by Kiernan Mehan | Nov 19, 2024 | Recent News, Veterans
100% Free VA Healthcare Entitlement per the TERA Memo
For all Vietnam, Gulf War, Middle East and Southwest Asia veterans covered under the PACT Act of 2022, you are now entitled to FREE VA Healthcare with the exposure to toxic materials because of TERA (Toxic Exposure Risk Activity). Sep 20, 2023 — In August 2022, the PACT Act was signed and expanded benefits and services for veterans with toxic exposures during service. Even if you have a VA Disability rated at 10%-40% or never, ever applied for any VA Disability Rating, the veteran is now eligible for free healthcare.
A TERA memorandum, or toxic exposure risk activity report, is a document that the VA medical examiner reviews when a veteran files a disability claim that references the PACT Act. The PACT Act, or Honoring our PACT Act of 2022, expanded benefits and services for veterans who were exposed to toxins while serving in the military.
Presently VA FREE Healthcare is available for those who:
CATEGORY 1: Veterans who participated in a toxic exposure risk activity (as defined by law) while serving on active duty, active duty for training, or inactive duty training.
Note: many stateside & overseas military posts and bases have been declared Toxic Waste Sites. These are not automatic and must be Service-Connected.
CATEGORY 2: Veterans who were assigned to a duty station in (including airspace above) certain locations during specific periods of time.
- On or after August 2, 1990, in: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates
- On or after September 11, 2001, in: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan, or any other country determined relevant by VA.
CATEGORY 3: Veterans who deployed in support of Operation Enduring Freedom, Operation Freedom’s Sentinel, Operation Iraqi Freedom, Operation New Dawn, Operation Inherent Resolve, or Resolute Support Mission and other designated locations.
- EFFECTIVE ON ENACTMENT (AUGUST 10, 2022): Veterans who served in the Republic of Vietnam (from 1/9/62–5/7/75), Thailand at any US or Royal Thai base (from 1/9/62–6/30/76), Laos (from 12/1/65–9/30/69), certain provinces in Cambodia (from 4/16/69–4/30/69), Guam, or American Samoa or their territorial waters (from 1/9/62–7/31/80), or the Johnston Atoll or a ship that called there (from 1/1/72–9/30/77) may enroll in VA health care.
- BETWEEN OCTOBER 1, 2022, AND OCTOBER 1, 2023: Veterans who served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998, and who were discharged or released between September 11, 2001, and October 1, 2013, may enroll in VA health care. Enrollment is free, there are no annual costs, and healthcare may be free as well.
In addition a Veteran is eligible for a TERA Memorandum placed into their medical records if the participated in a TERA activity which includes:
- Handling, maintain or detonating Nuclear Weapons
- Working with radioactive material
- Using calibration and measurement sources
- Being exposed to X-rays
- Being exposed to radiation from military occupational exposure
- Being exposed to warfare agents
- Being exposed to nerve agents
- Being exposed to chemical and biological weapons
As of March 5, 2024, veterans who meet the basic service and discharge requirements and participated in a TERA are eligible to enroll in VA health care, FREE, without applying for VA benefits; meaning applying for some disability rating.
Contact your local Veteran Service Officer (VSO) offer for details. Be aware the benefit is through the Veterans Healthcare Administration (VHA) and is not the same as applying for disability with the Veterans Benefit Administration (VBA) a Disability rating entitling you to money. There is VA Form 10-10EZ to get and read the instructions. When this form is submitted along with any supporting documentation usually on the VBA-21-4138 it goes off to a separate address in Janesville, WI. Although you should think about applying for VA Disability Benefits ($$$) because you may well be entitled to it.
VA Added More Presumptive Conditions for Military Conflicts Since 1990
The VA has added Male Breast Cancer, Urethral Cancer and Cancer of the Paraurethral glands to the list of illnesses presumed connected to military service in conflicts since 1990. The policy change covers veterans who served in Southwest Asia. Veterans whose claims are approved may also be eligible for benefits back to August 2022 when the PACT Act of 2022 was signed. Survivors of those with these cancers maybe automatically granted financial payouts. (AirForce Times – July 2024)
More Disabilities Added to What the VA Will accept
This spring the VA announced an update to the VA Schedule for Rating Disabilities (VASRD) specifically pertaining to digestive conditions. The changes add or modify rating criteria for 55 medical conditions in the rating schedule that incorporate medical advancements for treating certain disabilities and modern medical knowledge to compensate Veterans more accurately.
