4 Things I Learned During My First Appointment At The VA

Not all Veteran Affairs clinics are created equal.




Just before Veterans Day, and slightly over seven years after leaving the service, I finally had my first doctor’s appointment with the Department of Veterans Affairs. Like most vets, I’d heard both positive and negative stories about VA health care and I wasn’t quite sure what to expect. I’d have to say my experience was somewhere in the middle and, perhaps most importantly, very informative.


Related: The 4 key things that must be proven in every VA benefits claim »
Here are a few of the things I learned:

1. Not all VA clinics are created equal.

I originally enrolled in VA health care in 2011. I went to the local VA hospital, turned in my VA Form 10-10EZ, and had my picture taken. I was told my VA identification card would arrive in the mail in a few weeks and I would get a phone call or letter with an appointment date in roughly the same amount of time. Well, my ID never showed up and I finally got that phone call three years later.

When I decided to try again — this time in a different city and a different VA hospital — I went in with low expectations. The registration process, though, was fairly quick and painless and the woman who helped me was so polite that I hunted down her boss to tell her so. Even more surprising, the very next day, I had a letter in my mailbox with an appointment date scheduled less than 30 days later. While that initial appointment had to be cancelled due to physician illness, I was immediately rescheduled for two weeks later.

2. An extra copy of medical records would have been useful.

While we often think of VA as one cohesive entity, it actually has several distinct parts, two of which are the Veterans Benefits Administration and the Veterans Health Administration. According to the doctor I saw, the arm of VA responsible for determining disability compensation claims, and the arm of VA responsible for health services, do not share information. In fact, according to the doctor, information submitted to the Benefits Administration in support of a claim becomes confidential and cannot be shared with Health Administration without the veteran’s direct permission.

Not only would bringing a copy of my medical records have given the doctor some idea of my history, but it also would have improved my care — at least specifically when it came to the primary reason I’d gone in, namely the possibility of transferring prescriptions to the VA pharmacy. If you are like me and have spent a lot of time trying to get the right mix of prescriptions for your condition(s), you don’t want to have to start over or accept a substitute that you know doesn’t work. VA, like all health care networks, has its list of “formulary” drugs that are essentially prescriptions your VA doctor could write for you without jumping through any hoops because VA approves them and, often, keeps them on-hand. If you need a “non-formulary” medication, VA will, according to the doctor I saw, want you to switch to a formulary version of the medication unless the doctor can give cause why you need the non-formulary. Which is where having your medical records is helpful, as it can provide your VA doctor with the needed justification.

3. Not everyone has a co-pay.

I went into VA with the vague idea that there was a “you-broke-it-you-bought-it” rule in effect regarding my care. Essentially, if it was service-connected, the VA was responsible for the medical costs and I wouldn’t have a co-pay. However, after my visit, I called the claims department, just to be sure. A very pleasant gentleman informed me that VA would not be charging me a co-pay, ever, for any reason. Because I have a greater than 50% compensable VA service-connected disability rating, I would never be charged a co-pay, whether I went to the VA for a service-connected or nonservice-connected condition. Because I had gone for a compensable service-connected condition this time, they also would not be charging my health insurance. Recently, I picked up the 2014 version of the VA’s “Federal Benefits for Veterans Dependents and Survivors” and found even more useful details on who has to pay co-pays, how much they are, and for which services.

4. Veterans contribute to the delay in appointments.

Of all the reasons veterans may have difficulty getting access to VA health care, I know this is low on the list. However, I’m mentioning it because it’s something that we, as veterans, can do to help each other out.

As I sat answering questions for the nurse, she received notice that four veterans had cancelled their appointments for that day. Things come up, but every cancelled appointment means that not only are you not being seen, but neither is another veteran who could have used that spot. If you make an appointment at the VA, you should keep it. If you can’t, at least try to cancel with enough notice that your appointment can be given to another veteran who needs it.

One team, one fight, right?