Veteran’s Health Care: Why Idaho veterans are receiving massive medical bills

“It was pure panic, I didn’t know what to do,” Veterans speak out about insurance program woes

It’s a beautiful fall afternoon in Shanelle and Daniel Mele’s home. The couple of military veterans are playing with their son, their dogs, and they have a baby on the way, due in December. The problem is, the Meles were recently hit with a $21,000 bill from a hospital in the Upper Valley. Shocked and panicked, the Meles weren’t sure what to do next and so they had the most logical reaction- call their insurance company. When they called the company, HealthNet or “Veteran’s Choice” they received multiple answers. All they knew after their multiple calls, that bill wasn’t getting paid anytime soon.

“It was just pure panic I didn’t know what to do,” said Shanelle. With their baby on the way, she was uncertain about if she’d be able to deliver at Madison Memorial with such a large bill over her head. After working with the hospital’s billing department, Shanelle says they will let her deliver, but they no longer accept Veteran’s Choice because of numerous cases like the Meles. “It’s just not right, any way you look at it, it’s just not right,” said Daniel. The Meles took on another insurance option so that they can deliver without any problems.

This story isn’t just unique to Shanelle and Daniel, thousands of veterans across the country who live in rural areas are running into this. “They’ll stand there and tell us how much veterans deserve and how great of health care they provide us but when it comes down to it…this is what’s going on, ” said Daniel. Many veterans say they know it’s not the fault of the hospitals, it’s an issue with the Veteran’s Choice insurance program.

“It’s a matter of bureaucracy, and some incompetency,” What’s being done to fix a faulty system

Ron Naeglin, a veterans services officer in Madison County spends a good portion of his day handling claims with the Veteran’s Choice program. “We’ve been very lucky, but maybe it’s skill,” Naeglin says as a smile wipes across his face. With 200 open cases of veteran’s insurance claims, even Naeglin knows something needs to change. In fact, the way he’s getting some of these claims taken care isn’t exactly easy. “We contact [Idaho U.S. Senator Mike] Crapo, he contacts a backdoor V.A. who contacts choice, and that’s how we’re getting it done, “said Naeglin.

Naeglin also says he’s worked closely with “Choice Champions,” which are advocates with the insurance company to get bills paid. He’s had some luck working with the champions to get the bills paid for as well. Naeglin believes change is on the way, and it will make real progress for veterans living in rural areas.

Crapo- recently created a bill called the “Care in the Community Act”. Crapo says he aims to consolidate eight programs to streamline the insurance system. “This is what I mean when I say eliminate the maze and build a highway,” said Crapo.

Bureaucracy is what Crapo credits the problem to. While he admits their might be a learning curve for the people running the Veteran’s choice program, he believes there are some minor changes his bill cleans up.

“They need to know that we care, we as medical professionals absolutely care”

Veterans aren’t the only ones taking a hit from this program. Several local hospitals and medical clinics are eating the cost of these procedures because the program isn’t paying for them. In one case, a local cardiologist is doing surgeries worth hundreds of thousands of dollars because the insurance company isn’t taking care of the cost.

Dr. John “Jack” Lassetter said in one instance a patient needed immediate help after a heart attack in Idaho Falls. The Veteran’s Administration expected the patient to drive himself down to Salt Lake City to get approval for the surgery “it was an unethical request,” said Lassetter. The cardiologist went ahead and did the surgery, then the patient received a bill for about $90,000.