


The responses you submit are confidential and protected from unauthorized disclosure by 38 U.S.C. However, without disclosure, a credit card transaction or direct debit transaction cannot be processed. Privacy Act Information: The information you furnish on this form, including your Social Security Number, is used to associate your payment with your accounts receivable record so that we may properly credit your account. If you have questions, please call the VA Debt Management Center at 80 (TTY: 711) between 6:30 am and 6:00 pm Central time. Making payments on this Web site will delay application of those payments to your account and will not preclude fees charged by the collection agencies or law firms. This means the Department of the Treasury has referred your account for private collection. YOU HAVE RECEIVED COLLECTION LETTERS OR PHONE CALLS FROM A PRIVATE COLLECTION AGENCY OR LAW FIRM Questions regarding Treasury collection should be directed to the telephone number on the Treasury collection letter. If Treasury has sent you this letter, making a payment on this Web site will only delay application of the payment and will not preclude Treasury from adding fees to the amount you owe. YOU HAVE RECEIVED A COLLECTION LETTER FROM THE DEPARTMENT OF THE TREASURY GIVING YOU 10 DAYS TO MAKE PAYMENT TO AVOID FURTHER COLLECTION ACTION If you need help completing the co-payment form call 86. If you wish to make a VA medical co-payment click here. PLEASE DO NOT MAKE PAYMENTS ON THIS WEB SITE IF: YOU ARE PAYING A VA MEDICAL CO-PAYMENTĭMC does not collect nor have information concerning medical billing statements.
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To learn more about your services, go to your health plan’s website.*** A NOTE ABOUT YOUR WEB BROWSER *** You will need to use one of the following Internet Browsers in order to complete a transaction: Internet Explorer 5.5 SP2 or higher Mozilla Firefox 1.5 or greater Mozilla 1.7 or greater Netscape 7.x OR, Safari 1.2 (for MAC users). Call your dental plan if you need help with prior authorizations. If your child needs dental services beyond the cap, you will need to get a prior authorization. Co-pays for doctor visits and medicine range from $3 to $5 for lower-income families and $20 to $35 for higher-income families.ĬHIP has a cap for dental services. Enrollment fees are $50 or less per family, per year. CHIP Enrollment and Co-paysĭepending on your income, you may have to pay an enrollment fee and co-pay for doctor visits and medicine. Many health plans that provide Medicaid also provide CHIP.

If your child had Medicaid before and now has CHIP, you might be able to keep your health plan and your doctor. A service manager can make sure you get the health care services you need from your health plan. Some CHIP members with special health care needs might receive service management. Compare value-added services offered by the health plans in your service area.

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Learn more about how to choose or change your health plan. If you’re new to CHIP, you’ll choose a health plan for your child from the ones available in your service area. CHIP covers children in families that earn too much money to qualify for Medicaid but cannot afford to buy private insurance.
