Hey Jim,

Sometimes I meet very interesting people at our local VA OPC. Vietnam Veteran took a long time to explain that he travels 50 miles 1 way to come to the clinic and knows for a fact that the $6.00 deductible has been waived for veterans rated 50 percent or more. The poor lady at the window knew nothing about that change. He continued to argue but finally explained that his Congressional Rep. would be contacting this office. Perhaps I am a little different, I don’t know to many health care agencies that pay millage to come to a medical appointment that is free for many of us. If that change of policy is in effect I am sure you would know. Is it true? If the info gets out there it might save the people who work at the VA a lot of aggravation. The only time I heard that the $6.00 fee is waived that if it is a C&P exam.

Reply:

Thanks for taking the time to write to me. I enjoy hearing from veterans who have such good questions.

But first, let me point out that our health care isn't free. While we don't have to fork over any cash when we see a health care provider, that's only because we paid for the service way ahead of time. We paid in advance by doing our duty as soldiers, sailors, airmen and marines. That was in the contract.

The $6.00 deductible isn't waived for those rated over 50%. The $6.00 is only waived when there is a financial statement filed that shows the veteran can't afford it.

Here's a tip; My web site can be hard to navigate at times because there is so much intel there. I've put together a page of details and links about the most common benefits here http://www.vawatchdog.org/Benefits_Guide.html

As it happens, that page is about due for a tune-up so if you go there you may see some changes over the next couple of days.

On that page, in alpha order, you'll find "Travel". That's just a link that takes you to the VA web site...a site much more challenging to navigate than my own. On that page you'll see:

What are the deductible amounts? Is the monthly deductible cap for each facility or is it for travel to all VA facilities for health care? Who is required to pay the deductible?

Public Law 110-387 required VA to reduce (and freeze) the deductible amounts to those originally specified in 38 U.S.C. § 111(c)(5). Therefore, effective January 9, 2009 the Beneficiary Travel deductible was reduced to $3.00 per one way trip; $6.00 for a round trip; with a maximum deductible of $18.00 per calendar month. The $18.00 is the total monthly deductible amount for travel to all VA facilities. Regardless of the deductible amount withheld per trip, deductible requirements end after 6 one-way (3 round) trips in a calendar month. Should a veteran be going to multiple VA facilities, and the veteran notes this when applying for Travel reimbursement, it is incumbent upon the facility providing the care and travel to contact any other VA facilities to determine if the deductible has been met.

The only exemptions to the deductible are:

Veterans traveling in conjunction with a C&P examination, Non veteran donors, Veterans requiring a special mode of transportation, and when it is determined that the imposition of the deductible would cause a severe financial hardship (see “Waivers”)

All other eligible veterans, including those receiving care for service connected conditions, are required to have the deductible applied.

Who is eligible for a waiver? How do you determine if a veteran is eligible for the waiver?

Waivers of the deductible can be made when the deductible causes a “severe financial hardship” to the veteran. Per 38 CFR § 70.31(c), a severe financial hardship occurs when the veteran is in receipt of a VA pension; his or her income for the year prior to application, or projected income for the year of application (current year) does not exceed the appropriate VA pension level; or in the case of an SC veteran, income is at or below the appropriate “Means Test” thresholds for the year prior to application or projected for the year of application.

So...as you can see, the veteran who told you of some unknown rule about that deductible was wrong. I caution everyone to be skeptical of the many self professed experts you'll meet inside a VA facility. It's my experience that these guys and gals often have good intentions but they misinterpret much of what they hear and bend information to fit their own personal beliefs and needs.

Many of the worst sources of information come from VA employees who work for the VHA. They often profess to know something about benefits over on the VBA side and the truth is, they don't have a clue. If a VA doctor, nurse or social worker tells you anything about VA benefits, you can safely place your money on their story being wrong.