Veteran’s Choice Program helpful for some in seeking alternative health care procedures


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The idea behind the Veteran’s Choice Program is simple: Veterans deserve access to great care no matter where they live.

When Ken Rainey’s seasonal allergies suddenly became much more severe, he didn’t think much of it. Perhaps it was just a bad allergy season. That is, until he began to spit up blood. When he went in for a checkup with an ear, nose, and throat specialist, his worst fears were confirmed. He had a tumor in his throat.

Rainey was further devastated when his doctor told him that conventional radiation therapy would require the loss of 12 of his back teeth. The oral surgeon said the process would be disastrous to Rainey’s teeth and jaw, and he would be rendered unable to eat without a feeding tube. Rainey was understandably shocked.

“That floored me,” he said.

Rainey decided to choose another way to fight the tumor in his throat. This motivated him to search for any alternative cancer treatment that would not have such a lifelong impact on him. Eventually, he discovered the benefits of proton cancer treatment, an alternative to traditional radiation treatment.

What is proton cancer treatment?

Proton cancer treatment is a new type of non-invasive cancer treatment that is less damaging to the body than conventional radiation treatment. The basic idea behind the two treatments is the same: oncologists target the cancerous cells with radiation, which can help shrink or eliminate the tumor. But with traditional radiation treatment, that cancer-destroying radiation also harms the healthy tissues surrounding the tumor, often with devastating side effects. That’s why Rainey’s doctor warned him about losing his teeth.

However, proton cancer treatments can avoid this kind of collateral damage to the body. Proton treatments are performed with a single, high-energy beam of protons aimed precisely at the tumor cells. Proton therapy minimizes the damage to the surrounding healthy tissue. Thus, this non-invasive cancer treatment lowers the risk of the nasty side effects more commonly associated with radiation therapy, such as burns to the skin, fatigue, and loss of bodily functions like eating and chewing.

How the Veteran’s Choice Program helped

There’s been a lot of talk about the importance of choice and access in health care lately, usually the lack of it. While proton therapy seemed like the ideal solution, Rainey ran into another huge problem. Because he lives about an hour outside of Tupelo, Mississippi, he assumed he would have trouble accessing the health care provider of his choice. Going in for any cancer treatments would also require a lot of time driving to a proper facility, and like many rural Americans, Rainey is used to complicated insurance restrictions.

Luckily, Rainey was eligible for the Veteran’s Choice Program. This program was created to serve Veterans with long waiting periods or who live longer distances from treatment facilities. The Veteran’s Choice program allows these men and women to receive care with a non-VA provider of their choosing. Because Rainey lived so far from the city, the Veteran’s Choice program was a perfect fit.

He needed proton cancer treatment, and he needed it right away. Cancer isn’t known for accommodating long waiting periods. Instead, Rainey was able to travel to Knoxville, Tennessee, to receive proton treatments and the program even funded his stay there.

Here’s why access and choice are so important to Veterans like Rainey: he opted for proton cancer treatments against his doctor’s advice. His doctor feared the treatment was too new to be sure if it could help, but Rainey was convinced it was the right choice for him.

In the end, the proton cancer treatment proved to be a complete success. Though he experienced a sore throat and loss of taste, Rainey was able to keep all of his teeth and did not require a feeding tube at all during the process. Rainey says he is immensely grateful for non-invasive cancer treatment option.

“I could’ve taken the other treatment, but from now on I would have had all those other things to deal with,” he said.

How do you know if you qualify for the Veteran’s Choice Program?

Veterans who meet certain criteria will also be eligible for the Veteran’s Choice program. You might be eligible if:

  • You have VA health care and have been or will wait more than 30 days for VA medical care
  • The medical treatment you need is not offered by the VA
  • If you live more than 40 miles away from a VA provider
  • If you have specific issues that would make travel difficult or impossible, per Veterans Affairs guidelines

To find out more about the Veteran’s Choice Program, or to see if you are eligible, please visit: https://www.va.gov/opa/choiceact/.


