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Can I use any ER with my veteran's medical benefits?

The VA hospital is over an hour away but our local hospital is just down the street. Will VA deny payments if I go there instead?
Status: Open    Nov 20, 2014 - 07:50 PM

VA Benefits

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Aug 27, 2015 - 11:26 AM

You may use a local ER for bonafide emergency care (ie. a layperson would expect loss of life or limb, w/o emergency medical intervention immediately). You would go to the ER and make sure they know that you are a veteran who utilizes the VA for medical care. They are "supposed" to contact the VA hospital on your behalf, however I caution that you (or a family member) should also contact the VA and let them know(you will have a maximum of 3 days). Once you are stablized and able to travel you are "usually" sent to the VA hospital to continue any care required before discharge (However, this does not always happen). If that is followed, the VA "should" pick up the ER tab less any co-payments you are responsible for. If you have issues with that contact the Patient Advocate at the VA Hospital.

If the VA is that far away you should talk to your Primary Care at the VA and see if there is any way they could place you into the Fee-Basis Program.

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Apr 09, 2015 - 05:12 PM

In our practical experience, yes, they will be denied.

Some VA staffers have assured us that the VA will pay for Emergency Room/hospital care. Other staff has also said, Yes but ONLY if the visit has been pre-approved and pre-authorized. (So if you are bleeding to death or otherwise dying, you're screwed.)

I am my Veteran mother's caretaker. The half dozen times she has entered the local hospital after being told it would be covered, the billing was mucked up beyond belief. An unbelievable mess of red tape. Enough to stress her into another heart attack.

Her other health insurance is very weak. We have found it is simpler to just buck up and drive 1 1/2 hours to the Seattle VA hospital emergency room. This is in Washington state.

Good luck,
Lisa (and Mom)

Source: personal experience

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