When I discovered I was pregnant in late June of 2010, I was surprised; when I lost my job four days later, I was devastated. My employer-provided health insurance was up at the end of the month and I needed prenatal care for the next nine; not to mention post-delivery care for the baby. The stress of finding myself pregnant without insurance coupled with the loss of my job sent me into depression.

Recognizing I needed help and having few options, I contacted VA; I had signed up for the five years of healthcare from VA following my return from deployment in 2008. I had been once before because the shrapnel I had in my arm from an IED strike in Iraq had been causing me lingering pain. After the doctor looked at me during my evaluation, cocked her head to one side and said “I didn’t know women were on the front lines.” I hadn’t been back.

But I was desperate, and I knew there was a new law that said VA would pay for care of newborns. I thought I could get someone to talk to and care for an unborn child in the same place. I called the appointment line; the next opening was over a month away. Not having anything better to do, I went to the VA hospital and sat in the waiting room until the doctor had time to see me. When I finally got into the exam room I broke down.

This visit was the opposite of my previous attempt to access care. The doctor was patient and respectful. The depression care manager she sent me to was a wonderful women who sat and listened to me pour my heart out. She helped me get in touch with the Women’s Care Coordinator to find out about receiving prenatal care through VA. Things were looking up. I was getting the help with my depression and gaining access to much needed medical care.

There was a catch.

VA doesn’t currently house any services for female Veterans to receive obstetric care. I would have to use a civilian provider that contracts with VA. Unfortunately there were only two options and both were too far from where I lived to be viable options. I began to take the contract paperwork to various OBGYN practices closer to my home to see if I could convince one to accept reimbursement from VA. After many calls to billing departments attempting to explain what the reimbursement process was, and many rejections, I found a doctor willing to take me on as a patient.

Then something bad happened.

August 2010, 16 weeks into my pregnancy, I was involved in a car accident. Needing to make sure everything was still okay with the baby, I went to the Emergency Room of the VA medical center. I was told that all the ultrasound technicians had gone home for the day and that was the extent of the care they could give me. I would have to be transferred to another hospital for a full examination. During the transfer process I was assured all the paperwork was taken care of and the secondary hospital knew I was a VA patient and all the bills would be to the VA hospital.

A week after getting a clean bill of health for myself and the baby I got a bill for $1,999.94 from the hospital I was transferred to. It took several calls, being on hold, and a conference call with myself, VA’s Fee Basis Department and the hospital billing department to get everything straightened out.

As I approached 36 weeks of pregnancy I began to email VA about the process for having my labor and delivery covered. What paperwork did I need to bring to the hospital? How should I explain the contracting process to the hospital? Which VA offices should I be talking to? The initial response was that a process had not yet been put in place but that I should have a “Happy Holiday.” The stress of not knowing whether I would be able cover the cost of medical expenses made that “Happy Holiday” difficult to have. As my due date drew closer, the answers to my questions did not get any clearer. “I don’t know” changed to “Have the hospital call us and we’ll explain everything.” I entered the last trimester of my pregnancy with trepidation and not the expectant joy of most would-be-mothers.

My fears where confirmed when I arrived at the hospital the evening before my delivery. My arrival at the admittance desk coincided with the usual quitting times of civil servants, leaving no one at VA to answer the hospital’s calls per my instructions. The hospital had no way of imputing me into the system since VA isn’t an insurance company. The process took over an hour and involved me calling the Women’s Care Coordinator to let her know what was happening. I was eventually admitted with the promise that it would all be worked out after the delivery. At the end I was mentally exhausted and completely drained of the strength that I would need for the 12-hour labor ahead of me.

Through my entire pregnancy I encountered every stumbling block female Veterans face when accessing VA: my service in the Armed Forces was poorly understood, there were long wait times for appointments, I received fractured care and was forced to cut through miles of red tape. My successes in using VA for care have come from me spending hours of phone calls on hold, sending countless emails and being my own advocate. Many Veterans may not have the luxury of the time I’ve been able to put in.

But not all of the challenges I’ve faced are solely the fault of VA. I understand the medical billing is a vast bureaucracy in itself. Therefore, it’s up to VA to help build a streamlined process for the female Veterans coming after me. Putting into place a simple paperwork system and materials can help the Veteran explain to obstetricians and contract care providers what the VA covers.

I am now the proud mother of a beautiful baby girl but as I care for her, I keep a wary eye on my mailbox; I’m waiting for the hospital bills from the delivery to come in and join the growing pile. I wonder how long it will take to get VA to cover them.