Image of Larissa BrassLarisa Brass is a career journalist, freelance writer and 2014 graduate of Loma Linda University with a Master’s in Public Health. A devoted mother, she has worked as a volunteer in community health for many years. She is currently employed by Provision Healthcare in Knoxville, Tennessee.

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-- VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you'd like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Leslie Carroll    

    Unfortunately, we have to go through Triwest to use the service. This can take weeks to months. That might be okay for cancer treatment but it is not okay when you have a broken bone or need a colonoscopy. Our VA clinic used to get us in for non-VA appointments within about 3 days. So, the VA “fixed” a problem with the new Veteran’s Choice Program that wasn’t a problem. Very, very frustrating. I have complained before on social media and got responses from Triwest within hours. Hate doing that.

    1. Katherine Jane Dumestre    

      Leslie, I too am a Triwest patient. Perhaps I can offer some pointers? In addition I have created a facebook page “Veterans Choice Program-Veteran to Veteran” in which veterans and providers share complaints, clues, failures, successes, and advice. I have personally engaged a key staff member at Triwest and will be communicating regularly with them. You can private message me from the page.

      1. Raymond Rodriguez    

        The VA in Orlando are criminal actors in my case, yes it’s true or I would not say it.

    2. eric mckenney    

      Health net is no better, 3years ago my spine surgeon did a complete lumbar fusion and on his films saw a herniated disc at T7 wich is service connected, I have been constantly bounced around and have been seen 70 miles away by VA, but have not been able to see a spine surgeon. since that time I have been confined to a wheelchair and have lost urinary function due to nerve damage. Choice finally made an appointment with a Dermatologist, because they have him listed as a neurologist and will not correct their mistake. My Spine Surgeon will no longer accept choice and even the local Urologist has dropped out of the program.

  2. Joseph MacPherson    

    I live in Bend, OR where there is only a small VA outpatient clinic. My “home” hospital is over 160 miles away over the Cascade Mountains in Portland. The Bend clinic is understaffed with very limited medical services, and the caregiver turnover is incredibly high; I haven’t seen the same caregiver more than twice in the 10 years I have lived here. The choice program doesn’t work most of the time, because the clinics here in central Oregon are also undermanned, and can’t see me any more quickly than if I wait for my VA clinic to schedule my next appt. This US government is a disgrace; any military veteran who has served his country honorably should be seen in any healthcare facility in the country, and the country should pay for it GLADLY. I raised my right hand and swore an oath to give up my life if need be to protect the country and it’s people and the freedoms we hold, and after fulfilling my commitment my country doesn’t even want to allow me any kind of competent healthcare. My one regret in life will be that I served such unworthy people.

    Joseph MacPherson
    US Army Veteran/SGT E-5/Tank Commander, Abrams M1A1

  3. John Mathews    

    First complaint to PCP about back pain – November 2, 2016
    Finally get to see outside physical therapy via Choice) 7 weeks later.
    In the meantime I’m crawling up and down stairs on my hands and knees.

    BTW – I called the therapy provider directly and was told they could see me in 2 days.

    Pathetic.
    I can only guess at what vets with real problems go through.

  4. liz    

    Leslie, I have had great Success with Veterans Choice, EXCEPT for one Service Department Administrator, who has continually denied my Re authorization back into my local Community for a Spine Specialist.

    Even the Community MD, that accepts Vet Choice has written a letter to VA Secretary Dr. Shulkin, along with my family requesting that with his Speeches about removing the Red Tape, and Obstacles for Veterans with ADA disabilities-which is what I have, why can I not get Re Authorization back into my Community?

    This Department Director has made it his personal mission to explain to me in the past, that he will never grant Reauthorization, and since receiving this Correspondence from Dr. Shulkin to review my case; instead of just allowing me back into my Community, No, now there are more obstacles than ever, ie: more Tele Health Appointments wanting to be set up with the very Department Director that has denied all requests in the past, at clinics I cannot travel to due to my Geographical Burden.
    TriWest stating that my Geographical Burden now requires special “documentation.” I have had all my other needs granted for More than 2 years.

