Posted on Oct 26, 2023
How does a 100% disabled veteran get community care dental benefits?
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I have tried to get benefits for dental care and have been shuffled from provider to provider with nothing being done
Posted 1 y ago
Responses: 9
Community care will (unless grandfathered) generally depend on availability or services at the VA, time/distance you are away from the VA dental clinic, and/or the timeframe for being scheduled for services.
The first step is to have an initial exam by the VA dental clinic*. You can request that you receive future care at a community care provider if you meet one of the eligibility criteria*.
If you meet the eligibility based on travel time, then you should have no problem getting future care from a local provider. Other eligibility may be situational (i.e., "yes" for this treatment/procedure, but we'll have to evaluate for future needs).
One item of note - Community Care providers will have to get pre-authorization for everything. Most will "stack" requests up front (for example, an authorization request for a year's worth of exams, cleanings, etc.), especially if your VA facility's community care office takes a while to send an approval back.
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* Facility search - https://www.va.gov/find-locations/
* Community Care Eligibility - https://www.va.gov/COMMUNITYCARE/programs/veterans/General_Care.asp.
The first step is to have an initial exam by the VA dental clinic*. You can request that you receive future care at a community care provider if you meet one of the eligibility criteria*.
If you meet the eligibility based on travel time, then you should have no problem getting future care from a local provider. Other eligibility may be situational (i.e., "yes" for this treatment/procedure, but we'll have to evaluate for future needs).
One item of note - Community Care providers will have to get pre-authorization for everything. Most will "stack" requests up front (for example, an authorization request for a year's worth of exams, cleanings, etc.), especially if your VA facility's community care office takes a while to send an approval back.
---------------------------------
* Facility search - https://www.va.gov/find-locations/
* Community Care Eligibility - https://www.va.gov/COMMUNITYCARE/programs/veterans/General_Care.asp.
Find VA Locations | Veterans Affairs
Find a VA medical center, clinic, hospital, national cemetery, or VA regional office near you. You can search by city, state, postal code, or service. You'll get wait times and directions.
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COL Randall C.
PFC Kay Armstrong - If you're rated at 100% by the VA, you're absolutely eligible. Is it because there isn't a VA dental clinic near you or did you try to make an appointment and they said they wouldn't take you for some reason?
If the first, use the link below* and put in your address. If the second (you're eligible, but are being refused appointments), then contact the Patient Advocate* at the VA medical center you're assigned to for assistance.
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* Find VA Dental clinic - https://www.va.gov/find-locations/?facilityType=health&page=1&serviceType=DentalServices
* VA Patient Advocate - https://www.va.gov/health/patientadvocate/
If the first, use the link below* and put in your address. If the second (you're eligible, but are being refused appointments), then contact the Patient Advocate* at the VA medical center you're assigned to for assistance.
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* Find VA Dental clinic - https://www.va.gov/find-locations/?facilityType=health&page=1&serviceType=DentalServices
* VA Patient Advocate - https://www.va.gov/health/patientadvocate/
Find VA Locations | Veterans Affairs
Find a VA medical center, clinic, hospital, national cemetery, or VA regional office near you. You can search by city, state, postal code, or service. You'll get wait times and directions.
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This is all BS the dental care thur VA is a joke this needs to be looked into it should be "no dental care "
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PFC Kay Armstrong
I agree!!!! I'm 100% VA disabled and now 68 years of age. I have NEVER been able to see a VA Dentist. NEVER!!!
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1st Lt Mary James
I agree with you. I tried to get care (gosh make sure you're 100% disabled) for a broken crown that I almost choked on as it broke when I was eating. First I'm told there's no appts and to use the walk in triage at 12n. Fill out papers, wait, go in only to be told I can't be seen right away. They take X-rays only of the tooth involved instead of doing a panarex (whole mouth). Then if you're lucky you get an appt months away. You don't get any community referral whatsoever- this policy is constantly violated.