Staff Sergeant Jennifer Hunt has served 10Jennifer Hunt years as a Civil Affairs Specialist in the Army Reserve during which time she has deployed to both Afghanistan and Iraq. Since returning from her latest deployment, Jennifer has worked to raise awareness about the issues facing female Veterans returning from war and reintegrating into the civilian world. She currently resides in Maryland with her husband and newborn daughter.

 

 

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14 Comments

  1. Monica February 12, 2012 at 21:59

    I’d love to know where you ladies are located. I live in Maryland and since I found out I was pregnant in November of 2011 the most difficult part of having prenatal care through the VA was finding a provider in the DC/Baltimore area who would accept it. After about 3 – 4 weeks I found several who were willing to work with them/me. The practices have been very easy about it and so far, I have not felt compromised at all.

    As for dealing with the VA, there is a local office here and it has been very easy to get information from them (although they do not recommend any providers, which would help). They have been more than willing or so it seems to assist me in getting the care needed.

    Do you gals have a C-Services office for your region/state??

    If any of you need assistance finding the help you need I’d be happy to help you if possible.

  2. Alyssa December 15, 2011 at 16:44

    I am going through this same thing now. I’m currently 9 weeks pregnant with twins, and the midwife that I was seeing was being incredibly understanding about the process and has been working with me and the VA. Now that I found out I’m having twins, my midwife wont see me anymore and I can’t find an OB in my area that will see me without making me pay out of pocket and wait to be reimbursed by the VA. After weeks of e-mailing, faxing and calling the one person in the VA that can handle these issues and not hearing anything, my husband and I decided we need to fork over the cash for me to go onto his insurance plan which is money that we were really hoping to be able to put towards the cost of having twins. I am just a devestated nervous wreck, and I have no idea what to do. I’m scared to be seen because I am already fighting about a $2,000 ER bill and I don’t want anything else on top of this. It’s so frustrating, and maybe it’s just hormones, but I’m bawling my eyes out because of stress right now.

  3. Teryl June 5, 2011 at 23:39

    I injured my shoulder in Iraq in 2007 and was medically discharged in March 2009 due to other issues (Army said my shoulder was fine). The 1st VA doctor I saw told me she didn’t care about my injuries, so after finding out from my father-in-law (A Vietnam vet using the same VA) I requested a new doctor. The 2nd doctor I had was wonderful, she ordered xrays and MRI’s of all my injuries immediately and then once they came back she sent me for an orthopedic referal because I needed surgery. Neither VA here does surgery so I had to find an outside doctor to do this. The doctor wanted to try physcial therapy first but VA wouldn’t cover it so he went ahead and did the surgery Feb. 2010. When I tried to go through VA to get physical therapy after the surgery I was told that I needed to have a doctor put in a request, mine had retired so was given 1st avail. When I walked in there in my sling all she could fuss at me about was my weight, and said the next avail appt was for May, I took the appt even though I knew it would do me no good to wait that long. Luckly, I had a wonderful non-VA doctor who immediately set me up for physical thereapy through his office and said not to worry about the bills. My appt in May with VA was just to determine if I even needed physical therapy, I’m glad I didn’t have to wait for that appointment.
    While I have not yet had to deal with a pregnancy and VA my friend in a different state did and the VA there wouldn’t even see her for anything or even inprocess her into the system because she was pregnant, she had to get on the state welfare just to cover the cost of having her baby. Being a female in VA has been hit and miss for me but the wait times are so long I don’t go unless I need to.

    • Collin March 21, 2012 at 21:13

      Teryl,

      I have a service connected disability of my shoulder that I draw disability for. I was treated while still in service, but my injury has relapsed. Can I see the VA and have a new surgery done or Physical Therapy? Will they cover it? How do you go about that?

  4. MissKeshaOnline March 26, 2011 at 04:01

    Hi Jennifer,

    Thanks for sharing your story. I hope motherhood is treating you well. I am going through the same thing with the VA referring me out for my pregnancy and not taking care of the bill. It makes me so angry, because the crap is on my credit report. But this gives me the determination to keep fighting them, and I will most likely do a blog on the process. The VA is trying to get it together, but not quick enough.

  5. Mary Cox (Army) March 16, 2011 at 01:38

    I too encounter the same problem. My baby girl was born in Dec 2010, healthy thank god but not to the VA. I had a great coordinator but she could only do so much. I was told I had to see the VA for care if the VA a provided the care. Imagine my shock when I showed up to an appointment only to be told that the provider can’t see me due to my pregnancy. I had multiple complications such as diabetes, high blood pressure, tachycardia, and preeclamsia. Trying to find a provider that took the VA insurance was a joke. I went to 6 different doctors before I found one that was willing to accept me as a patient. As for the care, I am receiving bills which will have to be turned in. Luckily I have a good care coordinator in women’s wellness. Oh, for you ladies that are going to have babies or having babies, there is a new program that the VA will pay for a breastpump (100%) and lactation training. You have to request a referal. This saved my breastfeeding relationship with my child. My coordinator put me in for it.

