Question:
I have CHAMPVA insurance as a secondary insurance--my primary is united healthcare medicare solutions which is PPO. I have had 2 doctors' offices say they are not in the CHAMPVA network. One just said we don't take that insurance. Can they refuse a military insurance?? Since I am paying a copay, can I get reimbursed for it on a claim form with a receipt from the doctors office?? Thank you in advance for your help.
Jim's Reply:
A medical practice is a business like any other and can refuse any insurance, even Medicare. CHAMPVA isn't 'military' insurance, that would be Tricare. Many practices will only accept limited private insurance or even cash in 'boutique' specialty practices.
Health insurance is confusing at best and I always advise people that what you need is what you're comfortable with and what you can afford. I'm not a believer in Medicare supplemental policies and have never subscribed to one. They're often restrictive and expensive and rather than pay for a supplemental, I save the money and put it aside for out of pocket expenses. If you're visiting physicians in a PPO it's possible they only accept very limited insurance coverage from outside the PPO and because of their business structure they can't deal with any other insurers.
My wife uses CHAMPVA which is now the secondary payer to her Medicare. I use Part A & B more often than I use my VA care as it's just more convenient to me. I pay any copays out of pocket and haven't found that to be burdensome. I also use the VA Community Care Program when I can but that's an uphill climb most of the time.
I also usually advise that when you want to use CHAMPVA that you have an appointment with the doctor's insurance and billing people before you try to see the doctor. Many physicians believe they know about their insurance and billing policies and they don't. If they accept Medicare for them to accept CHAMPVA is a no brainer and they just need to learn how. Most offices are happy to see any payment that is equal or near equal to Medicare and once they're set up with CHAMPVA there are few issues.
To be honest I don't see any reimbursement for a copay coming your way. I would have guessed that's what the supplemental is for? You could call the CHAMPVA folks and ask...it can't hurt.
Like I said earlier, your insurance choices will depend on what you are comfortable with. I think CHAMPVA is great health insurance but it does take a little extra effort and a lot of patience to get it right. Good luck.