The three biggest changes that will impact you, as Veterans, include the new evaluations for Celiac Disease, Irritable Bowel Syndrome (IBS) and Hemorrhoids.
Beginning May 19, Celiac Disease—an autoimmune disorder that impacts how the body processes gluten—will have its own rating criteria specifically designed to address its disabling effects. Veterans with this condition were previously granted service connection and evaluated by analogy using rating criteria that ranged from zero to 30 percent. Now under a specific diagnostic code, Veterans will be eligible for an evaluation ranging from zero to 80 percent.
VA will also adjust the rating criteria for evaluating Irritable Bowel Syndrome, also known as IBS. Previously, VA offered zero, 10 and 30 percent evaluations for the condition. Under the new criteria, Veterans may be entitled to 10, 20, or 30 percent evaluations based on the frequency of symptoms; therefore, new rating criteria will always offer a compensable evaluation.
Finally, VA addressed the evaluations for both internal and external Hemorrhoids. Previously, VA assigned a zero percent evaluation if the condition was identified as mild or moderate. For more severe findings a 10 or 20 percent evaluation was warranted. With the new rating criteria set in the rating schedule, mild or moderate hemorrhoids will now qualify for the 10 percent evaluation.
Capt. Jim Marshall USAF retd. captjim@ancan.org
by Rick Davis | Oct 11, 2024 | Blood Cancers, Health Resources, High Risk/Recurrent/Advanced, High Risk/Recurrent/Advanced Prostate Cancer, Low/Intermediate Prostate Cancer, mCRPC, Men 'Speaking Freely', Men's Breast Cancer, Multiple Sclerosis, Pancreatic Cancer, Prostate Cancer, Recent News, RMC, Sarcoidosis, Thyroid Cancer, Veterans
Medicare Health Insurance Choices
With Open Enrollment starting on October 15, two AnCan’rs asked for advice this week on Medicare plans – and yes it’s complicated. AnCan recommends you watch the webinar we held last October to help understand the difference between traditional Medicare and Medicare Advantage. The dollar details are different for 2025 but not the principles.
We also suggest you visit the Triage website and attend its free webinars. Many of their resources can be found at https://triagecancer.org/medicare-cancer
Lastly, my own health insurance broker, Kim Umphres, is licensed to write in 15 States. He offered his help to all in last year’s webinar, so take him up umphres100@yahoo.com
Since the same questions are likely in the mind of many others, I have written this Blog Post. I am no expert but this may illustrate how I think about my own health insurance. Sadly, I cannot help you all individually – consult with your own Medicare health insurance for the best advice.
Onward & upwards, rick
Many of us on Medicare are faced with renewing our plans – or buying a plan for the first time. If you choose not to buy a plan to supplement Medicare, it leaves you exposed to roughly 20% of your medical costs. That can amount to very big bucks!
The main choice is whether to opt for Traditional Medicare + a Supplement (Medigap) Plan + a Drug Plan. Alternatively, a Medicare Advantage Plan can look attractive but comes with warts.
If you are low income and cannot afford the available plans, there are Medicaid alternatives for Medicare supplements.
Advantage Plans (Plan C) restrict your choice of Health Care Providers since they are based on Provider Networks. If you need a particular type of specialist, for example a genitourinary medical oncologist, or a neurologist who specializes in MS, this can be a problem with Advantage. Community Standard of Care is often the byword. If you choose an Advantage Plan, be sure it covers HCPs who practice at a Center of Excellence.
Advantage Plans usually have small monthly premiums, sometimes zero. They also include co-pays when you visit a Provider. Co-pays can be anywhere from Zero dollars to several hundred for fancy scans like PSMA, so you have to look carefully at the coverage. The more you use the plan, the more you pay. Some may include coinsurance – avoid those altogether. It’s a nuance we won’t get into here.
