Question:
Dad is 100% disabled. He was in AFib, I took him to a civilian hospital because it was closer. The VA wanted him moved to Togus, in Chelsea, Maine. The Dr. got him stable for transport, but seem skeptical, I opted to sign a paper that said he would pay a co-pay. He has been in the hospital for 5 days so far and they are still having a problem with maintaining a stable heartbeat. Dad wants to go home because he does not know what the co-pay is going to be and I can't find a % anywhere to alleviate his worry. Where might I find this?
Thank you for your time.
Jim's Reply:
I don't understand the copay part of your question? VA doesn't provide health insurance that results in a copay that I'm aware of. In very broad terms, a veteran who faces a life threatening emergency may use a civilian emergency facility and VA should pick up the tab until the veteran can be transferred to a VHA facility for extended care. The transfer to a VA facility is usually as soon as the veteran is stable enough to make the journey and the VA facility has space available. VHA has published some of these details here.
When VA picks up the tab in these situations it's all or nothing...often nothing. There isn't a copay. VA is very strict about paying for unauthorized civilian care...I see a lot of rejections. I fear that if VA offered him to transfer and there was space available and appropriate treatment was available from VA and he declined (for any reason), VA may not pay any of the civilian hospital bill. You say a doctor seemed skeptical and if you can get that doctor to put it in the record that the veteran was not stable enough for transfer, you may have an argument to make for full payment. I'd offer that he may be wise to get to a VA hospital.