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Question About Health Care


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#1 HDWildBill OFFLINE  

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Posted February 12, 2013 - 11:11 AM

Let me give you some background before I ask the question.  Our son was in the Army and went to Iraq where the humvee he was in was hit by one of those road side mine's.  I think one soldier was killed but all others made it out OK.  Our son suffered a brain injury where now his spinal column fills up with fluid and if not drained he becomes paralyzed, he also gets sever headaches.  He has also be diagnosed with PTSD and becomes very depressed and with drawn. The Army has since put him on medical retirement but is considering just paying him severance and letting him go.

 

Fast forward to today and he has now moved to GA and has a job with the state corrections dept.  They have Humana health care.  He is out of his medication to help him with his headaches and he has been trying to see a doctor to get a refill.  The problem is they say Humana does not cover pre-existing condition's.

 

Now here is the question.  I thought this great Obama care took the pre-existing thing out of the equation?  Wasn't that one of his big platform things of this last election?  Or am I wrong?


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#2 DougT ONLINE  

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Posted February 12, 2013 - 11:40 AM

I think its supposed to but parts of the bill are being phased in and it doesn't fully take affect until next year. I've read so many different angles, I don't know what to believe and its hard not to get too political here. Wouldn't he still qualify for treatment through the VA or was that part of the severance??


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#3 Texas Deere and Horse OFFLINE  

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Posted February 12, 2013 - 11:41 AM

I would think that going from a Federal Gov. job to a State Gov. job, there would be on problem with his insurance. I would contact the military then I would contact some of the big TV News stations in ATL.. Is Ken Howard still in ATL.?

 

If they won't cover him, I would let the WORLD know about it, THAT IS NOT RIGHT !!  IMHO


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#4 backwoods OFFLINE  

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Posted February 12, 2013 - 11:46 AM

He served our country and risked his life. to me the VA should still help him out. I agree with the above get the word out some how let everyone know what is going on.


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#5 olcowhand OFFLINE  

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Posted February 12, 2013 - 11:58 AM

I don't understand why he can't get VA treatment either.  Dad served one sting in WWII and still gets VA treatment today, but I don't think meds are covered by them.  Definitely not right what's happened with your son Bill, and I hope a solution is quick.  Your Son gave a part of his life for all of us, and he's earned what he isn't getting & way more to boot.


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#6 boyscout862 ONLINE  

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Posted February 12, 2013 - 12:21 PM

Bill, I'm very sorry to hear about your son's problems. He should be under the Army Retirement System  and its medical coverage. His meds should be free. Unfortunately, one of Bush's ways to cut the costs of his wars was to screw veterans worst since WWI(1918). Some of the activated reserves only were getting 2 years VA coverage.

 

Do not let them buy him out!  He should receive a pension and medical care for the rest of his life. It sounds like he needs a competent doctor to fix the spine problem. Talk to the VFW. They have a local rep to help with things. If you have to, they may recommend a lawyer. You can also contact your Congressman and Senators.

 

Make sure that he has copies of all his records in two secure places. I was screwed and my copy of my records was in the one box that disapeared when I moved. For some reason there are REMFs that feel they've got to shaft combat veterans to save the Arrny money. You have to fight these !@#$% because once he's separated they have won.

 

Check if he's under the TRICARE system at www.tricare.mil or 1-877-tricare.


Edited by boyscout862, February 12, 2013 - 12:55 PM.

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#7 JD DANNELS OFFLINE  

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Posted February 12, 2013 - 01:13 PM

My Two cents for what its worth. If your son has any option at all he should not accept any severence package and let them off the hook.

He served and now it's their responsibility. 

 

And Like Boyscout said, Send Letters to your Congressman and Senators in your state They are your best advocate!!

As much as I don't like the Guy, Senator Tom Harkin of Iowa has been a great and effective advocate for Veterans and has often done the impossible when no one else could or would.


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#8 jms180 OFFLINE  

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Posted February 12, 2013 - 01:29 PM

I agree America should take care of the Veterans for life. Our country gives billions to other countries but we cant take care of out veterans. Something is not right about this. :mad2:


Edited by jms180, February 12, 2013 - 06:57 PM.