You can also go out of network to a Provider of your choice, but copays will be significantly higher. For example, you may pay $50 for a visit to a specialist in-network. Out-of-network, the cost can be significantly higher – often 40% of the approved Medicare fee for the service sought.
Advantage Plans often have a Gatekeeper who must approve any referral. You may not be able to self refer. Also there can be stricter intervention by the Plan to pre-approve procedures.
Drugs are included, however there is also a co-pay for some generic and all branded drugs that depends on the tier in which they are classified in the Plan’s drug formulary. List the drugs you use and find the cost. That said, the good news in 2025 is that drug out-of-pocket costs cannot exceed $2,000.
Traditional Medicare with a Supplement (Plans F,G,K,L,M,N) may not restrict your choice of HCPs – you can go anywhere in or out of state provided the Provider accepts Medicare.
Traditional Medicare Supplement Plans cover the 20% not covered by Medicare A and B. You pay a monthly premium that varies according to the plan chosen. The different supplement plans have different features. The more you pay in monthly premium, the less the restrictions and the lower the deductibles.
In addition you will need drug coverage (Plan D). Again that includes a monthly premium, plus a charge for each drug, so you have to shop plans against your Rx. For 2025, drug out-of-pocket costs cannot exceed $2,000.
As long as your chosen Provider accepts self-referrals, there may be no Gatekeeper. Procedures and protocols may still be subject to pre-approval.
Since Advantage Plans can be more profitable for the Payer, they offer lots of bells and whistles to sell the plan – for example subsidies for OTC products. One plan I was offered recently, actually pays the Holder $5/month!
I’m trained as an economist so I look at risk reward. I compare the annual maximum out-of-pocket cost between the Advantage Plan and the Traditional Medicare Plans (inc. the drug plan).
For traditional Medicare There is a required monthly premium for both the Supplement and the Drug Plan. Add those together and multiply by 12. In addition you can have out-of-pocket drug costs, especially if you are using expensive cancer drugs, but that cannot exceed $2,000 in 2025. Btw, the $2000 will decrease in subsequent years.
Each Advantage Plan has a stipulated maximum out-of-pocket cost for in-network and out-of-network Providers. In-network will be less. I look at the out-of-network max, and add to that any monthly premiums that are usually minimal. Drugs are included with a co-pay, but that co-pay cannot exceed $2,000 in 2025.
Now that I know what I HAVE to pay with Traditional + Supplement vs what I could pay with Advantage depending on my usage, I can compare whether I want to roll the dice to save money.
If the Traditional route costs me $500 in monthly premiums, I know I am out-of-pocket $6,000 plus my drug copay costs capped at $2,000.
Say my Advantage Plan has a monthly premium of $25, then for sure I am out of pocket $300. The rest depends on how much medical care I use. Assume ( the economist’s favorite word) the out-of-pocket for out-of-network in my plan is $8,000, that is my max. I still have to consider up to $2,000 for drugs.
Let’s compare!
IN THE WORST CASE I am spending $6,000 (+ drugs) for Traditional Supplement versus $8,300 (+ drugs) for Advantage. The Advantage could be $2,300 more pricey.
IN THE BEST CASE, I am out-of-pocket $300 (+ drugs) for Advantage vs $6,000 (+ drugs) for Traditional Supplement, so I could save $5,700 with Advantage.
Risk-Reward… do I want to roll the dice to save up to $5,700 that could cost me an extra $2,300??
Each person has to make that decision.
There’s more to it than this. For example HMO’s like Kaiser Permanente may make it even harder to go out of network. And with KP, you are guarantied to only get community Standard of Care medicine . As I often say, KP is great as long as you don’t get seriously ill.
AnCan strongly suggests finding a local Medicare Health Insurance Agent to help you sort through this morass. Plans change by State, so your agent must be licensed in your State.
And one last thing. The first time you enter Medicare there is NO underwriting. No matter your preconditions, you are accepted to any Traditional supplement or Advantage Plan. In subsequent years, you may be subject to underwriting should you choose to switch plans. You can be restricted from changing between an Advantage and Traditional Supplement Plan.
AnCan recommends
watching our webinar from last October to help understand the difference between traditional Medicare and Medicare Advantage. 2025 details are different but not the principles.
