Veterans Choice Program offered at UPMC Somerset

May 23, 2019

UPMC Somerset continues to offer a health care program for veterans and active military personnel.

The Veterans Choice Program (VCP), or now called the Care in the Community Program for Veterans, has been offered at UPMC Somerset since January of 2016.

It is one of several programs through which a veteran can receive care from a community provider that’s paid for by the Department of Veterans Affairs (VA).

“Nothing has changed with the affiliation to UPMC,” said Amber Cross, RN, patient care liaison and veteran’s choice navigator. “We always accepted Tricare (insurance) for active military personnel and also for retired military personnel. We are still here and available.”

Director of Corporate Communications Sarah Deist said VCP was officially kicked off “to combat the long wait times at the VA and the mileage to get there to get care. A lot of the people in our area have to go to Altoona or Pittsburgh.”

According to Deist, there are 5,500 to 6,000 veterans in Somerset County; 4,500 to 5,000 of them are eligible for services; 2,800 are enrolled; but only 1,900 are active users.

The participant must be enrolled in the VA benefits program and be facing a 30 day wait time or travel more than 40 miles to get to the VA facility, Deist said.

The authorization is based on specific eligibility requirements and discussions with the veteran’s VA provider, Cross said.

Somerset is able to treat veterans with specialists available in cardiopulmonary, surgical, orthopedic, homology and pain management. It also helps with medications.

To be eligible for elective care program at UPMC Somerset, which includes procedures and therapy, the participant has to have pre-authorization by the VA, Cross said.

That means all the paperwork, which is not a quick process, is already done when they get to UPMC Somerset.

“There are a fair amount of veterans not enrolled in the VA,” Cross said. “It’s very important to get enrolled before you have the need to do so. Then it’s available when you need it.

You don’t want to be going through the paperwork in the middle of a health crisis.

“Once the VA approves the veteran for care, it’s a seamless process here. Getting them to pre-apply is the key.”

To be eligible to receive care through the program is based on one or more of the following conditions:

VA can’t provide the services the veteran needs.VA can’t make an appointment for the veteran at the nearest VA medical facility within 30 days of the clinically indicated date or if VA can’t determine the date, the date the veteran prefers to be seen next.Veteran lives more than 40 miles driving distance from the nearest VA medical facility with a full time primary care physician.Veteran has to travel by air, boat or ferry to get to the nearest VA medical facility.Veteran faces an excessive burden in traveling to the nearest VA medical facility (such as geographic challenges, environmental factors or a health problem that makes it hard to travel).The VA will work with the veteran to determine eligibility based on the above conditions and the veteran’s specific circumstances.

“The level of VA benefits depends on the level of injury,” Cross said.

Call 877-222-VETS to get enrolled. The Choice program support line is 866-606-8198 for additional information.

“The veterans who have used the program say it’s very beneficial,” Cross said.

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