I recently saw a building in Knoxville, TN that had a large sign: VA Dental Clinic. I asked about that. I'm informed that the VA has a hiring freeze on. So why have an empty building that you're paying utilities on, as well as other expenses, when it isn't used or isn't staffed? The insanity boggles the mind. Same with Podiatry- have to be 100% disabled to be seen. Finally get 100% rating (after 4 attempts.and 30+ years) and then told its difficult to get into nail care clinic. The VA is responsible for my debility for delaying my spine surgery to where I can't bend and I have neuropathy in both legs. No community care referral here either. Told I don't qualify to be seen in the spine clinic but can't get specifics on criteria to be seen. Once again, no community referral over and over and over again. Two White House Hotline complaints and no improvement
I recently saw a building in Knoxville, TN that had a large sign: VA Dental Clinic. I asked about that. I'm informed that the VA has a hiring freeze on. So why have an empty building that you're paying utilities on, as well as other expenses, when it isn't used or isn't staffed? The insanity boggles the mind. Same with Podiatry- have to be 100% disabled to be seen. Finally get 100% rating (after 4 attempts.and 30+ years) and then told its difficult to get into nail care clinic. The VA is responsible for my debility for delaying my spine surgery to where I can't bend and I have neuropathy in both legs. No community care referral here either. Told I don't qualify to be seen in the spine clinic but can't get specifics on criteria to be seen. Once again, no community referral over and over and over again. Two White House Hotline complaints and no improvement
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My dentist tells me I need a bottom implant I'm not able to chew my food correctly which causes a lot of stomach problems so if you could help please let me no thank you . Mr James Lafayette
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CW4 Donald Cusack
All you have to do is get your VA dentist to setup an appointment with oral surgery. It should be that simple.
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COL Randall C.
James, a lot of the advice depends on what your status is. For example, if you're a veteran that has a 100% disabled rating by the VA, then you can get free dental care for "any necessary dental care, prosthetic devices, and oral surgery", so that would cover the bottom implant.
Other categories that might apply that the VA would take care of your situation are:
● If you have any DENTAL condition that is service-connected. If it is 10%> then "any needed dental care". If it is 0% (non-compensable service-connected), then it is "Any dental care needed to make sure you have and can keep a functioning dentition (i.e., a working set of teeth)."
●If the issue with your bottom teeth is tied to an existing service-connected condition (regardless of rating)
● Have a service-connected disability (regardless of rating) that's the result of combat wounds or service trauma.
● Former POW
●
If you're in any of the above categories, then you need to make sure you're enrolled in VA health care* first and then you can schedule with the dental clinic.
If you aren't eligible for VA dental care, there are many programs available that will assist veterans financially or provide free dental care, but they are usually geographically limited, income limited, or application limited.
A good place to start is with your state's Department of Veterans Services (it might be called something else, but you should easily be able to find it) and they should have a good handle on at least state programs that might be able to assist as well as pointing you towards other non-state programs.
Also, just start searching - again, there's not one specific program that can be pointed to as your circumstances are different than the next veteran. Byte.com* put together a good starting point that has many programs for veterans that aren't eligible for VA dental. You can start there and continue searching (a good internet search would be "dental health care for veterans" with other qualifiers added in (such as "free", "discounted", your state, etc.).
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* Dental Benefits for Veterans - https://www.va.gov/healthbenefits/resources/publications/IB10-442_dental_benefits_for_veterans.pdf
* Enroll in VA Health Care - https://www.va.gov/health-care/apply/application/introduction
* Byte listing of some dental programs for veterans - https://www.byte.com/community/resources/article/veterans-dental-resources/
Other categories that might apply that the VA would take care of your situation are:
● If you have any DENTAL condition that is service-connected. If it is 10%> then "any needed dental care". If it is 0% (non-compensable service-connected), then it is "Any dental care needed to make sure you have and can keep a functioning dentition (i.e., a working set of teeth)."
●If the issue with your bottom teeth is tied to an existing service-connected condition (regardless of rating)
● Have a service-connected disability (regardless of rating) that's the result of combat wounds or service trauma.
● Former POW
●
If you're in any of the above categories, then you need to make sure you're enrolled in VA health care* first and then you can schedule with the dental clinic.
If you aren't eligible for VA dental care, there are many programs available that will assist veterans financially or provide free dental care, but they are usually geographically limited, income limited, or application limited.
A good place to start is with your state's Department of Veterans Services (it might be called something else, but you should easily be able to find it) and they should have a good handle on at least state programs that might be able to assist as well as pointing you towards other non-state programs.
Also, just start searching - again, there's not one specific program that can be pointed to as your circumstances are different than the next veteran. Byte.com* put together a good starting point that has many programs for veterans that aren't eligible for VA dental. You can start there and continue searching (a good internet search would be "dental health care for veterans" with other qualifiers added in (such as "free", "discounted", your state, etc.).
------------------------------------------
* Dental Benefits for Veterans - https://www.va.gov/healthbenefits/resources/publications/IB10-442_dental_benefits_for_veterans.pdf
* Enroll in VA Health Care - https://www.va.gov/health-care/apply/application/introduction
* Byte listing of some dental programs for veterans - https://www.byte.com/community/resources/article/veterans-dental-resources/
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