How Can Health Insurers Comply With SCRA?

Health care is a major issue in the United States, both for active-duty servicemembers and civilians. While those who are not employees of the armed forces may be primarily concerned with the Affordable Care Act, veterans may be thinking about problems with Veterans Affairs. Some may be concerned about health insurers complying with the SCRA.

health insurers must comply with scra too

A 2014 USA Today story said more than 600,000 veterans had to wait a month or more to see a doctor at VA hospitals and clinics. That comes to approximately 10 percent of all VA patients.

A Military Times story two years later reported that few improvements in that time.

Patients at dozens of VA medical facilities wait at least a month for an appointment. And 64 have average wait times for new patients that are over 60 days. Ten facilities reported wait times of more than 90 days for new patients to see a specialist. One in Westmoreland, Pennsylvania, had wait time for a specialist appointment of 174 days.

Military.com reported earlier this year that the VA now allows eligible veterans to receive medical care at urgent care facilities not affiliated with the VA.

The Servicemembers Civil Relief Act provides statutes that help those returning from active duty to more easily obtain private health care under their previous insurance. This does not apply in all cases, however. It is essential for health care professionals to understand how this law applies to the industry.

SCRA Health Insurance Statutes

Section 704 of the Servicemembers Civil Relief Act is titled Health Insurance Reinstatement. Any servicemember who is entitled to protections under the Act is also entitled to the reinstatement of health insurance upon release or termination of active duty.

For this to apply, the health insurance must have:

  • Been in effect on the day before their service began
  • Have been terminated effective on a date during their service.

In short, if the servicemember’s health insurance expired or the insurer canceled it during their period of active duty, the insurer has no choice but to reinstate it.

Section 704(b) specifies that there can be no exclusion or waiting period. Instead, the insurer must immediately reinstate the servicemember’s coverage. This applies if:

  • The condition has not been determined by the Secretary of Veterans Affairs to be a disability incurred or aggravated in the line of duty
  • The condition arose before or during the period of the servicemember’s service
  • An exclusion or waiting period would not have been imposed for the condition during the period of coverage

Health Insurers: Comply with the SCRA

Servicemembers returning from active duty have 120 days to apply for the reinstatement of their health insurance. After that, they must fill out a new application. This law does not apply to employer-offered insurance programs.

Health insurance companies that do not regularly verify military service in order to know who is eligible for automatic reinstatement are opening themselves to serious liability in civil or even criminal liability. The Servicemembers Civil Relief Act Centralized Verification Service can help make this process easier.

Attorney Roy Kaufmann serves as the Director of the Servicemembers Civil Relief Act Centralized Verification Service, located in Washington, D.C. As a recognized authority on the Servicemembers Civil Relief Act, Mr. Kaufmann has published hundreds of articles and hosted many webinars. His teachings help law firms and businesses to remain compliant with the SCRA rules and regulations so as to avoid costly fines.

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