VA Eastern Colorado Health Care System
Billing & Insurance
Attention Veterans with co-pays. Please read this important information concerning recent monthly co-pay suspensions.
On April 6, VA stopped sending monthly copay billing statements. The suspension applied only to Veterans who had copayments for medical care or prescriptions. It will run until Dec. 31, 2020.
Unless otherwise directed, VA will resume sending out monthly copay patient statements beginning in January of 2021. Veterans will receive a patient statement that may include the total amount of any:
- New copay charges for medical care and prescriptions they received from April 6, 2020, through December 31, 2020
- Unpaid copay charges for medical care and prescriptions they received before April 2020
We understand this may impose a financial burden on some of our Veterans, and we’re doing everything we can to help. If you can’t make your payments when billing starts again, please call us at 866-400-1238 or 844-698-2311 (TTY: 711). We’ll help determine your debt relief options.
For debt related to VA benefits, please contact the VA Debt Management Center at 800-827-0648 7:30 a.m. to 7 p.m. ET Monday through Friday.
For debt related to VA health care, or if you can pay your medical bills before Dec. 31, 2020, please contact the Health Resource Center at 888-827-4817. You can also pay online at www.pay.gov, or at the agent cashier’s office at a local VA medical center.
Attached, are three forms Veterans can fill out to help with their debt:
- VA Form 10-10HS is a request for hardship determination for priority groups 6, 7, 8a,c,d.
- VA Form 5655 is an application for prescription copayment waivers for priority group 5.
- VA Form 1100 is a repayment agreement and applies to all Veterans who have entered into a repayment arrangement.
The website https://www.va.gov/coronavirus-veteran-frequently-asked-questions/ discusses the changes further and some of the ways we can help.
If you have questions about your debts or medical bills, please reach out to us before the holidays so you are not left unprepared. Please feel free to contact our local customer service team at (801) 582-1565 ext. 1900 if you have additional questions.
You can read more about the decision here: https://www.whitehouse.gov/briefings-statements/remarks-president-trump-vice-president-pence-members-coronavirus-task-force-press-briefing-17/
To speak with someone about billing inquiries, please call the Health Revenue Center at 1-866-393-1846. For assistance with authorization for care contact the network authorization office at 1-888-795-0773.
Private Health Insurance
VA is required by law to bill private health insurance carriers for medical care, supplies and prescriptions provided for treatment of Veterans' nonservice-connected conditions. Private health insurance coverage through a Veteran or Veteran's spouse is insurance provided by an employer, Veteran or other non-federal source, including Medicare supplemental plans. Generally, VA does not bill Medicare or Medicaid for reimbursement; however, VA does bill other types of health insurance including Medicare Supplemental plans for covered services.
Note: A Veteran’s insurance coverage or lack of insurance coverage does not determine their eligibility for treatment at a VA health care facility.
Veterans applying for and using VA medical care must provide their health insurance information, including coverage provided under policies of their spouses. Veterans are not responsible for the remaining balance shown as patient responsibility on the explanation of benefits from their insurance carrier. However, Veterans may be responsible for a VA copayment depending on their assigned Priority Group.
Importance of Providing Health Insurance Information
- Veterans are not responsible for any unpaid balance that the insurance carrier does not pay, except for VA copayments they may be required to pay, depending on their assigned Priority Group.
- Payments received from a Veteran’s private health insurance carrier are credited towards any applicable VA copayments, reducing all or part of the Veterans out-of-pocket expenses.
- Many private health insurance companies will apply VA health care charges towards satisfying a Veteran's annual deductible and maximum out of pocket expnse.
- Money collected by VA from private health insurance carriers is returned back to the VA medical center providing the care. The funds are used to provide the best care possible to our Veterans.
Cancelling Private Health Insurance
Veterans who have private health insurance should consider a number of important factors before canceling their health insurance, such as:
- Impacts to Family Members. VA does not normally provide care for family members of Veterans enrolled in VA health care. If you cancel your private health insurance, they may have no health care coverage.
- Disenrollment in VA health care. 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 a Veteran with no health care coverage.
- Medicare Parts A and B. VA does not require a Veteran to have Medicare Part A or B to be enrolled in VA health care. However, Veterans should always consider their current and future health care needs before changing any insurance 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.
In most cases, if you don't sign up for Part B when you are first eligible, you'll have to pay a late enrollment penalty. You will have to pay this penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it. Also, you may have to wait until the General Enrollment Period (from January 1 to March 31) to enroll in Part B. Coverage will start July 1 of that year.
For these reasons, VA strongly encourages Veterans to consider important factors, risks and benefits before making any changes to their private health insurance.