Have you checked your mailbox lately for news from the Department of Veterans Affairs? Veterans around the country have started receiving a letter and brochure from the VA updating them on major changes coming to health care access.
The letter, signed by Dr. Richard Stone, executive in charge of the Veterans Health Administration, is dated May 7 and briefly lays out the changes, including new access benchmarks and a new urgent care benefit.
"We are excited about these changes that will strengthen VA care and care obtained through our community partners," the letter states. "The changes empower you to find the balance in the system that is right for you."
Here's what the flier says about the changes, known as the Mission Act -- and what they mean.
VA Health Care Eligibility
Veterans who have enrolled are eligible for care from VA hospitals based on a tier system that looks at their service-connected injuries, income and other criteria. Although the flier touches on eligibility, this system was not changed by the Mission Act. The flier also mentions an "annual patient enrollment system;" however, veterans do not need to take any action to remain enrolled, although the VA may reassess eligibility. Read more about VA health care eligibility.
VA Community Care Eligibility
The Mission Act's predecessor, VA Choice, established rules around who could receive care outside the VA hospital. Based on a variety of factors such as health needs and where the veteran lives, the Choice program let veterans see providers within a civilian health care network.
Now, that community care program has been given an update to include new eligibility standards. You can see a community-based doctor if:
- Care is not available within the new access standards, which cap wait times at 20 days and drive times for 30 minutes for primary care and 60 minutes for specialists.
- Necessary care is not provided by the VA at a nearby facility.
- You live in a designated state or territory where the VA is not full service, including Hawaii, Alaska, New Hampshire, Guam, American Samoa, Northern Mariana Islands and the U.S. Virgin Islands.
- You are grandfathered into the old Choice rules, which allowed for community-based care if you lived 40 miles or more from the nearest VA hospital.
- The VA doctor believes community-based care is best for you.
- The VA has designated the type of care you need as not meeting standards.
VA Urgent and Walk-In Care
Starting June 6, veterans who have received care from the VA in the last 24 months can get care at some community-based urgent care facilities. Read more about the urgent care update.
VA Co-Pays and Other Health Insurance
Veterans might have co-pays based on their tier status. But the big Mission Act-related change affects how the VA communicates with other health insurance held by some veterans. Under the new rules, the VA no longer needs a veteran's permission to bill or communicate with their other health insurance. If a veteran wants to keep the VA from making that contact, he or she should contact their local facility's privacy office.
VA Care Standards
Although the flier notes that the VA is actively "establishing standards for quality" and promises to "provide additional information" as it does so, the system also currently has in place care standards. Read more about care standards on the VA's website.
VA Complaints and Appeals
Although the flier touches on appeals, the Mission Act did not put in place any changes to this area. Read more about VA appeals and claims.
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