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  1. #1
    Warsaw Warrior JAZZ's Avatar
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    question

    I've been trying to get an answer to this, I thought in a emergency situation one could go to the closest civie hospital if you notified the VA within 24 hours and if the VA facility was an hour away. Last year I had a serious fall from a height and landed face first( shuddup ! ) It was a Sunday afternoon and the local clinic was closed, the Hospital in Gainesville an hour away so I went to the local hospital.They did 7 x-rays and a cat scan of the brain.Long story short, the VA paid nothing. Medicare paid and I kicked in 2 hundred and change.Where is my thin king wrong ? Just would like to know for future reference.Seems I can
    t afford to get old or sick. Tried to find a phone number or e-mail to just ask this question but all I get is " try this number " Thank you brothers:

  2. Member 1stindoor's Avatar
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    #2
    JAZZ
    Check this site out:
    https://www.va.gov/communitycare/pro...gency_care.asp

    Of note...
    Nonservice-Connected Emergency Care

    VA can also pay for emergency medical care at a community ED for a Veteran’s nonservice-connected condition. However, there are several requirements and factors that affect the extent to which VA can cover those services. Specifically, emergency medical care for a Veteran’s nonservice-connected condition(s) is eligible for VA payment when all of the following five elements are true:

    1. Care was provided in a hospital emergency department (or similar public facility held to provide emergency treatment to the public); AND
    2. The emergency was of such a nature that the Veteran (or other prudent layperson without medical training) would reasonably believe that any delay in seeking immediate medical attention would cause their life or health to be placed in jeopardy; AND
    3. A VA medical facility or another Federal facility was not reasonably available to provide the care; AND
    4. The Veteran is enrolled and has received care within a VA facility during the 24 months before the emergency care; AND
    5. The Veteran is financially liable to the provider of emergency treatment.

    There are limitations on VA’s ability to provide coverage when a Veteran has other health insurance (OHI). If OHI does not fully cover the costs of treatment, VA can pay certain costs for which the Veteran is personally liable. By law, VA cannot pay copayments, coinsurance, deductibles, or similar payments a Veteran may owe to the provider as required by their OHI.
    VA is also legally prohibited from providing coverage for individuals covered under a health plan contract because of a failure by the Veteran or the provider to comply with the provisions of that health plan contract, e.g., failure to submit a bill or medical records within specified time limits, or failure to exhaust appeals of the denial of payment.
    2016 Nitro Z21
    "They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." Benjamin Franklin

  3. Warsaw Warrior JAZZ's Avatar
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    #3
    Thank You

  4. Airborne/Infantry bassnman81's Avatar
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    #4
    When I fell out of my boat last year and near got killed, upon arrival to the ER they asked me if this was going to be a VA claim. They asked whe n they saw m VA card whe n I was searching for my Medicare card. I said no and it wasn't mentioned again. I'm not sure what would of happened if I said yes, but it seemed like they had a handle on it. Under the new rules I think the VA has n o choice but to pay. Check with your County VA Rep and see what info they have too.


    Lake Norman, N.C./New Britain, CT.
    An Khe 66-67

  5. Warsaw Warrior JAZZ's Avatar
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    #5
    roger that and I see a " Welcome Home and a Warrior Hug is called for