Publication of Final Regulations Fact Sheet Hospital Care and Medical Services for Camp Lejeune Veterans and Payment or Reimbursement for Certain Medical Expenses for Camp Lejeune Family Members September 23, 2014 Summary: The Department of Veterans Affairs (VA) is committed to providing the best care for Veterans and families related to Camp Lejeune historical drinking water contamination as required by law. VA is announcing the publication of two regulations: one providing health care for Camp Lejeune Veterans and the other reimbursing for health care expenses of their family members potentially affected by contaminated drinking water at U.S. Marine Corps Base Camp Lejeune, North Carolina. The regulations implement provisions of the “Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012.” The first regulation, entitled Hospital Care and Medical Services for Camp Lejeune Veterans (AO78), will take effect immediately. The second -- Payment or Reimbursement for Certain Medical Expenses for Camp Lejeune Family Members (AO79) – will take effect 30 days after publication. The published regulations now allow VA to reimburse eligible Camp Lejeune family members for out-of-pocket health care costs related to any of the 15 covered medical conditions listed in the 2012 Act. Under that law, VA can reimburse costs from March 26, 2013, onwards. Family members can start applying 30 days after the regulation publication date. For more information about VA’s Camp Lejeune program, including eligibility and how to apply, visit publichealth.va.gov/exposures/camp-lejeune/ or call 1-877-222-8387. Since the passage of “Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012”, VA has enrolled and provided health care to those Veterans who served on active duty at Camp Lejeune for at least 30 days between January 1, 1957 and December 31, 1987. Background: President Obama signed the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 into law on Monday, August 6, 2012. In compliance with the law, VA provides health care to Veterans stationed at Camp Lejeune in North Carolina between 1957 and 1987 and meeting certain criteria. In late 2014, VA will begin reimbursement of health care expenses to their affected family members. From 1957 to 1987, people living or working at Camp Lejeune were potentially exposed to drinking water contaminated with chemicals known as volatile compounds, including industrial solvents and benzene from fuels. The law provides that Veterans stationed at Camp Lejeune between 1957 and 1987 will be eligible to receive health care through VA, and exposed family members will be reimbursed for health care costs, for the following medical conditions: 1. Esophageal cancer; 2. Lung cancer; 3. Breast cancer; 4. Bladder cancer; 5. Kidney cancer; 6. Leukemia; 7. Multiple myeloma; 8. Myelodysplastic syndromes, 9. Renal toxicity; 10. Hepatitis steatosis; 11. Female infertility; 12. Miscarriage; 13. Scleroderma; 14. Neurobehavioral effects; and 15. Non-Hodgkin’s lymphoma. For family members, VA will be the last payer and will provide reimbursement after all other health insurance coverage and reimbursement is received, as required by law. Frequently Asked Questions: Q: Who is eligible for the Camp Lejeune program? A: Veterans may be eligible for Camp Lejeune coverage if they meet the following criteria: - Served on active duty at Camp Lejeune for no less than 30 days between January 1, 1957 and December 31, 1987 - Meet all the qualifications for VA benefits, including meeting the VA definition of “Veteran,” and receiving a discharge other than dishonorable Additional qualifications can be determined by completing the 10-10EZ form and enrolling in VA benefits. Family members may be eligible for the program if they resided on Camp Lejeune as a dependent of an Active Duty Servicemember, or were in utero, for no less than 30 days between January 1, 1957 and December 31, 1987 and have one of the illnesses or conditions listed in the law. VA may reimburse costs associated with hospital care and medical services, as the last payer, for the eligible family members for the 15 illnesses or conditions. Once those family members have submitted claims to their insurance companies, they can apply to VA for reimbursement of the remaining balance of charges and fees connected to the qualifying illnesses. Q: How do Veterans and family members apply for the Camp Lejeune program? A: For Veterans: Veterans seeking to enroll in VA health benefits can enroll online at va.gov/healthbenefits/apply or at their local VA Health facility (va.gov/directory). Veterans seeking more information about VA’s Camp Lejeune Program or to apply via phone can call 1–877–222–VETS (8387). Veterans should locate relevant documentation to show proof of Camp Lejeune residency of not less than 30 days (e.g., copies of orders, base housing records, medical or school records, etc.). This information will be utilized by the Veteran Health Administration to validate eligibility for care under this authority. For family members: Once the family member regulation is effective (30 days after it is published), interested family members will be able to apply online. Submitted applications and supporting documentation will be reviewed to determine family member eligibility for the program. Once deemed eligible for the program, family members who have received care for one of the 15 Camp Lejeune conditions since March 26, 2013, can submit a claim for reimbursement. Family members should keep receipts for medical expenses related to the covered illnesses/conditions. Because the Camp Lejeune law only reimburses expenses, as the payer of last resort, related to the 15 conditions, family members should not change their existing health insurance. Family members who have questions regarding applying for Camp Lejeune Family Member Program benefits, claims payment, appeals, or other related matters should call toll-free at 1-866-372-1144 between the hours of 7 to 4:30pm CST. Q: Is the reimbursement for care retroactive? A: No, reimbursement is only from the point in time the Veteran enrolls in VA, if after 8/6/12 or reimbursement of VA copayments back to 8/6/12, if already enrolled and identified as a Camp Lejeune member within 2 years of publication of the rule. VA began providing Veteran care for Camp Lejeune on 8/6/12, following the passage of “Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012”. Q: Does this law provide Veterans with disability compensation? A: No. This law allows Camp Lejeune Veterans to enroll in VA health care. It does not provide service connection and compensation. Veterans who believe they have an injury/illness related to their military service may file a claim for disability (adjudication) for their condition at their Department of Veterans Affairs Regional Office. A list of those offices by state can be found here: va.gov/directory/guide/division.asp?dnum=3&isFlash=0. VA’s online website for electronic claim submission: https://ebenefits.va.gov/ebenefits-portal/ebenefits.portal?_nfpb=true&_nfxr=false&_pageLabel=Apply.
Posted on: Tue, 23 Sep 2014 18:47:38 +0000
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