No need to call the VA before emergency care
I am registered with the Department of Veterans Affairs. What constitutes emergency care? How do I know if what is wrong with me is an emergency, and do I need to call the VA before I obtain emergency care?
Answer: A medical emergency is when you have an injury or illness that is so severe that without immediate treatment, the injury or illness threatens your health or life. If you believe you are suffering from something that is severe, call 911 or go to the nearest emergency room. You do not need to call the VA before obtaining emergency care; however, if you are admitted, your family, friends or hospital staff should contact the nearest medical center or community-based outpatient clinic on the neighbor islands as soon as possible to provide information about the emergency-room visit. If it is decided to admit you to the hospital and it is an emergency, the VA does not have to approve it first. If the admission is not considered an emergency, the VA needs to approve it. This must be done within 72 hours of the veteran's arrival in the emergency room. If a VA bed is available and if the veteran can be safely transferred, the veteran must be moved. If the veteran refuses to be transferred, the VA will not pay for any further care. For further information on what constitutes emergency care and how it is handled, call the VA Medical Center at 433-0600.
Q: If my insurance pays VA, why do I still receive a bill from VA, and why must my income be updated annually? My income has not changed that much.
A: The bill that goes to the insurance company is for the actual cost of the care that was provided to you. When your insurance company pays on the claim submitted, then VA credits your copayment obligation. The insurance payment does not always eliminate your VA copayment obligation. The VA copayment bill is a separate bill and cannot be submitted to your insurance company. In these cases, you may be responsible for a small balance of the copayment.
Updating your income information, also known as the Means Test, helps determine the enrollment priority group for each veteran and whether he or she is eligible for cost-free VA health care. Higher-income veterans may be required to share in the expense of their care by making copayments. For more information on copayments and billing, contact the VA Medical Clinic at 433-0600.
If you have questions about your benefits as a veteran, call Fred Ballard at the Veterans Affairs at 433-0049 or visit the VA Web site at www.va.gov/hawaii
or the Star-Bulletin at 529-4747.