rotator cuff, traumatic brain injury, lost a portion of your hearing in both ears, have tinnitus -- not to mention PTSD... and you want US to insure YOU?"

Noah assured him that the VA would cover his service-connected conditions (he's Priority 1)... but the agent told him that his company already had millions of claims in dispute with the VA and wasn't interested in more. (I should also point out that the VA has many, many millions of dollars of claims for non-service connected medical services provided to individuals in VA facilities for which they are awaiting reimbursement from Veterans' insurance companies as well.) Noah has been unable to find health insurance and, as of last week, he, his wife and their 2 month old son have no health insurance. (Please do not give me, "This is why we need socialized/socialist health insurance." We only need figure out how to insure the less than 10% of Americans who lack insurance.)

According to
this Harvard Medical School Study, there are 1.6 million American Veterans and family members who lack health insurance. That is about 12% of the approximately 47 million uninsured in America. (Now I'll caution that the study and report were authored by a physician who is pushing for the socialist system of national health care, but I don't doubt the empirical numbers.)

The Dole-Shalala Commission recommended
that all combat-wounded service members retain their insurance but I believe the legislation proposed as a result of that Commission's recommendations (the legislation that everyone made a big deal about in October but doesn't exist on paper apparently since no one can seem to provide a copy for review...) went further and recommended that all service members medically discharged from the service retain their insurance

If they continued Tricare for those medically discharged and assuming that if only half of those medically discharged from 2000 to 2006 lack medical insurance there would be at least 33,000 fewer uninsured Veterans and perhaps another 33,000 family members. I don't completely disagree with the VA priority system -- after all, there has to be some way to manage limited resources (on the other hand, perhaps we should be building MORE facilities and not restricting access to any Veteran??!!) That being said, Veterans -- who served this country and her citizens in war or peace -- who cannot afford or cannot acquire medical insurance for themselves and their families should be covered by either Tricare or the VA.


P.S. I have wondered recently why our government doesn't sell "Veterans Bonds" like our government used to sell "War Bonds" (and like the Savings Bond Program). I can't think of a person (or politician -- since those groups are occasionally mutually exclusive) who wouldn't buy them to support our Veterans (if you wouldn't -- you need to consider another country of residency... really). I'd like to do my part to assure that our Veterans' needs are met forever and are not held hostage to the budgeting processes of Washington or the threats or whims and flops (as in flip-flop) of "say one thing, do another" politicians. I'd like to be sure that no other agency could EVER touch the money we as citizens commit to our Veterans... until we have no more Veterans that need care. If there is a law that forbids it, the law should be changed.

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At 2/22/2008 4:31 PM , Blogger LoveMyTanker said...

Thank you for all of this information. It is truly eye opening and I am truly shocked within the details!

At 2/23/2008 7:01 AM , Blogger Kathie Costos said...

Great information that needs to be reported more. Most of the problems with the VA and claims are not new, but the numbers have increased. In the 90's there was a big problem with Vietnam Vets getting proper compensation and disability ratings. It was, and still is in most cases, a catch 22 for them.

Long story of my husband cut way down is his claim was tied up for six years. Before I convinced him to go to the VA, our private insurance covered him for rehab. He was self-medicating. They covered mental health care for private psychologists.

Once the VA doctors diagnosed him with PTSD because of Vietnam, they didn't have to cover his treatment associated with that any longer. They said, "It is the governments responsibility to treat him."

Because he still had a job, the VA deemed him billable for their services. We tried to prove we couldn't pay, at the same time we were paying huge premiums for health insurance, but they said he made too much money. They took our tax refund to cover the treatment.

The DAV service officer helping us with the claim told us that it was no big deal because once his claim was approved, we would get the money back. The problem was he couldn't tell us how to pay our bills without the money we lost.

Congress passed a rule in the early 90's allowing the VA to collect for "non-service connected" medical treatment.

When they did this they did not consider that there would be many claims denied wrongly, denied on technicalities and trapped in the appeals process. They may have thought they were only dealing with veterans with problems not associated with treatment but because they wrote the rule the way they did, it hurt veterans dealing with wounds connected to their service but not acknowledged as service connected.

When my husband's claim was finally approved, we did get back most of the money but during the 6 years of fighting them, we suffered financially as well as emotionally with the extra stress.

Living with a PTSD is hard enough on families but when you add in all that comes with it, it is nearly impossible to find the will to stay together. None of this has changed. It's still going on.

Once a claim is approved, the VA cannot do enough for the veteran and they receive great treatment for the most part, but if the rating is too low, it does them no good.

They have to fight to have their rate increased to be able to have the wound treated. This is all wrong but still goes on. Now there are just more suffering in the system and more families faced with battles they should not have to fight.

At 2/23/2008 9:58 PM , Anonymous Anonymous said...

Thank you for posting this information. Every citizen should read this. It is outrageous that our country is not taking care of the men and women of our armed services. It makes me sick. I can only imagine how these individuals and families must feel.
Cathy B

At 3/24/2008 5:17 AM , Anonymous Anonymous said...

