Insight by Optum Serve

VA and partners are trying to bring more Veterans into the fold as PACT Act expands benefits

Over the next 10 years, the Veterans Affairs Department (VA) expects millions of veterans will be eligible for VA benefits as part of the PACT Act.

Over the next 10 years, the Veterans Affairs Department (VA) expects millions of Veterans will be eligible for VA benefits as part of the PACT Act.

The law, passed in 2022, expands healthcare and benefits for Veterans, caregivers, survivors and family members who were exposed to toxic substances during their time in the military. Veterans who are suffering from illnesses and were exposed to toxic substances like burn pits, Agent Orange and other chemicals now have more options for relief when getting disability services.

“The PACT Act expands coverage to 23 presumptive conditions that were not previously covered,” said Chris McPherson Innovation Strategist at Optum Serve. “The key purpose in this expansion was to account for diagnoses, symptoms and conditions that Veterans have suffered as a result of their service.  Unfortunately, because of the limitations that were in place at that point in time, they did not qualify for benefits.”

The VA is experiencing more people getting disability benefits, with hundreds of thousands more applying each year, Karen Frederick Gallegos, vice president with Optum Serve’s Enterprise Integration and Innovation office said .*

The department and its partners are now finding new ways to bring Veterans into the fold to get the benefits afforded to them.

“This notion of outreach and engagement and education is vital,” Gallegos said. “We’re at a critical juncture in which there very well could be supports out there for impacted individuals and they are not connected through some of these typical communication channels.”

Optum Serve is working to increase points of contact between service members, Veterans and the VA.

“Optum Serve has multiple connections with service members as they navigate from active duty, transition out of the military, seek care in the community and have coverage through commercial insurance such as United Healthcare, so we have a unique viewpoint on how Veterans access and utilize community care,” Gallegos said.

Optum Serve is increasing touch points throughout the lifecycle of a career from when a service member enlists to when they are eligible for VA benefits and beyond.

For example, Optum Serve provides medical disability exams in support of the Veterans Benefits Administration (VBA) and helps the Veterans Health Administration deliver healthcare services in three regions under the VA Community Care Network Program.

By expanding points of contact or finding areas where Veterans interact with the broader health care system, Optum Serve has opportunities to inform and connect impacted Veterans with services that can help them lead healthier lives.

“It’s important that we’re not just touching Veterans at a single moment in time. We are touching them multiple times across their lifecycle and are invested in establishing long term, trusting relationships,” Gallegos said.

Richard Woods’ story highlights the impact that toxic exposure can have on Veterans and their families.  Woods was exposed to Agent Orange during his two tours in Vietnam.  He came home, worked as a postman, raised a family and lived a healthy life until he was diagnosed with prostate cancer in 2000, then a few years later a liver and kidney cancer diagnoses, and then a recurrence of prostate cancer in 2019, all related to his Agent Orange exposure.  In 2019 he chose to seek care for his cancer treatments from the VA because of the cost burden.  There he has found a caring and committed team and a peer community of fellow Veterans.

As his medical needs have become more complex, helping him stay on top of his health is a family affair.  His wife is his full time caregiver and helps him with his daily activities like administering his medications, help with dressing and bathing and helping him with his wheelchair; his daughter coordinates with his doctors and takes him to all his appointments while his sons help with transportation.  His daughter shared that their family is proud of his service and the sacrifices he’s made for his country and his family and are happy to do this for their father but acknowledges that it can be hard at times.  Under the PACT Act, Woods’ wife could qualify for benefits such as a monthly stipend, behavioral health services or respite care.

“These diagnoses can be serious and usually have a broader impact to family life,” Gallegos said. “Getting Veterans and their family members connected up with the benefits they’ve earned through their military service is the right thing to do.”

Sources

VA Benefits & Health Care Utilization Pocket Card

Veteran Population – National Center for Veterans Analysis and Statistics (va.gov)

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