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Veterans’ Emergency Care Costs at Non-VA Facilities

The need for emergency medical care can arise at any time without warning, and in many cases this means that a veteran may need to seek treatment at a non-VA healthcare facility if no VA facility is easily accessible. (Note: The VA operates 121 emergency care facilities and 46 urgent care units across the country.) In addition to the proximity of a non-VA location, veterans may also consider non-VA emergency care for its shorter wait times. From the Washington Times:

By the government’s own estimate just last month, the average American waits about 26 minutes in a hospital emergency room before being treated. But on average, war veterans must wait twice that long for the same care at Veterans affairs hospital centers, and a string of internal investigations suggests ER wait times for retired troops frequently can last hours.

The VA will cover some of the costs associated with emergency treatment from a non-VA provider, but how much depends on a number of different factors. First, the emergency must have been severe enough that it would have been unreasonable for the patient to take the extra time to go a VA facility. The patient must have no form of health care insurance other than VA coverage, and must have been provided care by a VA provider within the last 24 months.

Even if these criteria are met, it’s unlikely that the VA will cover all of the associated costs. “VA will reimburse health care providers for all medical services necessary to stabilize your condition up to the point you can be transferred to an approved VA health care facility or other federal facility.” You will have to pay for your ambulance bill from the private care facility to a VA facility. (Ambulance rides to the private facility are covered “If the VA accepts responsibility for the emergency room visit.) Also, if you choose to stay in the private care facility, you will be responsible for all further care costs.

Furthermore, it is your responsibility as the patient to inform the VA as soon as possible that you have sought non-VA emergency care. This is so the hospital knows to seek payment from the VA. If you do not do so, you will soon be stuck with a large bill. If you do not file a claim within 90 days, it will be denied and you will be stuck with the bill.

Though efforts have been made to expand Veterans access to non-VA emergency care, it remains an area in which Veterans can incur significant costs. It is for this reason that veterans may want to consider enrolling in a non-VA health care plan such as Medicare Advantage. Though enrolling in non-VA coverage eliminates a person’s eligibility for potential VA coverage of emergency care costs, in the end he or she may receive more coverage with Medicare than the VA, and with less hassle. Contact Global Premier Benefits today for more information.

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