As a vet, and a member of the American Legion, we are doing what we can to push legislation through to make sure this kind of crap doesn't happen. It isn't right for them not to be covered all the time. If your son ever needs help paying bills or an extra advocate, he can go to the American Legion for some assistance. They are only too happy to help.

At 4/11/2008 7:41 PM , Blogger kat8888 said...

Until just a few weeks ago, the VA's Priority Group 6 allowed for the enrollment of vets exposed to herbicides in Vietnam. Enrollment was based on the assumption that service in Vietnam exposed all service members to Agent Orange, and they were therefore eligible to enroll for healthcare.

This week I noticed that the VA's Handbook entitled Federal Benefits for Veterans and Dependents, 2008 Edition, has removed this eligibility for Vietnam vets.

The other eligibility criteria remained exactly the same. It's a shame, as Vietnam vets have been eligible to enroll for care based on Agent Orange exposure, and so many guys have never figured this out. Just as this cohort is getting ready to retire, and they need the "carry-over" health care the VA can provide between retirement and Medicare eligibility at age 65, it appears the system is again limiting enrollment. Those Vietnam vets who need to enroll will have to fall below the income threshold, or become service connected, before they can enter into the system.

The tragedy is that so many Vietnam vets came home, got their lives together, put it all behind them as best they were able, and led fully productive lives. As retirement approaches and their lives slow down a bit, many of these guys are starting to have more time to ponder their experiences in Vietnam. And many Vietnam vets are beginning to struggle with signs of PTSD that they had been too busy to pay any attention to while they were working, raising children, etc.

It's awful to think that a guy who barely made it out of basic training because he was unfit for service is getting VA health care for life, even with only a few weeks of service. This because he enrolled for care before the VA changed the eligibility rules in 2003. But guys who fought in combat in Vietnam are ineligible for enrollment because they're "over income". They are, in effect, punished because of their ability to get on with life after they returned home. Now that these guys NEED the VA, they cannot get in.

The system is incomprehensible. Instead of keeping "over income" Vietnam vets out, the VA should look at those vets who have never served in combat and who simply were lucky enough to have enrolled in the system before January 17, 2003. Many of these vets don't "need" the VA, but use it to get cheap medications that are prescribed by their physicians in the community. So... the vet/patient sees the doc in the community, gets a prescription for some medicine that might cost him a $40 copay with his insurance company's plan, takes the prescription to the VA doctor, who then examines the vet and orders the same medication through the VA pharmacy for a maximum of $8 for a 30-day supply. The vet/patient nets two medical appointments in order to get medications for $8 per month. It's called "co-managed care," and it's a nightmare.

Does this make ANY sense to anyone? For cheap medications, the VA should contract with pharmacies all over the country to provide $8 medications to anyone with a VA ID card, so long as the medication is on the VA formulary. This would free up phenomenal amounts of space in the VA system. People like my husband would stop seeing VA doctors and just use his VA prescription plan, and the appointment slots he uses would be freed up to accommodate guys who are currently barred from enrollment.

I'm getting off my soapbox now....

At 11/14/2008 8:35 AM , Anonymous Anonymous said...

far too many "assume",that the kwap they read on these bloGgs is the truth or even accurate.
In light of the REVISED INCOME levels for schip/medicaid whatever YOUR state is calling IT-should be 100% obvious that this statement and article is garbage.
Veterans receive appropriate and above health and wellness care.
Keep supporting the troops with your refrigerator magnets ,bumper stickers and posted BS.
Those in the military AND their families KNOW this is total nonsense.

At 11/14/2008 9:32 AM , Blogger Some Soldier's Mom said...

you know, Anonymous -- you're full of "kwap". The VA ONLY provides "free" care for those injuries and conditions that are a result of military service -- they DO NOT provide free health care for other conditions... and Tricare (medical insurance) is granted only to those service members that have been medically RETIRED (not medically discharged) with a disability level of 30% or greater from the service branch. According to a recent university study, more than 2.5 MILLION veterans are without health insurance. AND "schip/medicaid -- whatever your state is calling it" counts VA disability and GI Bill funds received as "income" and most veterans MAKE TOO MUCH MONEY to qualify for state-sponsored health care.... but they don't have enough money to pay rent, car payments, fuel costs, utilities, food, child care, school costs, etc. AND buy health insurance!

So while you may feel you have great health care IN the US military -- I suggest you stay there because when you leave -- it sux.

How do I know this PERSONALLY and why do I write about it, you a$$hat?? BECAUSE I'M WRITING ABOUT MY 23 YR OLD COMBAT-WOUNDED VETERAN SON. So don't come posting here to display your complete and total ignorance on the topic.

and PS "Those in the military AND their families..." -- IF you'd taken the time to read my short bio -- you'd know that my husband spent 24 in the US Navy (and we don't even qualify for VA Health care!), we have a son IN the US Navy and one Army veteran son and one Navy veteran son.


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