Easy Peasy Transition to The VA (a Healthcare Issue)

Selfie
The Great White North

When you spend your days living in an RV insurance can be a hassle. The monthly costs keep rising. Your insurance binds you to your state of residence so that any medical procedures from treatment for the sniffles to major surgery mandates a return to that state to avoid costly out of pocket expenses. Getting in with the VA could change all of that.

Insurance costs are exorbitant and climbing higher all the time. The laws are written to supply insurance to the destitute while pricing the coverage out of reasonable reach of others. I entered the healthcare market in 2016. The monthly payments were just over $400. In 2017 my monthly coverage increased to $519. To get that price I had to increase my deductible by $2,000 and settle for worse coverage. In 2018 the insurance company I used was leaving the market place. It was no longer available. The healthcare marketplace (Obamacare) assigned me a new insurance company and it would only cost $630/month. Only. The assignment was made before the marketplace was opened for enrollment in November. How can a government run healthcare system make an assignment before open enrollment even started? I made inquiries, The answer was that they can according to law but if I wanted to I could select something else before the end of open enrollment. I questioned the logic of the law. It was to no avail. It is just the way it is. I had an alternative up my sleeve.

I withdrew from the healthcare market. That was my plan. Of course, withdrawing from the market could not be so easy as just log in on line and click “Withdraw”. The “withdraw” button was grayed out. I doubt that it would have worked even if it were available.

I called the market place phone support and after a brief fifteen minute wait I was speaking with a representative. They asked me the same questions that I had already answered during the menu options I had to go through to get to the representative. This begs the question, “Why do they ask for the information in the menus if it is not available to the person I am speaking with?” The friendly young woman, (judging by the sound of her voice) assured me that she could help. When she got to a the menu where she should have withdrawn me from the marketplace she let me know that the button was grayed out.

“Yes I know. That is what I told you and why I am calling.”

She asked me to hold while she discussed this with someone else. After a few minutes I was told that I could not be withdrawn because the button was grayed out. I asked to speak with a manager. She tried to twist her way around that. Perhaps she would face some punishment if a call was escalated. She finally conceded and placed me on hold. Five minutes had passed before they managed to disconnect me.

I called back, went through the now familiar menu and after a ten minute wait I was speaking with a male representative. I explained to the guy that I had been disconnected while waiting to speak with a manager. I met instant resistance as he assured me that he could help me. I was just as insistent that I wanted to speak to a manager. Eventually I let him go through the menus that led him to the conclusion that the “withdrawal” button was grayed out. I should wait until after open enrollment and then call back. This was not an option to me. In between his insistences that I wait until after open enrollment, I kept insisting that he put me through to a manager.

“Sir, if you will just listen.”

“Are you going to put me through to a manager?”

“One moment.”

He placed me on hold as I was saying, “Don’t drop this call.”.

After a few minutes of eternity I heard a woman’s voice ask, “How can I help you?”.
I explained the situation adding some commentary regarding my dissatisfaction with the way things had gone so far. I received her sincerest apology. She then found her way through to the grayed out button and was able to bypass it with her assurance that I was withdrawn from the healthcare system. I thanked her for doing what the trainees were probably banned from doing. I did check back after open enrollment to guarantee that I was no longer obligated to the system. I also continued to get bills from the insurance company that had been selected for me. I was told to ignore them. If I did not pay I would not be obligated to take that insurance. Why is everything awry with the healthcare system? Because lawyers who know nothing about it wrote a monstrous kludge that nobody could possibly understand. But that’s just my guess.

This brings me to a discussion of the use of the VA as a primary healthcare provider. If you are deemed to have a minimum of a ten percent disability related to your military service you can qualify for VA coverage at no cost. It is not insurance. It qualifies in lieu of the costly insurance. No monthly payments. I needed to transfer all of my healthcare records to the VA and be assigned a VA doctor but that’s the cost of doing business at the VA.

I had an appointment in August of 2017 that determined a severe enough hearing loss to qualify for disability. As it turned out I could have done away with the healthcare insurance for half of last year too. It is a moot point, but I mention it anyways.

