Working where I do in the VA, I get a lot of calls or inquiries from veterans wanting to know why we are billing their insurance because they should be covered under Combat Veteran Status (CVS). I always have to explain what this means and that it doesn’t cover everything that they are seen at the VA for.
The Department of Veterans Affairs (VA) provides cost free health care services and ordered nursing home care if required. These services are provided for those soldiers who are suffering from an illness or injury that could be related to them being in the combat area or a high stress area of deployment. Eligible veterans include activated Reservists and National Guard, so long as they served as an active duty soldier in an area of combat operations after 1998 and have an honorable discharge.
There is a law currently in place which authorizes the VA to offer combat vets’ care for illnesses or injuries potentially incurred during active duty for a period of up to five years following discharge. This means, for example, if you are a woman who was deployed but come in for a female related problem, it is most likely not going to be considered CVS. However, if you come in for a back issue, knee issues, or anything that could have been caused because you were deployed, that is what is covered.
These veterans are enrolled into Enrollment Priority Group 6, if they are not eligible for a higher priority status. The VA provides full medical benefits by virtue of this enrollment status. If a veteran enrolls with the VA under this authority, they will retain eligibility even after their five year period after discharge has ended. Those who do not enroll during the first two years post-discharge-date can still apply for coverage based on other factors such as:
- Compensable service connection rating
- VA pension status
- Catastrophic disability determination
- Veterans financial circumstances
Another important benefit for veterans who qualify for this special eligibility program is that they do not have to pay any copayments for conditions potentially connected to their combat service. These veterans must disclose their financial status for the previous year to be eligible for no co-pays for all care, not only for potentially combat related illnesses. Veterans may decline to release this information. If they choose to do so, they must agree to make copayments for services that the VA determines to be unrelated to their military service. They would also lose travel reimbursement funds, cost free medications, as well as care for unrelated combat illnesses.
The VA healthcare provider is the one who must determine if the veteran’s treatment plan is due to the veterans’ military service. In order to reach this determination, the provider must consider that the following types of conditions are not normally considered to be service related:
- Congenital or developmental conditions, for example, scoliosis
- Conditions that are known to be pre-existing
- Conditions that have specific and well-established causes or began after military service ended
If you feel you need help or further information, here are a few areas where you may obtain additional information:
- You nearest Veterans Administration medical facility
- Veterans may also call 1-800-827-1000 or the Health Benefits Service Center at 1-877-222-8387
- Veterans may also visit the VA health benefits website
It is advisable for our veterans to contact the VA and act upon the necessary applications immediately upon discharge. As is the case with most applications, it can take time for the necessary paperwork to be processed. This time lapse could leave you without health care coverage, so please take immediate action to set things in motion as soon as you are discharged.
Disclaimer: The opinions expressed in this article are the opinion of the writer and do not reflect the policies of this website or organization.