For differences between the Traditional Supplement Plans, consult with a specialized Medicare Health Insurance agent. F and G are the best options. There are also high deductible options. An agent can also help you compare Advantage plans by various criteria, like maximum out-of-pocket for out-of-network care.
by Alexa Jett | Jun 28, 2024 | Active Surveillance PCa, Nutrition, Pancreatic Cancer, Prostate Cancer, Recorded Groups, RMC, Solo Arts Heal, Veterans, Webinars
Editor’s Note: We know you’ve missed receiving email notifications about our blog posts. Now that we are up and running on the new system via mailchimp (the same system you receive our group reminders on), here are the posts may have missed. They are categorized for your connivence. Enjoy!
Hi-Risk/Recurrent/Advanced PCa Video Chat Recordings
General Prostate Cancer
Solo Arts Heal
Veterans
Webinars
Pancreatic Cancer
RMC
by Rick Davis | May 27, 2024 | Recent News, Veterans, Volunteers
Memorial Day in Alexandria VA…
If you were walking down E. Luray Avenue in Alexandria, Virginia, maybe you saw this house ….
In front of that house was a table…..
… not, just any table but one bedecked with a white tablecloth, candle, red rose in a vase, wineglass, empty chair and more …
As you may have guessed, this is not just any house. Captain Jim Marshall (USAF Rtd) lives here with his good wife, Gail. It was Gail who came up with the idea to set up this symbolic table
On This Memorial Day We Honor The Fallen Soldier ★★
This table is reserved to honor our brave and selfless American military members who have perished on the battlefield, those who have not been returned to us after being taken prisoner on foreign soil, and for those who went missing and have not found their way back home.
The table is round- to show our everlasting concern for our fallen and our missing, and set for one, it is small, symbolizing the frailty of one prisoner alone against his or her suppressors.
The white tablecloth – symbolizing the purity of their intentions to respond to their country’s call to arms.
The single red rose– reminds us of the life of each of our fallen, and the loved ones and friends who miss them each and every day.
The vase is tied with a red ribbon – a symbol of our continued determination to remember our fallen and find our missing.
The slices of lemon – on the plate is to remind us of the bitter fate of those who will never return.
A pinch of salt– symbolizes the tears endured by the friends and families of those who have fallen and of those who have not returned.
The inverted wine glass– they cannot toast with us at this time.
The empty chair– they are no longer with us.
The candle – is reminiscent of the light of hope which lives in our hearts to illuminate their way home from their captors, to the open arms of a grateful nation.
Thank you Jim and Gail from all of us at AnCan Foundation on this National Memorial Day holiday!
by Rick Davis | Dec 8, 2023 | Active Surveillance PCa, AYA, Blood Cancers, Brain Tumors, Cancer Caregivers, Cancer Resources, Complementary Medicine, Health Resources, mCRPC, Men 'Speaking Freely', Men's Breast Cancer, Mental Health, mHSPC, Multiple Sclerosis, nmCRPC, Ovarian Cancer, Pancreatic Cancer, Prostate Cancer, Recent News, RMC, Thyroid Cancer, Veterans, Women's Breast Cancer
Bang your drum… it could make you smarter and healthier!
I don’t want to work
I want to bang on the drum all day
I don’t want to play
I just want to bang on the drum all day
–Todd Rundgren
Twice in the last several months, the topic of drumming came up in our AnCan Men Speaking Freely group and it generated some excitement both times. So this month’s invite will be on that topic.In my former practice whenever I have given a non-verbal treatment there is a big relief that no talking is involved. In bypassing the verbal and left-brain systems we gain access to a typically unused part of ourselves. I wonder if we can use this approach to cope with our serious illnesses and have a better life?
Our brains have a characteristic called plasticity, the ability to change. You may have heard of this regarding the little finger brain circuit of violinists; it grows as they become proficient. Drummers also have different brains than the rest of us. They have fewer, thicker nerve fibers between the two halves of the brain. They have more efficiently organized motor cortices. (Schlaffke, 2019). Because of this, drummers can do things that we can’t. They can coordinate the two sides of the brain better, and perform motor tasks with greater efficiency. They can play different rhythms with each hand and foot at the same time.