I was given a lab appointment on January 25th. I arrived fifteen minutes early. It can be very difficult finding a parking place at the Fort Wayne VA. I lucked out and legally parked after only one pass. I registered early, was called in before I could begin reading the book I had brought, and was seated with the phlebotomist immediately. Her name was Angel. Above the patient’s seat was a home made sign with a bat, a hypodermic bloody needle, and the gothic printed word “VAMPIRE”. Angel told me a regular patient of hers had made it for her. She considered it a paradox, “Angel the Vampire”. We talked as she drew five vials of blood without me so much as feeling a needle prick. I was dismissed to obtain my urine sample and then sent on my way. Quick and painless.

My next appointment was on the following Wednesday January 31st. I registered quickly and before I could be seated in the waiting room I was called to be seen by the screening nurse. I answered the same set of questions multiple times to determine if I was depressed or suicidal. She apologized letting me know that this was the new protocol to reduce veteran suicide. I let her know that I understood and sympathized with those who were fighting such depressions.

The nurse took all of my vitals and then left assuring me that the doctor would be in shortly. Five minutes later the nurse returned and ushered me to the room next door. I was introduced to the doctor whose Indian name was unpronounceable and contained a D sound that was not written as part of the surname. He sat staring at some papers and then at the computer screen in front of him. He indifferently asked my name and last four giving me a brief glance before lowering his head to jot some notes while resting his brow along the edge of his left hand.

I received a battery of questions that I had already been asked by the nurse. He made notes. He rarely looked at me. He seemed bored, maybe tired or depressed. I repeatedly asked him to repeat himself as he spoke to the papers on the desk while mumbling in a thick accent. The interview was frustrating. When He asked what I needed I was dumbfounded. I needed a checkup to get in the VA system. Wasn’t that obvious? He asked what specifically I needed that day. I wanted to get a checkup and prescriptions filled.

We had a discussion about prescriptions. His take was that he could not renew my prescriptions to be filled at the VA. They would need to be prescribed by my doctor and then filled at the VA. When I brought to his attention that he was my doctor he skirted the subject declaring that he could not fill the prescriptions because he had not prescribed them and he would just be taking my word that I needed the prescriptions. The prescriptions I take are all very innocuous. I threw my hands up in resignation. I would have to contact my doctor to get new prescriptions.

The VA doctor continued with a review of my lab results. Most of what he said were just mumbles. I understood very little and often asked him to please repeat what he had said. Next he asked me to sit on the exam table and remove my shoes and socks. He listened to my heart and lungs and declared, “Good.” Next he brushed the arch of my foot and asked if I felt that. Yes, I felt it. I have had foot exams before and that is not a thorough neuropathy test. I guess it was definitive to him. He had me put my shoes and socks back on.

He next directed me to records to have them request my medical records from my provider. After that I should go to Cardiopulmonary to request new materials for my CPAP. Vision would be on the second floor.

Records personnel did not request files. I would have to request that they be sent to the VA.

Cardiopulmonary required a copy of my last sleep study (from 2011) before issuing any replacement materials.

Vision was on the first floor. I made an appointment. The soonest available is May third.

I also stopped to obtain a VA ID. I did not have to wait long to get my photo taken. The ID would be mailed and would take six to seven days.

I left the VA with the feeling that I had entered a compartmentalized military extension that lacked any semblance of structure or sense.

The following day I drove to my family doctor’s office. I spoke with people there whom I have known for many years. They made sense and were willing to help me with my VA quests. I obtained a records request form. I asked for the new prescriptions. I would have to see the doctor before he could write the prescriptions. Since I do not have health insurance I would
need to pay out of pocket, a minimum of $65.00. There had been a cancellation and I could see him right away, except he wanted to see my lab results which I did not have.

I drove the forty five miles to the VA. There the records personnel finished filling out the records request form. She was also able to print off a copy of my lab results. I called my family doctor’s office and was able to see him yet that afternoon.

I submitted the records request form and the doctor’s office personnel took care of it immediately. It had been sent to the VA before the office visit was over.

The visit with my GP went well. The doctor looked over the lab results and renewed the medicines on a three month fill for one year. He warned me that the VA may require a doctor to rewrite the prescriptions before they filled them. I laughed but he was serious. He was also right. I thanked him for all the years of association and we resolved to stay in touch. He has been my family doctor for twenty eight years.

On Friday I stopped at the Cardiopulmonary department and handed over a copy of the last sleep study. I had hunted it down and obtained a copy. It was looked over and I was told I could expect to receive my CPAP materials in in six to seven days. There was no immediate gratification. It would be shipped by mail.

