Tennessee Valley Healthcare System

Billing & Insurance

Information for Veterans Experiencing Financial Hardship

Veterans who may have suffered a reduction in income may be eligible to submit a new Means Test, which, if approved, would enable the Department of Veterans Affairs to not charge a co-pay for current and future care. For existing debt there is a Hardship Waiver process which may be applicable in some cases.

Any Veteran who thinks they qualify should contact the Health Resource Center at 1-888-313-5421 for additional information and assistance.

Copayments

The US Department of Veterans Affairs has established guidelines for veterans and their copayments. Copayments may be charged for the following services —

• inpatient care
• outpatient care
• outpatient prescriptions
• long-term care

Nashville Campus

• Any copayments due should be paid upon checking out of the medical center. Copayments may be made at the Agent Cashier window, ground floor (Room D-125) at the Nashville Campus.
• If you have any questions about your copay balance, please contact our Billing Office at (888) 313-5421.

Alvin C. York Campus

• Any copayments due should be paid upon checking out of the medical center. Copayments may be made at the Agent Cashier window, Building 3, ground floor (Room G-13) at the Alvin C. York Campus in Murfreesboro, TN.
• If you have any questions about your copay balance, please contact our Billing Office at (888) 313-5421.

Veterans who do not make their copayments upon checking out will receive a bill at their address of record within 30 days after their stay or appointment.

Private Health Insurance

Private health insurance coverage through a Veteran or Veteran's spouse is insurance provided by employer, Veteran or other non-federal source.

VA health care is not considered a health insurance plan.

VA is required to bill private health insurance providers for medical care, supplies and prescriptions provided for treatment of Veterans' nonservice-connected conditions. Generally, VA cannot bill Medicare, but can bill Medicare supplemental health insurance for covered services.

All Veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. Veterans are not responsible for paying any remaining balance of VA's insurance claim not paid or covered by their health insurance, and any payment received by VA may be used to offset "dollar for dollar" a Veteran's VA copay responsibility.

What's in it for me for providing health insurance information?

• You will not be responsible for any unpaid balance that the insurance carrier does not pay except for VA copay.
• Payments from your private health insurance carrier may allow us to offset part or all of your copay.
• Many private health insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.

Insurance Coverage and Eligibility for VA Health Care

Your insurance coverage or lack of insurance coverage does not determine your eligibility for treatment at a VA health care facility.

Risks of Giving Up Your Private Insurance

What should you do with your private health insurance if you are accepted into VA health care? You could save of money if you dropped the insurance, but there are some things you should consider.

• What about your non-Veteran family members?

VA does not normally provide care for family members of Veterans enrolled in VA's health care program. If you drop your private health insurance, they may have no health care coverage.

• What would happen if you are disenrolled from VA's health care program?

There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.

• Do I still need Medicare Parts A and B if I receive my health care from VA?

VA does not require a Veteran to have Medicare Part A or B to be enrolled in VA health care. However, a Veteran may want to consider their total health care needs before changing any insurance coverage.

• What would happen if you drop your Medicare Part B coverage?

If you cancel your Medicare Part B Coverage, you need to know that you cannot be reinstated until January of the following year, and you may be penalized for reinstatement.

For these reasons, VA encourages you to keep your private health insurance.