    Even my Primary Care Doctor has said she cannot go against such a Bully. Medical Directors at the Hospital Facility have been Interims and they have been useless.

    I cannot jump through their hoops, it is not healthy for me. It will result in the same denial as was promised by this Department Nazi, and why isn’t Dr. Shulkin asking these questions?

    1. Stephen L Gale    

      I agree with the comment that veterans deserve the best and under certain circumstances Choice program would be good. What I fear however, is that congress is using the Choice Program to privatize the VA. That would mean that instead of having all the medical resources we presently have, we would have to go to private doctors who would have a list of what the VA would and would not pay for. Instead of having our medical records all in one place, they would be spread all over the place. I like the idea that when I’m asked what meds I’m taking I can just refer them to my VA records. I hear some veterans complain about the treatment at the VA, but I find the work they do much better than what I got at the Heber City IHC hospital and the UTAH VALLEY hospital. If the VA is behind in getting Vets in, it’s because congress has failed to fund the VA enough.

    2. Raymond Rodriguez    

      I’m stage 3 cancer VA Orlando case mgr had to personally run my permissions because I’ve been black balled by a Orlando VA employee or employees. They are criminal in my case no doubt about it and if I found out my cancer has spread because the VA has dragged their feet for over a year. (I’m crying)

  5. James Tobleck    

    Similar, 40 years of denying civilian and last 2 VA doctors requests for total knee replacement at local hospital 5 miles from home instead of zero star rated Detroit VA hospital. Also over a year for unpaid dental bill $311.00 , unsafe medical practice’s having to wait over 3 years before L.M. would allow colonoscopy, then 2 separate anastasia’s before finding bleeder. I request a IG for malpractice , malfeasance charges , and 40+ years of back pay +interest for lack of denova by VA . Homeless ,bankruptcy’s 3 wife’s , yet all you VA did was make life a living hell. Sooner or later my story and photos will go fox cnn news . Remember my whole family have served in the military including my son. You ought to check out the photos. Govt.waste by the VA

  6. James Tobleck    

    Lets not forget 40 mile rule even though broom closet facilities rule out most vets from using choice! Somehow it seems a little fishy I can’t use local hospital 5 miles from home , yet VA orders me to Detroit MI 4 hours Each Way. No E.R. when I get infected , no P.T. rehab. Nothing as usuall. 40 + years of bone on bone knee. NARCOTIC pain pills but never fix the problem for 40 frigging years. F.O.I.R. ,how many pills have you prescribed me? No wonder my kidney liver are shot.

  7. Kenneth R Pulliam    

    I used the choice problem in Colorado Springs because our VA Medical facilities could not timely provide much needed surgery for severe nerve problems in my hands secondary to long term crutch use.

    Unfortunately, Choice did not honor it’s promise to pay the doctors contracted by Choice. As a result there are at least one medical collection on my credit report ruining my credit. The official at Choice told me that Choice and the VA have no authority to help me clear my credit.

    Where can I get help?

    1. Gretchen Reinhardt    

      Try this place for help: Consumer Financial Protection Bureau https://www.consumerfinance.gov/

      I’ve had the exact same problem as you have described. In the end, I have always won and always gotten my credit rating restored.

  8. John Swisher    

    Juxst because Veterans deserve access to great care wherever they live doesn’t mean Veterans Choice will provide it. If my VA primary care tells me he or she will send to a civilian doctor I tell them “no thanks.” Why? Because where I live doctors either won’t accept Veterans Choice, require the veteran to sign a financial responsibility agreement in case the VA doesn’t pay, or you don’t hear from anyone again.

