Information update on Veterans Choice Program

First Posted: 10:35 am - August 26th, 2015

By Thomas Crisp - Contributing Columnist

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The Veterans Choice Program is a new, temporary benefit that allows eligible veterans to receive health care in their communities rather than waiting for a VA appointment or traveling to a VA facility. Call 1-866-606-8198 to make sure you qualify. Below are 10 things you need to know:

1. Am I eligible for the Choice Program? You must have been enrolled in VA health care on or before August 1, 2014, or be eligible to enroll as a recently discharged combat Veteran. You must also meet at least one of the following criteria:

• You are told by your local VA medical facility that you will need to wait more than 30 days for an appointment from the date clinically determined by your physician, or, if not such date is provided, our preferred date.

• Your residence is more than 40 miles driving distance from the closest VA medical facility.

• You need to travel by plane or boat to the VA medical facility closest to your home.

• You face an unusual or excessive burden in traveling to the closest VA medical facility based on geographic challenges, environmental factors, or a medical condition. Staff at your local VA medical facility will work with you to determine if you are eligible for any of these reasons.

• You reside in a state or a United States Territory without a full-service VA medical facility that provides hospital care, emergency services and surgical care, and reside more than 20 miles from such a VA medical facility.

2. What if I think I am eligible? Call 866-606-8198 to verify your eligibility and set up an appointment.

3. Can I call my non-VA doctor to make an appointment? No. Call the Choice Program call center at 866-606-8198 to verify eligibility and set up an appointment.

4. How is the 40 mile calculation made? This calculation is based on the driving distance from your permanent residence (or an active temporary address) to the closest VA facility, including Community-Based Outpatient Clinics and VA Medical Centers.

5. If I am eligible, can I receive Beneficiary Travel for travel to appointments with a Choice provider? Yes. However, the Choice Act did not provide any new Beneficiary Travel eligibility.

6. I did not get my Choice Card, what do I do? You do not need your Choice Card to access the Choice Program. If you did not receive a Choice Card, call 866-606-8198 to find out if you are eligible and to make an appointment.

7. How do I get my prescription filled if I use the Choice Program? The Choice Program non-VA Provider will issue a prescription with up to a 14-day supply of a National Formulary drug. You may have the 14-day supply prescription filled at any non-VA pharmacy of your choosing and may submit a request for reimbursement to VA. For prescriptions needed past 14 days, follow standard procedures to fill a prescription at the VA pharmacy.

8. If I use the Choice Program, does that affect my VA health care? No. You do not have to choose between the two.

9. Am I responsible for Medicare, Medicaid or TRICARE cost-shares? No, these plans are not considered Other Health Insurance for purposes of the Choice Program. You will not be billed for any of the cost-shares associated with these plans.

10. What about VA co-payments? Will they be collected by the community provider? VA copays will be billed by VA after the appointment. If you currently pay VA co-payments you will be subject to the same co-payment requirements under the Choice Program. Your VA copay will be determined by VA after the care is provided.

What adults should have

The majority of cases in the current measles outbreak have occurred in unvaccinated children and young people. Although the measles-mumps-rubella (MMR) vaccine is considered a childhood immunization, adults should discuss with their provider whether immunization is needed.

For veterans born in the U.S. before 1957, immunity is assumed because of the high prevalence of measles in that era. Veterans who entered the service after 1998 are likely to have received two doses of MMR. Veterans who are not sure of their immunization history can be assessed for immunity with lab testing.

In particular, women of childbearing age need to assure they are immune to prevent congenital infection with these diseases.

Several new vaccines are now in use to protect older adults and those with underlying conditions like diabetes, chronic lung disease, or compromised immunity.

A high-dose flu vaccine is available for those over 65 to give better protection. Older veterans and those with certain medical conditions are most susceptible to pneumonia.

Two different pneumonia vaccines are now recommended for persons over 65 and younger patients with compromised immune systems: a conjugate pneumococcal vaccine plus a polysaccharide vaccine. These two vaccines are given in a set sequence and booster recommendations may differ for each patient. Ask your provider.

For veterans with diabetes, immunization for Hepatitis B is recommended as soon as diabetes is diagnosed. Persons with diabetes may be at risk for Hepatitis B in later life if lapses occur in infection control in dialysis or communal living settings.

A vaccine for Hepatitis A is recommended for those who travel to other countries or live in a U.S. community with high rates of Hepatitis A; or who have chronic liver disease such as Hepatitis C, engage in male-to-male sex, or inject drugs.

Hepatitis B vaccine is also recommended for patients with Hepatitis C, other forms of chronic liver disease, multiple sexual partners or injection drug use.

Shingles (herpes zoster) is caused by the same virus that causes chickenpox, which reactivates along a nerve, causing rash and pain. People over the age of 60 may receive a single dose of the shingles vaccine. This vaccine can reduce the risk of shingles and associated pain by 60 percent. Consult with your physician first.

Booster doses of tetanus-diptheria (Td) are needed at 10-year intervals. In place of the Td booster, people ages 19-64 and those 65 and older who are in contact with infants should get a one-time dose of tetanus-diptheria-pertussis (Tdap) to also protect against whooping cough.

By Thomas Crisp

Contributing Columnist

Thomas Crisp is a retired military officer from Whitmire. His veterans updates can be found weekly in The Newberry Observer.


Thomas Crisp is a retired military officer from Whitmire. His veterans updates can be found weekly in The Newberry Observer.


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