By Larry Dandridge
This article is the second in a series of two.
Last week’s article for The Island News introduced three types of VA healthcare programs and a DOD healthcare program for spouses, dependents, and family caregivers. That article provided an overview of the Department of Defense (DOD) TRICARE Program, The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC), and The VA Camp Lejeune Family Member Program.
Last week’s column also encouraged veterans and their family members to read the information at https://bit.ly/3O0GBhl and https://bit.ly/3JgMCoa.
Veteran Service Officers (VSOs)
Last week’s article recommended that veterans and their family members use their local Veterans Service Officer (VSO) or a VA-accredited Attorney or Claims Agent to help them apply for VA benefits. Because VSO services are free, your local Veterans Service Officer or County Veteran Affairs Office is the best place to learn what your state and federal veterans’ benefits are and how to apply for those benefits. Attorneys are usually only needed in the most complicated cases where an initial claim has been denied by the VA.
This article will cover three more important and valuable VA healthcare benefits that a veteran’s family member may be eligible for. Those three programs include:
1. The Spina Bifida Health Care Benefits Program (SBHCBP): If you are the biological child of a Korean or Vietnam War Veteran and you have been diagnosed with spina bifida, you may qualify for disability benefits, including health care benefits. Find out if you qualify for the SBHCBP Program at the VA’s Community Care SBHCP webpage https://bit.ly/3HseZ0X.
On the VA’s Community Care SBHCP webpage, you can find detailed answers to
- How to file a claim for Spina Bifida healthcare benefits?
- How SBHCBP Program satisfy the minimal essential coverage requirements of the Affordable Care Act?
- What other resources (guide, brochure, policy manual, fact sheet, provider locator, and SB Association website) are available?
- What are the phone numbers for SB healthcare general information, eligibility, and preauthorization?
- How to use ASK CA (AVA)?
- What are the pharmacy benefits?
2. The Children of Women Vietnam Veterans (CWVV) Health Care Benefits Program: If you’re the biological child of a “Woman Vietnam War Veteran” and you have been diagnosed with certain birth defects, you may qualify for VA health care benefits. These benefits may help pay for services needed to treat your covered birth defect and related medical conditions. Find out if you qualify for the CWVV Health Care Benefits Program and how to apply at the VA’s Community Care CWVV webpage https://bit.ly/47PXh1Y.
CWVV is limited in scope. The CWVV Health Care Benefits Program is not a comprehensive health care plan and only covers those services necessary for the treatment of a covered birth defect and associated medical conditions. It does not cover care that is unrelated to a covered birth defect. The VHA Office of Integrated Veteran Care (IVC) manages the CWVV Health Care Benefits Program, including the authorization of medical benefits and the subsequent processing and payment of claims.
CWVV Eligibility
Children whose biological mother is a Vietnam Veteran and who were conceived after the date the veteran entered the Republic of Vietnam (period beginning Feb. 28, 1961, and ending May 7, 1975), and who have one of the covered birth defects as determined by the Veterans Benefits Administration (VBA) are eligible for the program.
Enrollment
To enroll in the CWVV Health Care Benefits Program, eligibility must first be established for a monetary award under the VBA. The Denver VA Regional Office determines that entitlement. You must mail a completed Application for Benefits For Certain Children of Vietnam Veterans With Disabilities, VA Form 21-0304 found at https://bit.ly/3U6gJED, along with medical evidence to the VA Regional Office, Veterans Service Center, listed on the form. Once eligibility is determined, enrollment in the CWVV Health Care Benefits Program is automatic.
CWVV Contacts and Other Resources
The VA’s Community Care CWVV webpage provides the answers to:
- What other CWVV resources (guide, brochure, policy manual, fact sheets, provider locator, and VBA Compensation for special birth defects) are available?
- What are the phone numbers for CWVV healthcare general information, eligibility application, and preauthorization?
- What is the VHA Office of Veteran Care CWVV Program mailing address?
3. Pharmacy benefits: If you qualify for CHAMPVA or the Spina Bifida or Children of Women Vietnam Veterans (CWVV) programs, you can get prescription benefits through your local retail pharmacy or the VA’s Meds by Mail program. However, prescription medication must be approved by the U.S. Food and Drug Administration (FDA) and must not be used in conjunction with any experimental program. Learn more about pharmacy benefits at the VA’s Community Care Pharmacy Benefits webpage https://bit.ly/3vLK6lo.
VA’s Community Care Pharmacy Benefits webpage covers detailed information on:
- Information and Fact Sheets for CHAMPVA, Spina Bifida, and CWVV beneficiaries.
- Using the VA’s CHAMPVA, Spina Bifida, and Primary Faily Caregivers, or Children of Women Vietnam Veterans Meds by Mail (MbM), East and West Centers, Frequently Asked Questions (FAQs), contacts, other resources, and key phone numbers.
- Using Medications by Mail VA Form 10-0426, which is downloadable at https://bit.ly/47KiL0q. Learn more at https://bit.ly/47LHpNS.
- Using a local pharmacy and Optum RX (see https://bit.ly/42bvIPp and https://bit.ly/3vSiA5E).
- The phone numbers for Meds by Mail EAST and WEST, Office of Integrated Veteran Care, and the Automated Prescription Refill Line.
- More resources (brochure, form, fact sheet, and guide).
Caution
VA benefits are complicated. Filing for VA benefits is complicated. Appealing VA denials of claims for benefits can be even more complicated. The above information is a summary only. Veterans and their family members should read all of the information on the referenced web pages in this series of two articles. They should also read all of the resources (and linked web pages) on the web pages referenced in these articles. Most importantly, veterans and their spouses, dependents, and family caregivers should ask a VSO and the VA for help understanding their veterans’ benefits and how to apply for their federal and state benefits.
Larry Dandridge is a Vietnam War wounded warrior, disabled veteran, ex-Enlisted Infantryman, ex-Warrant Officer Pilot, and retired Lt. Colonel. He is a past Veterans Service Officer, a Patient Adviser at the RHJ VA Hospital, the Fisher House Charleston Good Will Ambassador, and the VP for Veteran Affairs for the local Army Association Chapter. Larry is the author of the award-winning book Blades of Thunder and a contributing free-lance writer with the Island News. Contact him at LDandridge@earthlink.net or 843-276-7164.
