As of June 6, Uvalde County’s 1,134 veterans enrolled in the Department of Veterans Affairs program are allowed to visit non-VA health care providers in their community using VA coverage.
“It’s new but from what I heard about it, it should work great,” said Uvalde County veterans service officer Lalo Zamora, who noted a meeting will be held in July to inform local veterans.
“But we still have to get doctors and urgent care clinics to go along with it. They have to opt into it,” Zamora said, noting that Our Health/Nuestro Centro de Salud already serves as the primary care provider for some of his veterans. Last year, the clinic served 265 veterans.
According to Zamora, veterans must first receive approval from the VA before receiving care from a community provider.
Veterans must meet one of several criteria to be eligible, such as needing a service not available at a VA medical facility, living more than 40 miles from a VA facility, or being subjected to a VA wait time of more than 20 days. Previously, veterans facing a wait of 30 days or more could seek private care.
Uvalde is more than 40 miles from the nearest VA hospitals in Kerrville and San Antonio. According to Zamora, the majority of his veterans have been faced with wait times longer than 20 days.
“The majority of my veterans use private vehicles to access the facilities in Kerrville or San Antonio. I have an average of five veterans utilizing SWART a month,” Zamora said, referring to Southwest Area Regional Transit District.
Veterans can either choose their preferred community provider or a VA staff member can assist in selecting one. The selected community provider must be part of the VA’s network. Once seen, the community care facility will be reimbursed by the VA within 30 days.
To schedule an appointment, the veteran must directly schedule an appointment and inform a VA staff member about the appointment, use VA online scheduling to request an appointment, or have a VA staff member schedule the appointment.
The VA will send the veteran and the selected community provider a referral.
According to Zamora, if prescription medication is needed, the prescription should be sent to and filled by the nearest VA pharmacy. Veterans can receive short-term prescription medication for a 14-day or fewer supply that can be filled at a non-VA pharmacy.
Veterans may have to pay a co-payment for non service-connected care, just as the veteran would if care was received at a VA medical facility.
Community providers can’t bill or collect a VA co-payment directly from veterans. Instead, co-payments are billed as part of the VA’s billing process.
According to Zamora, urgent care clinics should be used to treat injuries and illnesses that require immediate attention but are not life-threatening. These include colds, ear infections, skin infections, minor injuries or strep throat.
Veterans may receive seasonal flu shots at urgent care clinics at no cost.
In an emergency, Zamora said veterans may also visit Uvalde Memorial Hospital. When visiting the hospital, veterans must state they are veterans wishing to use VA benefits.
“It has to be life-threatening. Signs of a heart attack, loss of a limb or eyesight. If not, the VA will probably not cover care cost and you will be stuck with the bill,” Zamora said.
Zamora said after a visit to the emergency room, veterans have 72 hours to notify the Va.
According to Zamora, the VA spent $13 million on Uvalde’s veterans last year. Of that figure, $7 million was for disability compensation, while $6 million was for medical care, education, home improvement.
“Four hundred and eleven Uvalde veterans received disability compensation last year,” Zamora said. “Sixty-eight are older than 75, and 26 are female.”
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