  9. Alden Morrrison    

    I used Veterans Choice last year when I could not get a eye exam for 7 months at the va clinic in Gainesville but they set the appointment for me. I live in Ocala. The Gainesville Hospital gave me the choice telephone number. I called and a very polite lady took my information and said they would get back to me. About 3 months later another phone call to me asking the same information from the first call. Approximately 2 months later I get a call late in the afternoon for a appointment in a city 80 miles away. I had told them any eye doctor in Ocala which there are hundreds . So I told them to cancel appointment and waited out the 7 months for the appointment in Gainesville.

    So although they are very polite they let this verteran down, but I must say this is the first bad experience I have had in the VA System all others which include many were what I would call OUTSTANDING and more. You see I have also spent time in Ocala Monroe and I will take the VA anytime. I am talking about the VA Hospital in Gainesville, Fl

  10. James Tobleck    

    I have to ask if we vets that leave our stories here and make it through the cappy editing, chapta, why doesn’t the VA get in contact with us ? Obviously no one at VA gives a damn, only the appearance of caring, correcting these obvious problems. If this weren’t true I’d be walking on a total knee replacement for the last 40 years.

  11. Walter B DeVoe Jr.    

    I requested to see an orthopedic Dr., regarding my knee, my Dr., stated they would probably only want to do surgery on it take some more Tylenol.
    I asked to use the program so may see an outside Dr., and he said that he would send consults to orthopedic clinic.
    I finally went to knee specialist useing my own insurance, the found two discuss on my lower spine that were pinching my nerves.
    I went back to VA Dr. told him that I need permission to stop two blood thinners for five days in order to receive an epidural injection. It has been two weeks since my request was made, I am told by RN, that she would give to him today.
    Since I. moved from Atlanta Georgia, to Greenville SC, I have found the primary care sucks.

  12. Walter B DeVoe Jr.    

    I also dislike traveling two hours to go to VAMC Columbia, SC. for testing, and procedures.

  13. Blake McKinney    

    I think the choice program might be great for some but tell what happens when you’re sick on a weekend where the treatment then. Tha VA does not have anything open with the hospital so what are veterans to do for medical care. The hospital has never heard of the choice program.

  14. Di. L.    

    I work in a specialists office that accepts Veteran’s Choice patients. The major problem with this program is that the Veteran’s Choice representatives that send the referral want us to get the patient in the same day. Unfortunately, that is not feasible in the state that I am in. Second, they don’t send the required information that we need for authorizations and referrals to us in a timely fashion, but again expect us to get the patient in same day. When we ask for authorization for surgeries, or procedures, we have to fax the information to Veterans Choice more than 3 times because its “Somewhere” or its on someone’s desk and they are working on it and will get it to us next week, but the authorization was needed a month prior. Thirdly, when the Veterans Choice reps call our office they are rude and disrespectful, and if you dialed a number and the person that answers the phone says hi this is such and such office, the person taking the call shouldn’t have to repeat that and the address all over just to finally get what patient they want to discuss with the office about. Lastly, waiting on hold to get someone on the phone to answer questions about authorizations and referrals, we can be on hold for literally, no joke, hours.
    I could honestly go on and on. The problem is not the veterans, the problem is the program that is soooo disorganized and has hired representative with no medical experience at all to do the job.

  15. Rex H. Miller    

    I was in heart failure after years of seeing VA cardiologists for service connected breathing problems. My local VA provider sent me to the International Heart Institute here in Missoula, MT. My heart valve was failing and they wanted to do immediate surgery before I had a stroke or heart attack. The VA “Choice” program said I had to drive over 650 miles to Salt Lake City and they provided no date for surgery or even transportation. After serving my country for 20 years I had to pay for my own open heart surgery The Choice program is criminal and is an abuse of veterans. Vets need to see local providers if they live more than 50 miles away from a major VA medical center. I would have died if I had of went to the VA anyway because I had serious complications and the International Heart Institute is one of the top 50 heart hospitals in the country. about 10 miles from my home. All “Choice” did was add another layer of red tape to a broken system. The Choice program is a horrible joke.

    MSGT Rex Miller, USAF (Ret).

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