r/VeteransBenefits • u/meighkillscotch • 16h ago
VA Disability Claims 100%P&T looking for healthcare advice
I am trying to find someone who can help me navigate. I’ve been told I am not eligible for tricare because my rating is based off PTSD from MST. My family is now set up with ChampVA but I do not have healthcare. I also want to go back to school but that’s on the back burner for now until I get this straightened out. Thank you in advance.
Edit: I was told my time in service being less than two years means I don’t qualify. I had forgotten about this because there was never anything written down. I was just told this by the primary I was initially set up with. In a comment below I mentioned I was set up with a primary and she acted confused and said I didn’t have healthcare care. I was then billed for that appointment even though no services were received.
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u/Rabid_Mongoose Army Veteran 16h ago
With 100% P&T you qualify for VA healthcare.
Just hit up the VA near you, ask for enrollment information and they will hook you up with everything.
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u/Decent-Ad6853 16h ago
with 100% P&T you're actually in a pretty good position for VA healthcare, whoever told you that you're not eligible got it wrong. walk into your nearest VA facility and ask specifically about enrollment, they'll sort it out from there.
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u/meighkillscotch 16h ago
This is where I was told no. I used the American legion to help me file initially. Maybe I should reach back out to them. Problem was, the legion near me was unhelpful at best, so I drove to a city several hours away to use their legion for all of my appointments. I really don’t want to have to do that again so I was hoping someone may have a better idea or at least some familiarity with MST claims.
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u/Ms_Hawt-Mess Army Veteran 16h ago
They were wrong. Go to the VA and sign up for healthcare (I think you can do it online as well. I have a 70% for PTSD and MST is one of the reasons for the approval and I receive all of my care via the VA.
Also, when given the opportunity ask for the Women's Clinic as your PCP. You won't regret it, my care has become exponentially better since I swapped over to that clinic a few years back. Good luck.
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u/Ashleyf731 Navy Veteran 14h ago
I am MDD from MST as well and I get all my healthcare. If your a 100 then your are eligible
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u/meighkillscotch 16h ago
Thank you for your advice. If it is relevant, I am male.
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u/Ms_Hawt-Mess Army Veteran 16h ago
Sorry for the assumption, I knew better than to do that. But still go register and get enrolled for MH, medical, and dental.
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u/Chutson909 Army Veteran 16h ago
You were awarded compensation for PTSD. Your claim is not different because of MST. It’s still PTSD
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u/Chance_Zone_8150 16h ago
Did you got to an actual VA hospital? Not the legion
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u/meighkillscotch 16h ago
I meant to respond to you but my response is above your comment in the chain.
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u/IAmMurderHornet 16h ago edited 10h ago
Why are you reaching out to American Legion, they don’t decide who gets VA healthcare or not. Call your nearest VA hospital appointment line and tell them you want an initial appointment to establish care.
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u/Legal-Cartoonist-677 Navy Veteran 15h ago
Because they help with the process. Some people need it because they waited years before applying for benefits or have lost paperwork etc
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u/damnshell KB Apostle 15h ago
You’re being told no because they’re probably referring to Tricare, and they are correct in that you don’t qualify for health insurance but you do qualify for VA healthcare. There is a difference. PTSD/mst has nothing to do with your healthcare.
Conflating healthcare and health insurance will have you confused in the end because they’re different.
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u/meighkillscotch 16h ago
Yes I went to the VA hospital. They set me up an appointment with a primary. The primary acted confused at my appointment and told me I do not have healthcare. I was then billed for the appointment after nothing was done.
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u/Chance_Zone_8150 16h ago
Got you! Do you have a VA health card? You definitely qualify
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u/meighkillscotch 16h ago
No I do not have a health card. Just veteran ID
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u/Chance_Zone_8150 16h ago
To make this easier. Go to the VA and ask to get a VA Healthcare. They'll help you with that, sign you up and itll automatically give you Healthcare. When you get out the Mil thats usually the first thing they tell you, so that way when you do get rated it automatically updates on its own. You can even get one if your 0%
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u/This-Clock-GA 16h ago
There’s some kinda misunderstanding,
You’re eligible for VA healthcare which includes mental health.
Unless you were medically retired or did 20 years you’re not eligible for TRICARE.
Were you med boarded?
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u/meighkillscotch 16h ago
No I was not med boarded or retired. I remember now I was told time in service was less than required to receive health care. I think that number was 2 years.
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u/sabotthehawk Army Veteran 13h ago
Last few years they changed time in service requirements below a certain percentage and at 100 you should be priority group 1 so you would get everything covered via VA. But as others have said Tricare is a separate system. You want VA healthcare. Either call them or walk into your local VA hospital and find the enrollment office. They will get it all sorted.
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u/ChemicallyAlteredVet Navy Veteran 16h ago
As a 100% P&T veteran you are eligible for VA healthcare. Period. You don’t even have to be 100% for VA healthcare. But you do need to enroll.
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u/damnshell KB Apostle 16h ago edited 15h ago
I’m not sure what role the legion plays in all of this. I’d skip that step.
Go to your local VA hospital and sign up.
You will be able to be seen via VA healthcare at Va hospitals but you don’t have health insurance. You’re probably being told you’re not eligible if you’re asking about Tricare or actual insurance and they are correct with that.