Schlaffke’s subjects had drummed many hours per week for decades. But Bruchhage’s (2020) subjects trained for only 8 weeks and showed several changes in the cerebellum plus changes in the cortex, showing not only cerebellar plasticity but also communication and coordination between the cerebellum and brain sensorimotor areas as well as areas for cognitive control.
Drumming is very complicated, which is why it’s unfair that the lead guitar and vocal guy gets all the girls (Greenfield, J. 2022).
For some reason, there is a close association between beat synchronization (integrating auditory perception with motor activity) and reading ability in children (Bonacina, 2021). Higher synchronization ability predicts better literacy skills. Maybe early intervention involving drumming can improve literacy in kids?
Cahart et.al (2022) showed that drumming can improve behavioral outcomes for autistic adolescents and elucidated some of the neurology involved. Does this mean it could help us?
Drums have been used for millennia for healing, inducing trance, and even psyching up soldiers.
We have learned that drumming is not just about waking up the right brain, but also about connecting the sides of the brain, and the cerebellum with the cortex. It can induce alpha brain waves. It can release endorphins. Even T-cells respond to drumming (Bittman). It induces present-moment experience, which we often work toward to deal with death anxiety. Interpersonal connections are made when people drum together. Despite the effort involved, it induces relaxation. I have come across papers describing drumming and music therapy for a wide variety of emotional problems and currently, there are 8000 music therapists in the US.
How about for us? We see above the possibility of reductions in anxiety, tension, pain, isolation, depression, and over-thinking the past and future. There are many studies of music therapy in ICUs, with patients on ventilators, easing hemodialysis pain, with positive results. Also, helpful with narcotic use, social integration, and depression. MSKCC uses music therapy.
With terminal cancer, there is data showing that music helps breathing, QOL, psychospiritual integration, reducing pain in chemotherapy, radiation, and helps pediatric breast and lung Ca patients (Ramirez 2018, Hilliard 2003, Burns 2015 Tuinmann 2017, Barrera 2002, Li 2011, Lin 2011). Atkinson (2020) found improvement with fatigue. I couldn’t find any studies focused only on Prostate Cancer.
Well, all this scholarly stuff is really unnecessary to anyone who ever banged a pot with a wooden spoon. Kids love it. Adults love situations where it’s OK to be wild and make noise, such as drumming circles and Pound classes. It’s just fun and feels good.
Dr. John Antonucci
Editor: Dr. John wrote this for our Men Speaking Freely Reminder on Dec 7, 2023. It’s such a perceptive, helpful and instructive piece, AnCan wanted to share it widely.
by Hannah Garrison | Oct 21, 2023 | Advocacy, Health Resources, Multiple Sclerosis, Veterans
So, you have MS. You may also be a Veteran of the United States military. What kinds of benefits and resources are available to those who have served and are now living with this debilitating disease? Here we hope you’ll find our beginner’s guide helpful in your search for benefits and resources.
Having MS and navigating the world of healthcare is dangerously daunting all on its own. Throw in some confusion about VA benefits, and you have a confusion cocktail to contend with (see what I did there?).
Before we dive in, just be warned: there is a plethora of information. Take your time researching, because there are a lot of links in this blog post. Because there’s so much info to take into consideration, we will do our best to update this blog as necessary. Check back regularly for more information as we come across it.
We have to thank Captain James “Jim” Marshall, who is a retired US Air Force Veteran, for bringing up this topic in the first place. Jim regularly moderates our Veteran Support Group, and also attends the High -Risk Prostate Cancer group & Blood Cancer group.
Over this past weekend, Jim struck up a conversation with an Air Force Veteran who has MS. He was surprised to learn that MS is, in fact, not covered under the Agent Orange Act or the PACT Act. MS has not been identified as an illness associated with the substances that these Acts target.
In his conversation, and subsequent research later on, he found that many people (perhaps as high as 60% of people) were denied upgrades to their disability rating. The VA, depending on evidence, will often award up to 30%. However, sometimes specific symptoms will allow for a higher percentage; one of those being chronic fatigue, which gets a 60% rating all on its own.
