Wednesday, October 10, 2012

Lessons in bureaucracy...and sweet, sweet VICTORY!

One big lesson I learned in the military is that nothing is ever as easy as it should be. Getting paid, taking leave, submitting a briefing for a meeting—everything was drowned in extra layers of bureaucracy. My Army instructors at pre-deployment training were fond of saying, “It’s not the right way, but it’s a way.”

Thus, another big lesson I learned was perseverance. I needed to get paid, take leave and submit briefings for meetings, so I waded through the red tape until I could.

Sometimes it sucked. (Extra administrative stress is exactly what you need when preparing for war). But you know what I’ve learned since leaving the military and entering the “real world”? Sometimes that sucks too.

Sometimes a process like waiving school health insurance because you get comprehensive coverage through the VA hospital is not as simple as filling out the waiver form, showing your VA ID, having a VA representative call the school, or even providing examples of legislation that identify VA coverage as fulfilling the state insurance requirement.

And sometimes it would be easier to give up.

But then, two weeks, two in-person visits, two identical forms, and three phone calls later you receive a response like this that makes it all worthwhile: 
Dear Lauren,  
After reviewing the Veteran's Administration Health Care Program in reference to State requirements of comparable coverage, we have determined that although your program does not meet each individual requirement, you are provided with access to the necessary coverages, and the Health Care Program covers the costs of the requirements which aren't included (specifically emergency care). I have processed your waiver request for the Emerson Health Insurance and Health Services Fee and the charges have been removed from your account.  
I want to thank you for taking the time to send us the information you did regarding the Health Care Program. In order to make our policies clear for future Veteran's with this coverage, we will be revising our website to include the VA Health Care Program under acceptable comparable coverage for waivers.
The VA is a strange entity that straddles the line between the military and the real world. Therefore, it comes with a certain amount of built-in confusion—a knowledge gap, as with so many military issues, on the civilian side, and a perpetual inability for the government to keep up with the need to educate. Caught in the fray are the veterans, left to struggle through frustration and ignorance in order to use their earned benefits.

Until the government effectively takes control (lots of rolls of red tape away, I'm sure), I guess the task of bridging the gap is left to grassroots educators, like me.

So here’s my advice: persevere. Do your research, and throw it in their face (tactfully, of course). Kick and scream (tactfully) until you get what you’re entitled to. Eventually, you’ll get it. And you just might make it easier for those who follow.

For any MA vets struggling with insurance waiver issues (Hi! Thanks for reading!), here’s some helpful legislation:

When filling out MA State Taxes, there is an option to select U.S. Military (including TRICARE and VA coverage) to satisfy the requirement for minimal credible healthcare coverage.  

14. What is required for a student to obtain a waiver from the SHP plan for alternative coverage?
The student must submit a waiver application to the school and certify, in writing, that he or she has alternative coverage, the name of the entity offering the plan, the policy number or member identification number, the name of the subscriber or primary enrollee and the relationship of that person to the student, and a statement that the coverage is comparable to the coverage required under a SHP. The waiver request must be on a form supplied by the institution, and may be submitted electronically.

15. What is considered "comparable coverage" necessary to obtain a waiver from the SHP?
The health plan must provide reasonably comprehensive coverage of health services, including preventive and primary care, emergency services, surgical services hospitalization benefit, ambulatory patient services, and mental health services; and be reasonably accessible to the student in the area where the student attends school.

According to the Mass Student Health Insurance legislation Section 3.05, waivers can be given to students with MassHealth coverage. VA coverage is acceptable for the MassHealth waiver, and qualifies veterans under state and now federal legislation as comprehensively covered 

UMass, the state's university, declares that veterans are eligible for health insurance waivers (See Waiver Eligibility).

And good luck.