How Can Health Insurers Comply With SCRA?

Health Insurers Must Comply With SCRA Too

‘Health Insurers Must Comply With SCRA Too’

Healthcare has become a major political issue in the United States, both for active duty servicemembers and for civilians. While those who are not employed by the armed forces may be primarily concerned with the Affordable Care Act, veterans may be thinking about the problems with Veterans Affairs.

A recent investigation found that more than 600,000 thousand veterans are still forced to wait one month or more to see a doctor at VA hospitals and clinics, according to USA Today. That comes to approximately 10 percent of all VA patients. Dozens of medical facilities run by the organization make a quarter or more of their patients wait at least a month for an appointment, and 64 have average wait times for new patients that are over 60 days. There were ten facilities that reported wait times of more than 90 days for new patients to see a specialist, including one in Westmoreland, Pennsylvania, where the wait time for a specialist appointment was 174 days.

The VA has made some progress in dealing with its backlog problem, however, the news source reported. The organization cut its number of veterans who had recently waited four months or more for an appointment from 120,000 to 23,000 between May 2014 and October 2014. Between June and September, the VA completed 1.2 million more appointments than it did in the same period of the previous year, coming to a total of 19 million. However, it bears noting that much of the overall improvement in the VA’s numbers comes from patients receiving care from private providers.

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, and it is essential for healthcare professionals or those entering the field to understand the specifics of 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 (1) have been in effect on the day before his or her service began, and (2) have been terminated effective on a date during the period of his or her service. In short, if the servicemember’s health insurance expired or was canceled during his or her 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 coverage of the servicemember must be immediately reinstated. This applies if (1) the condition arose before or during the period of the servicemember’s service, (2) an exclusion or waiting period would not have been imposed for the condition during the period of coverage, and (3) the condition has not been determined by the Secretary of Veterans Affairs to be a disability incurred or aggravated in the line of duty.

Servicemembers returning from active duty have 120 days to apply for the reinstatement of their health insurance. After this period, they must fill out a new application. Employer-offered insurance programs are not required to comply with this law.

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 court. The Servicemembers Civil Relief Act Centralized Verification Service can help to 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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