Health & Safety

CHAMPVA pros and cons

Question:

Jim: I've recently earned 100% P/T. Of course, this benefit opens many more doors within the state and the VA. My question is about CHAMPVA's pros/cons. I've searched many websites but there is not a lot of info or references that does a deep-dive into the program. Some say it's a great program while others say it's a bad program due to many doctors, hospitals, etc are unaware of the program (payments scheduler, etc). Can you please elaborate a bit on what you might know concerning CHAMPVA (pros/cons) to include providing any veteran dependent stories about their care via CHAMPVA online? Thank you for your time and assistance.

 

Jim's Reply:

I'm not at all sure what you're reading or where but CHAMPVA is insurance, nothing more, nothing less. Like all insurances the program requires that you learn how it works. Dealing with the offices of CHAMPVA is a very typical VA experience with lost paperwork, unanswered calls, voice mailboxes that are full and all the administrative bungling we know and love at our VA. Patience and an eternal cuppa are the secret to working with CHAMPVA.

Of course that can be said for almost any insurer today, they're all a pain to deal with and figure out what the rules are that they play by. I've not come across any hospital that doesn't readily accept CHAMPVA and most doctors who accept Medicare (most doctors) are happy to see the CHAMPVA patient.

My wife has used CHAMPVA for over 15 years as her only insurance and we think it's the best insurance she's ever had. She's currently melding her new Medicare benefit into the fold with CHAMPVA and doesn't seem to have hit any bumps in the road.

My stepson's family (spouse, 2 kids) all use CHAMPVA and everyone is happy and healthy.

The disabled veteran is assigned a primary caregiver who may or may not timely refer you to specialists that you might have to travel hours to see. You have little choice in how your care is doled out. The CHAMPVA beneficiary is able to choose their provider and seek out specialty care without a referral. Medicines come in the mail, copays are low, preventive care is included and...it's free.

That a given doctor's office may not be familiar with CHAMPVA isn't surprising. With the ACA small and unheard of insurance companies are everywhere and the people who deal with the insurance for the doctor are always happy to talk with you up front. My wife has educated some doctors offices and everyone is happy...they get paid, she gets good care.

If you can find a better deal, take it. Once you're set with a doc or two, it's seriously good insurance. I'd like to have CHAMPVA for myself but all I get is this VA care thing...

 

 

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NEXUS Letters?

Question:

do you know of a good doctor in Oregon who helps veterans write NEXUS letters?

 

Jim's Reply:

No, darn it...I don't know of anyone in Oregon who writes nexus letters. In fact, we don't talk of nexus letters these days, rather we talk about the independent medical opinion or IMO. You don't want the doctor closest to you, you want the doctor who will do the task you need done as professionally as it can be done.

I refer to a small handful of professionals across America who will be able to help you. Have a look here and talk to any one of these doctors or talk with each one https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html  

 

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