Jim also states that Veterans who are prevented from working as a result of their MS may be able to receive a benefit called
“Total Disability on Individual Unemployment Ability”, or TDIU. This benefit
compensates Veterans at the 100 percent rating, even if their overall disability rating may be less than that. Veteran’s symptoms must be Service-Connected (SC), and already have a 60% disability rating OR have “2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more”. You also must not be able to hold down a steady job that would have supported you financially. Definitely click on he link above to read more about it and see if you qualify.
The website states: “The VA provides health care services to Veterans with MS from the time of diagnosis throughout their life, whether or not they have a service-connected or non-service connected status. If an individual had symptoms of MS in the military, or within seven years after honorable discharge, he/she may be eligible for service-connected disability.”
For those who are new to the benefits game:
The website suggests filling out the
VA Compensation and/or the
VA Pension form available online or at his/her local medical center for starters.
But oh my goodness, that’s a lot to sift through. Here are a few things on that web page that stand out to us:
Info on Filing and Intent to File – Sounds a little silly, but you may be able to receive retroactive payments for the time between when you submitted your intent to file and when they approve your claim.
Pension Benefit details – At least one of these must be true:
- You’re at least 65 years old, or
- You have a permanent and total disability, or
- You’re a patient in a nursing home for long-term care because of a disability, or
- You’re getting Social Security Disability Insurance or Supplemental Security Income
There’s more to this list, so click that link for info on Pension Benefits
Disability Housing Grants Information –
- Specially Adapted Housing Grant (SAH) for those who own their home, or will own their home, this is a grant that allows adaptive modifications to your home. Can receive up to $109,986 as of 2023
- Special Home Adaptation Grant (SHA) is the same as the above, but with different qualifications. Can receive up to $22,036 as of 2023
- Temporary Residence Adaptation for those who are living in a temporary family member’s home that needs changes in order to meet your adaptive needs. You must meet all the qualifying criteria for one of the two grants above. The amount changes depending on which one you qualify for.
Many people with a chronic or debilitating illnesses will tell you that advocating for yourself and your needs is of utmost importance. When dealing with and anything VA-related, persistence is key.
It’s tricky, and it’s a lot to deal with on top of managing symptoms.
Keep in touch with your primary care provider and your MS social worker. They’ll be able to help you refine your case for increasing your disability rating. They’re an invaluable source of information and help in signing up for various benefits. The provide supportive counseling to assist Veterans on the physical and emotional impact that MS can have on you and you family. They’re there to be your advocate, your negotiator, your case manager, and more.
If you don’t have a social worker on your team,
look for the Social Work department at your local VA, or talk to your primary care provider or MS Specialist.Here’s a summarized list of just some benefits offered at the VA. These programs require the help of a social worker:
Veteran Directed Care – offers monetary help with personal care services and daily living. Veterans are given a budget, and can even hire their own workers.
Medical Foster Home – This is a residency that’s similar to a nursing home, except Veterans are housed in a private home. Caregiving staff is on call 24/7. The VA ensures that these staff are well trained.
Other good Veterans Service Organizations (VSO) resources are:
Captain James “Jim” Marshall wants you all to know that if you have any questions pertaining to benefits and navigating the system, feel free to send him an email:
Marshall-James@comcast.net
As we mentioned above, this article is just a small portion of info about benefits in the VA system. We will continue to update or even create new blogs as we see fit.
Above all we sincerely thank each of our Veterans for their service. We love and appreciate you!
Don’t forget to check out our MS Peer Support Group, which meets every 2nd and 4th Tuesday of the month
And of course our Veterans Peer Support Group, which meets every 4th Thursday of every month
UPDATE #1 – Jim let me know that Amyotrophic Lateral Sclerosis (ALS) “is a presumptive condition for veterans with 90 days or more of continuously active service in the military. Any veteran with ALS should apply for Disability Compensation.”.
He goes on the state “Looking into justifying MS [and ALS] as Service-Connected, it is not as difficult as it seems. If the Vet was exposed to Hazardous Materials, most of us come across such things even in the states, then present VA thinking has MS service-connected because ‘IT IS AS LIKELY AS NOT’ caused by the exposure.”