I then went to the pharmacy to receive my prescriptions. The waiting area was blocked off from a construction zone with Visqueen plastic. Chairs were placed on either site of the entrance corridor. A diverse group of veterans occupied the seats. When the automatic doors frequently opened a freezing wind sucked out all the warmth. I entered my name and last four into a computer screen. A numbered ticket spit out. I was assigned # 1371. I checked a hall display monitor. It did not display any numbers. A man called to me, “That’s not working. I’m calling out the numbers.”. With that he boomed out “1364”.

I found a seat in a side hallway out of the cold and pulled out a crossword puzzle book. Fifteen minutes later I put away the crossword puzzles after hearing, “1370”. “1371” was called out within a minute after that. I was escorted into a room to be interviewed by a woman who asked name and last four. This is the standard first question. No hello. No how are you? “Name? Last four?”

I said hello and then answered her questions followed by, “How are you today?” She smiled, said fine and asked how I was. That’s better, I thought.

She did not have any prescriptions for me. I explained about my mission that the VA doctor had given me. Her reply, “That’s not how it works.” I only know what I had been told to do and I had fulfilled it. She explained that the doctor would need to rewrite the prescriptions and then submit them to the filled at the VA pharmacy (my family doctor had warned me). To speed things up I walked with the prescriptions in hand to submit them to the doctor to be rewritten.

The young woman in the registration office was very helpful. I guess she has not been there very long. She displayed an almost Pollyanna attitude by comparison to other personnel within the VA. In the end, she was able to hand over the prescriptions to the doctor’s nurse. I should be able to pick up the prescriptions on Monday. I have copies of the prescriptions, just in case. Fulfillment of the orders had yet to be seen.

I returned to the VA on Monday. I took a number for the pharmacy “1647”. I heard the familiar voice call out “1646”. I walked down the hallway and stood in the vicinity of the pharmacy offices. The caller looked at me and asked, “Are you 1646?”

“No” I replied “1647”.

He called out “1646” again then turned to me and said “Follow me.” as he led me to a room occupied by a woman who introduced herself as Carmen.

“How can I help you she asked?”

“I’m here for prescriptions”

“Name and last four?”

I was told that the prescriptions had been mailed. After explaining that I was supposed to pick them up, she tried what she described as “MAGIC”. She clicked away on her keyboard announcing “Cancelled” multiple times. Three of the four prescriptions were cancelled. I asked what exactly that meant. One prescription had already mailed. The others would be filled and available for pickup shortly. In the meantime she requested ten days worth of the one prescription that had mailed.

I thanked Carmen and walked down the cold corridor to have a seat within view of the working pharmacy medication fill display monitor. The other vets ranged from a working class clad group with Korean War and Vietnam emblazoned hats to disheveled elderly individuals in their pajamas. I neither wore a hat nor pajamas.

I watched the board while working on a crossword puzzle. Somewhere between glancing up and back to the puzzle my name was called. When I looked at the monitor, my number was among the others on the display. I passed the numbered ticket under the glass to the pharmacy tech as she placed my bag of drugs into a pass through box to the left of the window. I opened the door to the box, retrieved the bag, and reviewed its contents. “Thanks” I said as I waved to the tech and headed toward the parking lot.

I am staying in the area waiting for the prescription, the CPAP supplies, VA ID, and a replacement ATM card (the chip is malfunctioning). In the meantime my RV is parked at my friends (Terry and Helen) in Chattanooga, Tennessee. I did not want to winterize the RV to venture briefly to northern Indiana. While in Indiana I have depended on the kindness of Jason and Heather for a place to lay my head. If not for the kind understanding of my friends I don’t know what I would have done. I might also add that Dennis and Sue have been kind enough to allow me to receive my mail at their house. Their Neighbor Sue has been gathering in the mail lately and contacted me whenever something had come in for me. Thanks everyone. I like to think of myself as independent but I rely on a group of friends and family to help me out. What would I do without you all?

 

 

2 thoughts on “Easy Peasy Transition to The VA (a Healthcare Issue)

  1. Welcome again to the goverment”s way to do things. Would u believe I have the same problems with the welfare department. Sent what they asked me for. The worker said ” oh I am sorry but I also need this and that?” Why did you not ask me for that the first time, response was I forgot. So in 3 trips toTiffin and Bettsville we completed the task. So I fully understand your statements. Plus I see the Hassle has had with the VA.

    Like

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