In 2016, I separated from active duty after seven years of service and as a new mom with a 3-week old son.
Not only did I have to learn to navigate life as a new mom, I was also thrown into the world of not having health insurance and not knowing how to coordinate civilian healthcare. For my civilian friends out there, the military takes care of every aspect of your medical care. They schedule your appointments, tell you where and when to go, and manages your healthcare records. Trying to get an ad hoc sick appointment or a copy of my medical records was nearly impossible. This also meant that I never had to worry about costs, billing, co-payments, referrals or finding a healthcare provider. Everything was managed by the military.
Once I left active duty, my family and I no longer had health insurance.
Initially, I participated in TRICARE’s COBRA program while my husband and son had their own separate insurance plans. I could only afford one quarter (3 months) of COBRA coverage so I looked for other ways to get my healthcare covered. That is how I stumbled across the VA healthcare system.
As a veteran, it should have been automatic for me to enroll in the Department of Veteran Affairs (VA) Health benefit program, but I was under the false assumption that the VA is only for service-connected medical care. This may have been true in the past, but the U.S. Congress passed additional legislation that extended healthcare benefits for OEF / OIF / OND veterans and waived income requirements for care during an enhanced eligibility period.
According to the VA, OEF / OIF / OND Combat Veterans can receive free VA health care for up to 10 years after discharge or release for any condition related to your service in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF) or Operation New Dawn (OND) in Iraq. This is called an enhanced eligibility period. Learn more about the enhanced eligibility period HERE.
VA Maternity Care Facts You Should Know
Maternity care is one of the many medical benefits available to female veterans through the VA. I am a veteran mom of four little ones and delivered three of my four children through the VA’s Community Care Network. The following list are my lessons learned that I want to share with other veteran moms so that your VA maternity care process runs smoothly.
1. You Need to Enroll in the VA Healthcare System As Soon As Possible
As previously mentioned, I was under the false assumption that I could only use the VA system if I had a service-connected disability. This is not true. You may be entitled to healthcare through the VA based on your discharge status, service dates, military branch, combat-related disability rating and other factors. Determine your eligibility status by applying for VA Benefits HERE. For a more detailed step-by-step guide on how to get healthcare through the VA, please see the How-To Guide that I developed HERE.
2. Maternity Care is Provided By the VA
Maternity care is one of the medical benefits available to female veterans through the VA. You must first be enrolled in the VA system in order to receive maternity care. You are also entitled to nursing supplies, breast pump and lactation support. For a step-by-step guide on how to get maternity care through the VA, please see the How-To Guide that I developed HERE.
3. You Will Probably See a Civilian Medical Provider Through the Community Care Network
This is VA facility dependent. Given the complexity of prenatal and postpartum care, you will be enrolled in the Community Care Network and sent to a civilian OBGYN medical provider. Most VA facilities do not have the staff or equipment to provide adequate prenatal, delivery and postpartum services. Being sent to a civilian medical provider ensures that you have immediate access to Labor and Delivery and pediatrician services at a local hospital. Learn more about the Community Care Network HERE.
4. Stay in Communication with the Maternity Care Coordinator (MCC)
The MCC is the local VA’s representative responsible for coordinating maternity care and your VA authorization. They will initiate the Community Care Network process and should contact you on a monthly basis to ensure that you are receiving the care that you deserve. If they do not contact you, make sure that you reach out to your local VA and ask to speak with the MCC. They will forget to call you! Learn more about the MCC HERE.
5. Your VA Authorization Number is Your “Insurance Card”
You will receive an authorization letter from the VA that includes an authorization number and billing information for your civilian Community Care medical provider. Take a copy of this form to all of your maternity care appointments and present it to your medical provider’s office in lieu of an insurance card. Make sure that you explain to your Community Care medical provider that you are a veteran participating in the Community Care Network. Your VA authorization number must be included in your insurance information profile to ensure the VA is billed for services.
6. You Will Have Billing Issues
I did not expect to spend hours on the phone with the VA or civilian medical provider’s office trying to get a bill paid. Please be aware that the insurance company listed on your VA authorization letter should be identified as the primary insurance company in your Community Care medical provider’s billing system. Your private insurance company (if you have it) should be listed as the secondary insurance provider. If you receive a bill directly from your Community Care medical provider’s office, immediately contact them and direct them to re-bill the insurance company listed on your VA authorization letter. Make sure that that they include your VA authorization number or the Community Care Network will not pay the bill. If you continue to have billing issues, contact your local MCC or the VA Community Care Network directly. Learn more about the VA Community Care Network HERE.
7. The Community Care Network Provider Will Send Past Due Bills to Collections
Do not ignore bills sent to you from your Community Care Network provider. They will send unpaid medical bills to a collection company if they do not receive a timely payment from you or the VA. In my experience, this occurred when my Community Care medical provider’s office did not bill the insurance company listed in my VA authorization letter correctly, which led to non-payment for services. If this happens to you, contact your MCC or the Community Care Network immediately. They will contact the Community Care medical provider’s office and get the billing issue resolved. Learn more about the Community Care Network HERE and the MCC HERE.
8. Your Child is Authorized Care Up to 7 Days After Delivery
As part of your VA authorization, your child is entitled to medical care for the first seven days after delivery. These services should include all in-patient care during your stay at the hospital, and the first follow-up appointments with the pediatrician. You may or may not receive a separate VA authorization letter for your child. The billing process for your child is the same as your medical care.
The information provided in this post is not medical advice and is based on open source information provided by the Department of Veterans Affairs and my personnel experience with the VA Community Care program. Please consult with your local VA Facility and healthcare provider regarding your medical needs.
