Getting an Implant Through the VA

[flyingduck2019]

Hello guys----I have read on this forum several inputs regarding guys getting implants through the VA. I am considering doing the same thing but would like some information before I take the plunge.
I am a veteran with no disability rating although I have received eye glasses and hearing aids through the VA. I currently see a civilian family doctor and also a civilian ERO.

What I would like from you guys is what your copay was to get the implant through the VA and how long was your recovery time before you could see if the new toy worked?

Appreciate any inputs.

[Lost Sheep]

I have no information regarding copay for a veteran who has no service-connected disability. Sorry.

I do have service-connected disability and am registered with the VA Health System (which I assume, since you have received some medical benefits). I receive general medical treatment at my local VA facility and the related military hospital. I received an implant in that way in 2017.

Treatment at VA facilities (or authorized outside facilities - I was authorized to go to a civilian provider and eventually used a military hospital as that outside facility because the surgeon (active duty Air Force, but an expert at IPP surgery) varies from facility to facility. Some VA facilities have dismal track records for treating vets. Some are great. How is yours?

Recovery and other medical issues will be no different via VA-provided surgery than non-VA provided surgery. VA medical care has the same standards of care as any other professional medical provider in this country.

[flyingduck2019]

Lost sheep--Thank you for your fast response. The VA clinic/hospital I use has a good track record as far as I know. I have not heard any bad remarks about it. It's about an hours drive depending on work traffic. As it is in southern california it has taken me a little less than an hour to drive there but if traffic is bad it can take over 2 hours.
I am fighting with tricare over my trimix. First two orders went through without a hitch, got 10ml for $46.00. This last one they are refusing to pay because they say two of the ingredients (which I would bet both my balls are used in a lot of other compounded medications they pay for) are not covered. It's neither of the 3 main juices, it's the water and poweder used to prevent bacteria and transport the 3 in a injectable form.

If they don't change their mind I will see if my URO can order something else that will give the same reslults and if that won't work then it's time for the implant.

[Lost Sheep]

My advice in this thread is as good as I can give.
viewtopic.php?f=6&t=4947

Use the "search" functions to find others, or just cruise through a couple years of old threads. There are several mentions of the V.A. authorizing and providing implants.

[Quester]

I too am service connected. So I can’t speak to all your questions. I can give information based upon what I’ve been told, this is second hand information so I’d advise you to contact the medical center’s patient advocate as they can often answer the medical insurance type information.

It is my understanding based on also being an employee at VA Medical center I get care at that by law the VA will bill a Veterans insurance carrier if any.

The are copays on medication if as a general rule the veteran is less than 50% service connected disabled. Less than 50% the ability to see, and get treatment is based upon ability of the medical center having “space” and the patient to seek, afford care, often called a means test.

Again second hand information. As to Tricare not covering your compounded medication could be a lot of insurance will push back on non FDA uses for medication even if they pay for them separately once those medications are mixed together they are considered a new medication. This is a guess on my part as I’m a pharmacy technician and to have a compounded medication at my facility it has to be approved after meeting safety, stability, & often no other approved medication available. Call Tricare’s patient advocate and see if they can tell you why they won’t cover your trimix.

Not sure if this helps or hinders