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Intruder72 wrote:

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There have been several posts about when VA will cover vets for emergency care outside a VA facility.

While the VA will cover ER, in Non VA facility there are many requirements including:

1. Vet must be enrolled in VA health care system.

2.  Vet must have been provided care by VA health provider in last 24 months excluding C & P, AO, Gulf war and radiation exams

3. Vet has no other health insurance, medicare, medicaid, etc that will pay any part of the bill.

4. Vet has no contractual or legal recourse against a third party such as claim arising out of motor vehicle accident that will pay some or all of the bill.

5. Claim must be submitted to nearest VA medical facility within 90 days of discharge.

6. VA will only pay for emergency care until condition is stabililized. Vet is liable for treatment for stays beyond date condition is stabilized.

Counting on VA paying for ER treatment is not for the faint of heart. I prefer paying $100 per month for Medicare so I dont have any anxiety about whether my non VA care will be paid for.

Having gone thru this in a real exp, let me add that there is also some language about ''in a prudent lay person's opinion, the health threat is too immient to make it to the regional VA,'' or close to that affect. My VAMC is 70 miles away and I came down with acute chest pains on my right side, my wife being a trained MOA took me to the local ER. Six hours and $6,000 later, I was released. The local ER took care of everything, calling the VA for auth and so on. I thought, well this is great. This was April 7,2009.

I did not do the ''aggressive followup'' thing, since the hospital never contacted me, I thought all was ok, until I got a notice 18 months later from a collection agency. With a little involvement on my part and the Fee Basis people, the bill was paid (at $2000, not $6,000). Well, I thought all was well.

Following month, I get a notice from my credit monitoring service that my credit score had dropped 75 points, the azzhole collection agency reported it and that was Jan 2011. I just two weeks ago got that resolved and deleted from my credit report.

My advice from that bad experience, if you have to go that route, once you've gotten better, be very aggressive and follow up regularly with the Fee Basis people and your local hospital's billing office. I could have avoided all the credit bureau issues had I been more attentive.

BTW, I know you said your husband does not have Medicare but if he did, the VA will not pay anything if the hospital files on Medicare and Medicare pays something. You would be on your own for the copay. I believe that is by law, either VA is the sole payer or they do not pay at all, even on SC'd issued.