  6. Christy Smith March 8, 2011 at 00:02

    Jennifer, I have been subjected to the same “fee basis” issues. Finally, after trying to coordinate with the VA for a “pre-approved” medical procedure that was not available through the VA, I ended up paying the civilian provider myself.The VA kept giving me the run-around, transferring me from office to office, of coarse it is always someone else’s “area”. I was always told I would get a call back from a VA fee basis coordinator, but this never happened. The VA ordered the tests, sent me to the civilian privider and then NEVER paid the bill. Still upset in Iowa!

  7. Mike Bailey March 7, 2011 at 16:13

    Ladies please don’t take this the wrong way but they stick it to us men also when it comes to dealing with bills dealing with Emergency room care even for service cconnected issues. I had to have an ambulance and was hospitalized due to cardiac issues which are SC and I spent months dealing with the hospital and fee basis to get the bills paid.

    I think it is just fee basis period that makes it harder than is necessary on all veterans.

    • Carolyn March 8, 2011 at 10:16

      Mike I don’t think anyone will take your comment the wrong way. I think this is an issue (the bills being paid) that is not gender specific. However, the reality is that service-connected male vets have been struggling for years and people tend to forget. Males should embrace the opportunity that the growing pool for female vets presents- a fresh take on an old problem. By supporting each others struggles, we hopefully, and eventually, will help everyone.

  8. Kayla March 7, 2011 at 15:09

    VA is also supposed to cover some infertility treatments, but I encountered similar problems finding out how to get a doctor’s office to actually take the VA’s money since it’s not an insurance company. I actually had one tell me that even if VA mailed them a check they wouldn’t cash it for that reason! It was baffling to me. Good for you for sticking it out – I gave up.

    • Christy Smith March 8, 2011 at 00:05

      I gave up too and paid the bill myself. Frustrating!

      • Bruce Roberts March 8, 2011 at 18:30

        Personally, I sent the bills to the VA and a copy to the US Attorney’s office when they tried to charge me for their cost over what the VA would pay. Let them answer to the Government when they do not follow the US Statutes. Never give in and pay for what you legally do not have to.

  9. Ellen March 7, 2011 at 13:49

    I know about being in an auto accident and no insurance due to being 100% service connected. The Dept of Veterans Affairs had to go after the other driver who was at fault for the accident. Since the guy didn’t have insurance, drivers license, etc, they went after me for payment. It was well over $50,000 and my attorney fought hard for me and got it down to $5000 which would be taken out of my personal injury funds.

    Many years later the guy was charged w/ fellony DUI and put in prison for only 2 yrs.. The courts ordered resitution to the Dept of Veterans Affairs and to me. The VA Hosp was granted $75,000 and I was awarded $12,000. The guy is paying the minimum pymts.

    I also hated all the bills that came in from the accident since I was air evac out due to my injuries. They had to go thru my insurance company and the VA Hosp.. The VA Hosp had to take some of the expenses out due to them being service connected treatments.

    • Courtney March 12, 2011 at 03:42

      Congratulations on the birth of your daughter! I hope you are doing well. I can relate somewhat to what you are going through. I thought my life would be changing in extraordinary ways in 2005 when I was hired at my local VA as a GS-11 in mental health, as I have a degree in social work. The same day I found out I was hired, I took a pregnancy test that came up positive.
      No need to go into details, because I could write a book about my short tenure at the VA, but let’s just say that my life became hell. My wonderful boss who hired me, got a promotion and told me that my life was going to be very tough without her there and an increase in visibility with the upper administrators while they hired a new supervisor.
      My work life was he’ll. They demanded, they were uncaring and cold. I began to get harassed, and my health began to suffer. I needed to be infused with iron via IV during my pregnancy and they insisted that I call in to a nationwide conference call while being infused at the hospital. It goes on and on.
      I finally had enough. I quit, and sued them for pregnancy discrimination. Although it didn’t o anything to heal my broken heart from losing this great job, they did settle with me…. A first legal victory for a VA employee here in 18 years. I won nothing substantial, but I felt vindicated.
      I stayed faaaar away from the VA or years, even when I became service connected for MST. But at my whits end, I sought out treatment for PTSD. The care was amazing. The staff were extraordinarily kind, and I too was referred to the Womans program. I have had many bumps along the way, but agree that they are trying to b more veteran focused. I can’t say that I am thrilled, but I do have faith in the psych services.
      Good luck to you and your family.

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