Nothing Comes for Free

Does anyone else here have to deal with Veteran’s Affairs (VA)? I’m beyond grateful for the benefits they offer as John, myself, and Eva have or will benefit because of John’s service. However, the saying, “nothing comes for free” applies.

I could go on-and-on about the long, expensive and hard won battles with the VA that John has fought over the last decade. I could also go on-and-on about the monthly, continuous battles John deals with. Here, I’m going to speak of two. The first is about the COVID vaccine. The second is about the ability, or maybe inability is a better use of language, to get medications.

First, the vaccine, John has been wondering if he should go to the VA for his vaccine or the local health department. With his pre-existing conditions, he also thought that perhaps he might receive the vaccine a little sooner than someone else his age who is reasonably healthier. He has checked many times on the VA site and by calling and was told, by a recorded message, that the VA is offering the vaccine to only those 65 and older. It’s been like this for weeks.

This week, he was on the phone with the Congressional Liaisons Officer, about the second matter, which I will address shortly. At the end of the conversation, John asked if he knew if he should plan to receive his vaccine from the VA or the local health department. The liaison officer paused for a moment and asked, “You haven’t received your shot yet?” John said no. The liaison asked, “Has anyone contacted you about getting it?” John said no. “And you want it?” John said yes. This is when we learned that, apparently, the VA has been offering a large portion of their vaccines to the local general health departments to be distributed and have been for some time now. They claim that no more veterans want to take the shot. That they have offered it to all of them. In our case, this is a bald faced lie. For us, we shouldn’t be surprised because this is pretty much how we’ve learned the VA operates. It’s infuriating.

The liaison officer told John to call, wait through the message to speak to a human, and get scheduled for the vaccine. When John called, he once again heard the prerecorded message that the VA was still only accepting those 65 or older. He waited this time until someone answered. He told the person that the liaison officer told him to call and that some of his medical conditions might give him access to a shot sooner. The person told John, “Oh, you don’t have to worry about any of that anymore. It’s been open for 3 weeks now.” John was scheduled for a shot on Monday. Bureaucracy at its best.

The second major issue is the constant, full-time job worth amount of time John spends on the phone every week between his doctor’s offices, the VA pharmacy, the Community Care Center (CCC), and TriWest (a contracted company the VA uses that is supposed to help). At the risk of drowning you, my dear reader, I feel compelled to share with you just one example of an experience John regularly deals with in managing his care. The below is one example but it’s like this every time he goes to see any of his doctors (GI, primary care physician, neurologist, and a number of other specialists). He has 4 regular doctors and 7 regular medications he takes.

Calendar Outline:

