Pictured is a Hawaii veterans plate. (Courtesy photo)
Jennifer S. Gutowski, MHA, FACHE
Director, VA Pacific Islands Health Care System
HONOLULU -- As you may know, VA implemented the Mission Act on June 6. But one of the lesser known provisions of the law established a new urgent care and pharmacy benefit that allows eligible veterans access to urgent and walk-in care at participating clinics in their communities.
This is a giant step forward in terms of convenience for our patients, as eligible veterans do not need to get prior authorization from VA to visit an urgent care provider in VA’s network.
This urgent care benefit is meant to give veterans a convenient way to get treatment for minor injuries and illnesses such as colds, strep throat and pink eye. To be eligible for urgent and walk-in care, veterans must be enrolled in the VA health care system and have received care through VA from either a VA or community provider within the past 24 months.
In our area, the following urgent care clinics are participating: VA Urgent Care Locator at https://vaurgentcarelocator.triwest.com/Locator/Care.
VA Urgent Care Benefit
As of June 6, 2019, VA offers eligible veterans an urgent care benefit in the community. This new benefit provides another option for the treatment of minor injuries and illnesses.
Under VA’s urgent care benefit, Veterans must seek care from VA’s contracted network of urgent care/retail locations.
If you are seeking urgent care benefits and pharmacy benefits related to urgent care visits, go to Urgent Care Tips at https://www.triwest.com/globalassets/documents/urgent-care/va_urgent_care_tips.pdf.
- As part of implementing the VA Mission Act of 2018, VA will start offering urgent care services to provide Veterans with greater choice and access to timely, high-quality care.
- Urgent care providers treat injuries and illnesses that require immediate attention but are not life-threatening, such as influenza, minor burns, and skin infections.
- There are two types of urgent care network locations: Retail and Urgent.
Retail locations include a walk-in health clinic, other than an office, urgent care facility, pharmacy, or independent clinic located within a retail operation. Reasons why you would seek care at a retail location include treatment of an uncomplicated illness such as a sore throat or earache.
Urgent locations include an office or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention (aside from emergency rooms). Reasons why you would seek care at an urgent location include treatment of more pressing illnesses or injuries that are not life-threatening, like splinting, casting, lacerations, or wound treatment.
- This benefit is considered open access, allowing Veterans to access urgent care within VA’s community care network and receive care without prior authorization from VA. The benefit started in June 2019.
WHAT PHARMACY PERSCRIPTIONS WILL VA COVER UNDER THE MISSION ACT?
VA will pay for or fill prescriptions resulting from your urgent care visit. The urgent care provider may write a medically necessary prescription for up to a 14-day supply. Veterans will be able to fill their prescription at any in-network pharmacy with Express Scripts.
- The construction of the urgent care network is well underway with thousands of locations nationwide, and it will be fully complete by July 15, 2019. To ensure the most optimal user experience, you will continue to see refinements to this tool.
- Call for urgent care or pharmacy hours of operation before seeking care.
- You do not have an insurance card for this benefit.
- Call 1-833-4VETNOW (1-833-483-8669) to verify you are eligible for urgent care services.
Do NOT Pay a Copayment at Time of Visit. Eligible Veterans will be billed separately by VA for any copayment that is applicable.
Receive Prescription, If Needed. A network urgent care/retail location provider may write you a prescription for up to a 14-day supply. The medicine must be listed on VA’s Urgent Care Formulary at www.triwest.com/urgent-formulary. If the medicine is needed urgently and is not listed on the Urgent Care Formulary, it must be listed on the VA National Formulary, available here at www.pbm.va.gov/nationalformulary.asp. Urgent prescriptions may be filled at a VA facility or pharmacy in the Express Scripts network (as “VAPC3RX”). Opiates will be limited to seven days or less, consistent with state law.
If you encounter any challenges at the urgent care visit or pharmacy, call 1-866-620-2071.
For more information on the Mission Act, visit https://www.missionact.va.gov/.
An update on VA clothing allowance for Veterans with certain disabilities
Has your clothing been damaged by your prosthetic or orthopedic device (such as a wheelchair) or by the medicine you’re taking for a skin condition? If it has, you may be able to get money each year to help you buy new clothes. This is a disability compensation benefit known as an annual clothing allowance. Find out if you can get this benefit.
Can I get disability benefits from VA?
You may be able to get disability benefits if you meet both of the requirements listed below.
Both of these must be true:
- Your prosthetic or orthopedic device or your skin medicine causes damage to your clothes,and
- You need this device or skin medicine because of an injury or illness related to your military service (called a service-connected condition)
Who’s covered? Veterans
What disability benefits can I get?
- A one-time payment, or
- A yearly payment
Note: The current clothing allowance rate can be up to $817.48.
View current rates for special allowances at https://www.benefits.va.gov/COMPENSATION/special_Benefit_Allowances_2018.asp.
How do I get these benefits?
You’ll need to file a claim for disability compensation.
Find out how to file a claim for disability compensation at https://www.va.gov/disability/how-to-file-claim/.
When you file a disability claim, you’ll also need to fill out this additional form:
An Application for Annual Clothing Allowance (VA Form 10-8678):Download VA Form 10-8678 (PDF) at https://www.va.gov/vaforms/medical/pdf/10-8678-fill.pdf.
Bring it to the prosthetic representative at your local VA medical center.
To apply for your yearly payment, you’ll need to submit your application by Aug. 1 of that year. You may be able to get more than one payment if you meet at least one of the requirements listed below.
At least one of these must be true:
• You have more than one prosthetic or orthopedic device, or
• You have more than one skin medicine, and/or
• Your device or skin medicine affects more than one area of your body.
View the current payment rates at https://www.benefits.va.gov/COMPENSATION/special_Benefit_Allowances_2018.asp.
Note: If you qualify, you’ll receive payments between Sept. 1 and Oct. 31.
Use our facility locator to find your nearest VA medical center.Find a VA medical center near you at https://www.va.gov/find-locations/.
For more information, call us at 800-827-1000, Monday through Friday, 8:00 a.m. to 9:00 p.m. ET. We collect applications throughout the year and hold them until the August 1 closing date.
“One Team, One Ohana”