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Kansas City VA Medical Center

 

Billing & Insurance

Copayments

The US Department of Veterans Affairs has established guidelines for veterans and their copayments. Copayments may be charged for the following services —

  • inpatient care 
  • outpatient care 
  • outpatient prescriptions 
  • long-term care 
  • Fee basis

Typical copayments are:

  • $15 for visit to Primary Care Clinic
  • $50 for visit to Specialty Clinic (Radiation, Orthopedics, Podiatry, etc.)
  • $8 for each 30-day prescription ( Priority group 2-6 )
  • $9 for each 30-day prescription ( Priority group 7-8 )

Veterans who do not make their copayments upon checking out and who have third party insurance will receive a bill at their address of record within 90 days. If a Veteran does not have third party insurance, they will receive a bill at their address of record within 30 days.

If you have questions about your copay balance, please contact the Health Resource Center at 1-866-393-4074.

Repayment Plans

If you have a problem making copayments, you may contact the Health Resource Center at 1-866-393-9132 to request that a repayment plan be established for your financial situation. If approved, the plan will result in a more affordable monthly payment. VA Form 1100, Agreement to Pay Indebtedness, and VA Form 5655, Financial Status Report, is used to create a repayment plan. If you set up a repayment plan, and cannot make one of your monthly payments, you must notify the Health Resource Center. If you miss a payment and do not notify us, you will not be able to use the repayment plan option again. Repayment plans must be updated every 90 days for new charges.

Waiver Requests

Special circumstances such as job loss may qualify you for a one time cancellation of debt if the debt is not older than 180 days. You may request a waiver for paying your current debt by submitting a written request and sufficient proof that you cannot financially afford to make payment to VA.

Forms that are required include VA Form 5655, Financial Status Report, and VA form 4138, Statement in Support of Claim. To further support your claim, you may want to provide copies of the following information as it applies:

  • Unemployment Statement
  • Divorce Decree
  • Federal Income Tax Return
  • Social Security Statements
  • Business or Personal Bankruptcy Documents
  • Last Two Bank Statements
  • Last Two Paycheck Stubs
  • Medical Care Bills Paid/Owed by You
  • Income Verification
  • VA Compensation/Pension Benefit Statement
  • Disability Benefit Statement

Mail all documents to:

VA Medical Center
Attn: CPAC/Facility Revenue Division
4801 E Linwood Blvd
Kansas City, MO 64128

Other Health Insurance

VA is required by law to bill your private insurance company for care provided for your nonservice-connected conditions. You should bring your insurance card with you for your appointment and present it during the check-in process.

Reimbursements received from private insurance carriers are retained at the Marion VA Medical Center. These funds may be used to provide better equipment, additional staffing, facility improvements, and expanded services for you and fellow veterans.

Please note:

  • You will NOT be responsible for any unpaid balance that the insurance carrier does not pay except for VA copay.
  • Please disregard any information about balance due on the Explanation of Benefits (EOB) provided by your insurance company. VA will send a bill for the amount you owe.
  • Payments from your private health insurance carrier may allow us to offset part or all of your copay 
  • Many private health insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.

Learn more about private health insurance and your VA benefits 

Health Resource Center (HRC)

The VA Health Resource Center, First Party Call Center, takes calls from veterans to answer questions about bills. Veterans have the opportunity to use pre-programmed options when calling the toll free number 1-866-393-4074 to retrieve their balance, or to hear answers to frequently asked questions. Hours of operation are from 7:00 AM to 7:00 PM CST, Monday through Friday.

When calling, please have your account number (located in the middle of your statement) ready, and input it on your keypad when requested. If you do not have the account number, your call will be transferred to a trained contact representative. Although Mondays and the days following a holiday can be busy, the average wait time the rest of the week is less than one minute.

Private Health Insurance

Private health insurance coverage through a Veteran or Veteran's spouse is insurance provided by employer, Veteran or other non-federal source.

VA health care is not considered a health insurance plan.

VA is required to bill private health insurance providers for medical care, supplies and prescriptions provided for treatment of Veterans' nonservice-connected conditions. Generally, VA cannot bill Medicare, but can bill Medicare supplemental health insurance for covered services.

All Veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. Veterans are not responsible for paying any remaining balance of VA's insurance claim not paid or covered by their health insurance, and any payment received by VA may be used to offset "dollar for dollar" a Veteran's VA copay responsibility.

What's in it for me for providing health insurance information?

  • You will not be responsible for any unpaid balance that the insurance carrier does not pay except for VA copay.
  • Payments from your private health insurance carrier may allow us to offset part or all of your copay.
  • Many private health insurance companies will apply VA health care charges toward the satisfaction of your annual deductible.

Insurance Coverage and Eligibility for VA Health Care

Your insurance coverage or lack of insurance coverage does not determine your eligibility for treatment at a VA health care facility.

Risks of Giving Up Your Private Insurance

What should you do with your private health insurance if you are accepted into VA health care? You could save of money if you dropped the insurance, but there are some things you should consider.

  • What about your non-Veteran family members?
  • VA does not normally provide care for family members of Veterans enrolled in VA's health care program. If you drop your private health insurance, they may have no health care coverage.

  • What would happen if you are disenrolled from VA's health care program?
  • There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.

  • Do I still need Medicare Parts A and B if I receive my health care from VA?
  • VA does not require a Veteran to have Medicare Part A or B to be enrolled in VA health care. However, a Veteran may want to consider their total health care needs before changing any insurance coverage.

  • What would happen if you drop your Medicare Part B coverage?
  • If you cancel your Medicare Part B Coverage, you need to know that you cannot be reinstated until January of the following year, and you may be penalized for reinstatement.

For these reasons, VA encourages you to keep your private health insurance.