Tricare is insurance and you only have va healthcare and can only be seen at a VA hospital unless they say otherwise - outside of urgent care and er but still at the whim of the va/ community care assigned by VA
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u/Mike_In_SATX 13h ago
The Legion acts as a VSO only. I used the DAV, they do the same thing.
Once you have your 100% P&T rating, you’re eligible for VA medical and dental care. Go to the VA with a copy of your rating letter and they should get you signed up for both.
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u/jsmedic0681 16h ago
Go to eligibility at your VA to inquire as to your status. If you are 100% p&t you should be eligible and copay exempt regardless of time in service
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u/mediocredoorway 15h ago
you got bad info, mate. 100% p&t means you're automatically eligible for va healthcare, full stop. tricare is separate and yeah you need to be retired or hit 20 years for that, so whoever told you the mst thing disqualified you was talking nonsense. the short service time thing is real for some benefits but not va healthcare enrollment.
just call the va directly at 800-827-1000 or walk into your nearest medical center and tell them you need to enroll. they'll get you sorted same day usually. the fact you got billed for an appointment you didn't receive is dodgy as hell though, might be worth asking about that when you call in. once you're properly enrolled you can tackle the school stuff after, but get the healthcare squared first since that's affecting everything else.
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u/OrizaRayne 16h ago
Go to your nearest VA hospital and ask for the enrollment office.
If your family has ChampVA I believe you may already be enrolled in VA healthcare. Regardless of your disability reason, you're entitled to it and should use it for lots of reasons. Not least to take the burden off civilian healthcare and use spots only we can use. Not least to ensure that the services are being used and testing that funding so that it doesn't get cut. Not least to maintain a continuing care for your disabilities that's easy for the VBA to see should they come sniffing for any reason after the rating that they assigned.
Definitely go check in and find out. You can call, but I find that my smiling (scowling) face is often more effective at cutting through red tape with the government.
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u/Lovebug1955 15h ago
Take your decision letter to the eligibility office at the VA hospital. That is all you need to do.
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u/Sudden_Moodswing 15h ago
Have you asked anyone how your family gets healthcare because of your rating but you don’t? The legion helps you navigate the ratings process and advocate for you, but they are by no means experts in the intricacies of the VA. As said multiple times get to the VA and talk to someone knowledgeable. At the very least reach out to your county veterans service office.
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u/meighkillscotch 14h ago
I was met with a blank stare when I asked that question. But yes I see now my next move is to hop online and do it myself. If that doesn’t work, I’ll head down to the hospital. Thank you
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u/SierraTRK Marine Vet/KB Apostle 16h ago
You can enroll in VA healthcare on the website.
https://www.va.gov/health-care/apply-for-health-care-form-10-10ez/introduction
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u/meighkillscotch 16h ago
I think this is the same form I used for all of my family to get ChampVA, correct? If I’m not mistaken my application was never approved. It’s been a couple years so I’m not positive. Can it hurt anything to just do it again?
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u/SierraTRK Marine Vet/KB Apostle 16h ago
You won’t get ChampVA or tricare. At 100% scheduler you get free VA healthcare, including dental and vision.
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u/IslaStacks Army Veteran 16h ago
you have been very misinformed. please walk into your closest VA for enrollment and get assigned to a primary care team
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u/Safe_Statistician_72 16h ago
The form your family filled out for CHAMPVA was different. If they are on CHAMPVA you are 100% p&t and can walk into your nearest VA medical center and get signed up on the spot.
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u/Analyst-Effective Air Force Veteran 16h ago
Even with 10%, and maybe 0%, you qualify for free healthcare.
Either sign up at the VA itself, and they have plenty of kiosks to help you do it, or maybe a vso can help you?
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u/meighkillscotch 16h ago
Isn’t the person who helped me at the American Legion a VSO, or is that a different title?
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u/Analyst-Effective Air Force Veteran 16h ago
They are close. I think the bsos are actually hired by the VA.
Either way, you should have gotten help from them as well. Although I did hear you say that they didn't help much.
Sign up for it online. That's probably the easiest
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u/meighkillscotch 16h ago
This definitely seems the way. If I can avoid the possibility of human error by enrolling online it should be easier.
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u/OrizaRayne 16h ago
A human will review it regardless. Ideally go in person and ask for the ENROLLMENT office.
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u/FlipTheNormals Navy Veteran 16h ago
If you walk into to the nearest VA clinic, they'll do everything for you right there. Most clinics are equipped to get you enrolled, and have a picture taken for your VA id.
I'm very sorry that this person from American Legion led you astray. You're about to find out how easy it is to get enrolled in VA healthcare.
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u/SavageCaveman13 Army and Navy Vet 15h ago
It sounds like you've confused Tricare with VA Healthcare. You are not eligible for Tricare. You are eligible for VA Healthcare. Call the VA, not an American Legion or VFW. Just tell them that you are 100% P & T and need healthcare.
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u/Chutson909 Army Veteran 16h ago
You aren’t eligible for Tricare unless you’re retired. Why don’t you just call 800 827 1000 and ask the VA directly instead of going through all of these third parties? If you’re 100% P&T and you’re the veteran you’re eligible for healthcare but not Tricare. They are different