Home / VA Benefits Overview / Health Care Insurance and Veteran Copays

Health Care Insurance and Veteran Copays

The private health care insurance companies are billed by the VA for the medical care, prescriptions and health supplies that they provide for the veterans who are suffering from non-service related health conditions. The Medicare cannot be billed by the VA, instead the VA can request bills from the supplemental health care insurance of Medicare for those services that are covered under them.

Information relevant to the veterans’ health insurance and the coverage it offers and also details pertaining to the coverage policies of their spouses, etc. must be provided by the veterans when they apply for the VA medical care services. In cases when the health insurance doesn’t cover the balance amount of the insurance claimed by VA or when it is not paid, the veterans cannot be held responsible for this. And the payments that the VA receives are compensated in the form of the veteran’s copay to the VA.

There are three different choices in situations where the copay cannot be repaid, even with some assistance from the insurance provider:

  1. You can request a waiver for the copays that you hold at present. A proof must be submitted to state that the payments as copays to VA cannot be afforded by you so that you can request a waiver. For more details regarding this you can connect to the revenue coordinator in the health care facility of VA.
  2. If you don’t want to be charged for the copays in the future, you can request a determination for your hardship. Request a hardship determination, so you will not be charged in the future. This would mean that you are requesting the VA to assign you to a lower number in the priority group assignment.
  3. Compromise requisition: You request for a compromise which means you make an offer to do partial settlement of pay and fulfillment of the debt that exists during the time when you make the offer. The accepted compromise offers must be paid within 30 days from when the offer is accepted. For more info contact the local VA enrollment coordinator.

3 comments

  1. I have a patient – that I need to get Prior Authorization for him to get Blood work done and and office procedure. I believe I need a form to fill out. Can you fax it to me at 484-526-2598 – Thank you.

Leave a Reply

Your email address will not be published. Required fields are marked *