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#9 HDWildBill OFFLINE  

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Posted February 12, 2013 - 01:38 PM

Thanks for the replies,  the main issue right now is, it takes over a month to get into the VA so he can get a prescription and he is out of the medication.  So he has been trying to get an appointment with a doctor in order to get the prescription and maybe start with a local doctor.  Since he took health care when he started working at the prison that health care becomes his primary and tricare becomes secondary so if the primary doesn't cover it then tricare doesn't kick in.  His other option is to drop Humana and just use tricare like I do, but since all this severance stuff came about he wanted to try and cover him self and his kids.

 

I was just under the impression that the insurance companies could no longer use the excuse of a pre-existing condition did not qualify.  So I was trying to confirm if my impression was correct or not.  

 

The Army has not made a determination of his case yet and he is still on medical retirement.  He also receive disability from VA and that would continue. But if they separate him then he would loose his retirement pay and tricare.  We will just have to wait and see and then go from there.  Thanks



#10 boyscout862 ONLINE  

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Posted February 12, 2013 - 03:02 PM

Now that I understand better, he should be able to call the VA advice nurse and get into the Urgent Care Clinic within a day. 


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#11 grand OFFLINE  

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Posted February 12, 2013 - 03:43 PM

Bill, first I want to thank your son for his service. I'm sorry to hear of his insurance problems. When I retired, I kept paying the premiums on our insurance because my wife still needed several procedures on her ankle. This insurance was thru the Teamsters Union and had excellent coverage. Last fall we received a letter informing us that they were discontinuing that program for all retirees and would put us in a different program. The problem was that the coverage was no where near what we had before and the premium jumped to $1700 a month. We informed our doctor that our coverage would end Dec 31st. Now to comment on Obamacare from what our doctor told us and an insurance broker we dealt with that was able to find us affordable coverage. They both told us the full effects of the program starts next year in 2014. At that time all companies will have to accept clients with pre-existing conditions.
Sorry my reply was so long but wanted to let you know that we had traveled a somewhat similar insurance road.I hope your son is able to get adequate medical care and insurance coverage.
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#12 Amigatec OFFLINE  

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Posted February 12, 2013 - 05:35 PM

Since this was a service connected injury, the VA can access the records. You just have find somebody that knows what they are doing, It may take a while but keep fighting. I work for the VA and I have seen this same thing time and time again. I have seen them take Service Connection away, and the Vet has to keep fighting to get it back. The last thing the VA wants is a call from your Senator. Trust me, we call them "Blue Folders". Luckily one of the OK US Senators is on the Vet Affairs committee. He has a special office setup just to deal with these issues. I don't know where you live, but contact the DAV, your US Senator, your US Congressman, and your State will have a VA Rep as well. Another option is if your state has a Chapter of the Order of the Purple Heart. Keep fighting, and don't give up.
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#13 Wade M OFFLINE  

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Posted February 12, 2013 - 07:02 PM

I am retired Military.  I do not use the VA Hospital except for required checkups they make me go to. Now the checkups they make me go to are service connected medical issues.  Minor.  Has he contacted the DAV (Disabled American Veterens)? That is their mission.  They are not another government agency. In fact I thing they are a non-prophit. They will review his medical record right there and advise.  They know the system. They know who to call. I am not sure if the pharmacy is free, but I do not recall paying for the 1 script I did get from there.   


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#14 HDWildBill OFFLINE  

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Posted February 12, 2013 - 07:14 PM

Well good news. Mike did get through to someone in VA (like BoyScout suggested) today and they set him up to come in on Thursday to get his med's rolling again and to see a doctor.  I would like to thank everyone for their suggestions and help.  I will pass all this info on to him.  


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#15 Amigatec OFFLINE  

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Posted February 12, 2013 - 07:22 PM

A lot of the benefits are based on percentage of Service Connection. At 30% you recieve a bit more, the next big increase is at 50%, at 100% you get just about everything. There are other benefits along the way, but those 3 are the big ones. Also remember there hasn't been a budget passed in almost 4 years, the budget is currently set at the same levels as the last budget that was passed, so I lot of VA Hosp, are cutting costs everywhere they can. At least here most of the C&P exams are performed at locations outside the VA.
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