• 2/2/21 – John sees his GI doctor. At the appointment, he reminds the scheduler to check his verification for his medication. If it’s expired, to please fax an updated one to the Community Care Center (CCC).
• He gives this a reasonable amount of time to get accomplished.
• 2/7/21 – John checks e-Benefits (the VA system where he can track his medications and files). His medications have not posted. This is the trigger to let him know that he needs to start calling to track things down.
• 2/8/21 – He double checked e-Benefits and still hasn’t seen his meds. He calls the VA pharmacy, spent 15-min. on hold, and spoke with someone who was unwilling to give him their name or identifying information. After asking them to check on his medications, they put him on hold, and he was disconnected. He called back and got a different voice who still didn’t identify herself but told him the prescription was there and waiting but they didn’t have an authorization number yet so could not release it.
• 2/8/21 – John called the GI doctor’s office. He asked for them to send the verification to the CCC. This started a verbal confrontation with the person on the other end of the call. She was adamant that she’d sent the authorization. She finally verified the number she sent it to, which, come to find out, she’d faxed to TriWest. In a perfect world, that is what is supposed to happen but John had asked her to fax it to CCC because of bad experiences with TriWest. TriWest had received the fax but could not find it now. She finally agreed to send the new request to the CCC.
• 2/11/21 – John called the CCC. He was on hold for 45-min. before a recorded voice announced that they were experiencing technical difficulties and to please call back later. The call was disconnected. John waits 2 hours and calls back. This time waiting 35-min. before the same thing occurred. John decided to call back another day.
• 2/12/21 – John called the CCC again. He spent 45-min. on hold before finally getting an answer from an irate employee. She verified that they did receive the request from the hospital and that it was now waiting to be approved by a nurse. John explained that he was going to run out of medication (not a good thing as it could send him into a relapse with his ulcerative colitis. If that occurs, he spends time in the hospital and nearly dies from blood loss). Since it seemed like it was going to take time, he asked if he could pay out of pocket for the medication (a few hundred dollars) but get confirmation that he would be paid back by CCC. The woman told him she didn’t know and “I just can’t help you.”
• 2/17/21 – John checked e-Benefits again. His meds are not there. He called the VA pharmacy again to check. They informed him that they had not yet received the authorization number. John then called the CCC again, was on hold for another 45-minutes, and disconnected. He then called TriWest. They answered the phone and he asked if they received the re-authorization numbers. The reply was, “I don’t know.” John prodded her to look. She put him on hold and he got disconnected. At this point, John is frazzled so he takes a break.
• 2/19/21 – John called CCC again and waited for 30-minutes. He finally got to talk with someone. This woman was extremely helpful and polite. She was able to tell him where his referral was in the process and that everything should go through by Monday (2/22).
• 2/24/21 – John looked at his e-Benefits and it’s still not there. He called CCC three more times with the same above mentioned wait times and disconnections.
• At this point, John is reaching a state of dread at calling anyone anymore. He’s frustrated and broken down. He doesn’t want to call or deal with this. He just wants his medication.
• 3/1/21 – Still no changes to e-Benefits. He calls back to the CCC and gets someone who is customer service oriented. John explains his situation to this man and the guy takes the time to read John’s notes, which are numerous. He also ensures that John has his name and number in case they get disconnected. John is on hold for 30-min. and they are disconnected but 10 min. later the guy called John back and told him that he didn’t know what was going on. That a nurse approved it but the office in Montana decided that John needed to do a tela-health appoint with a VA doctor about the medications. (Someone other than his current GI doctor.) John asks why the VA is changing his continuity of care without asking him, where his meds are, and how is he supposed to get his meds. The employee apologized profusely and referenced John to call his Congressional Liaison Officer, whom John has on speed dial at this point, which is just sad.
• 3/1/21 – John left a message with the Liaison Officer.
• 3/2/21 – The Liaison Officer called John back letting John know he’d sent emails to all the department heads related to this and that they should be contacting John by the end of the day.
• 3/5/21 – John hasn’t heard anything from anyone. Just as he’s calling the Liaison’s Officer back, he gets a call from someone who does not identify himself but tells John that he has refilled all his medications and sent them to the central distribution center which may take several weeks before arriving to John. Then, he hung up.
• 3/9/21 – John checked e-Benefits again. Still no changes. He called the Liaison’s Officer again and explained the entire situation. He promised John that he would have a phone call that day. 30 min. later John gets a call from the supervisor of the VA pharmacy letting John know he had just looked at his case and a doctor John had never seen before had filled his prescriptions but that they still didn’t have an authorization number for the actual doctor John sees. This is an issue because no authorization number means no payment by the VA.
• 3/9/21 – John calls the Liaison Officer back. He apologized for this, as John is fully aware that the Liaison Officer has other things to do with his day but that John’s at his wits end. He explains the new situation to him. The Officer assures John that by the end of the day, John will have heard from the director of the CCC office. This man does call John. This man is a GS-15 or the equivalent of a full bird colonel or brigadier general. John explains the situation to him. He apologizes and tells John he needs about 3 hours and he will call him back personally by the end of the day. 3 hours later, he does call John back and tells John that everything has been taken care of. 30-minutes after that the VA pharmacist calls and confirms with John that they now have his prescriptions ready and that they will be sent overnight to him.
• He finally got his meds.

If you’re still with me my dear reader, like the title of this post says, nothing comes for free.