By now, many of you who are in the VA health care system have received your Veterans Choice Card in the mail. Before you think about using the card for medical services administered by a non-VA health care provider, you should know the facts. This card came to be because of the Veterans Access, Choice and Accountability Act of 2014, and that act was created in the wake of multiple deaths that happened because of delayed medical treatment at the VA Medical Center, Phoenix, AZ. The program, often referred to as the “Choice Program”, is temporary and is scheduled to last up to three years. Every veteran enrolled in the VA health care system as of August 1, 2014 and recently discharged combat veterans will receive a card but just because you receive a card, doesn’t mean you’re eligible to use it. The following veterans can use their card for medical treatment:
1. Veterans whose current residence is more than 40 miles from any VA Health Care
Facility (in a straight-line distance), which includes all VA clinics and Community Based Outreach Clinics (CBOCs).
2. Veterans who need to travel by plane or boat to the VA medical facility closest to their home.
3. Veterans who face a geographic challenge, such as extensive distances around water or other geologic formations that present a significant travel hardship.
4. Veterans who are told by their local VA medical facility that they will need to wait more than 30 days from their preferred date or the date medically determined by their physician.
If you would like to see a non-VA provider based on number 4 above, you must first contact your normal VA medical facility to see if they can schedule an appointment for you within 30 days. If they cannot, you should be offered the opportunity to use your Choice Card for non-VA care. If you’re not asked, you can request them to make a referral so you can. You should then wait a few days for this to take place then call the number on your Choice Card, which is 866-606-8198. This number is staffed by a Third Party Administrator, or TPA, and is a contracted company, not federal VA employees. They will schedule your appointment at an approved medical facility. If you are happy with the medical services you’re receiving from the VA, no action is needed on your part.
The Choice Card is not an insurance card. If you go into a non-VA facility and present it as one without prior approval, your medical costs will not be covered. All use of the card must be pre-approved. If you are authorized to use the Choice Card and have health insurance, the VA will be secondarily responsible for costs associated with non-service connected care but will be primarily responsible for service connected care. The VA will work with the Indian Health Service (IHS) to ensure that certain medical facilities operated by an Indian tribe or tribal organization are aware of the opportunity to negotiate reimbursement agreements with the VA.
Tammy Walters is available at (715) 369-6127 or firstname.lastname@example.org.