Big Considerations: Health Insurance for Veterans

health insurance for veteransConsidered the largest health care provider in the country, the Department of Veterans Affairs operates more than 1,400 health care facilities and serves more than 5 million veterans. Although not all veterans are eligible for health insurance coverage through the Veterans Administration, most of them are. Length of service, income and combat injuries are some of the factors that are considered when determining eligibility. Most of the 1.3 million veterans who are not eligible will generally be eligible for either Medicare, or will qualify for insurance subsidies under Affordable Care Act (ACA) provisions in 2014. Veterans who served in Vietnam may be eligible for enhanced VA benefits.

Health Insurance for Veterans: VA Benefits

VA benefits are not health insurance for Veterans  in the strictest sense of the term. In fact, if a veteran has health insurance, the VA will first bill that insurance company for any medical care or condition not related to his or her military service.

The exception is Medicare. When applying for VA care, a veteran will be required to provide current, accurate health insurance information for this purpose. The veteran will not be required to pay copayments, coinsurance or other out-of-pocket costs other than the VA copayment, however.

For most veterans, VA benefits are far less expensive than traditional health insurance options or even Medicare. Traditional health insurance and Medicare plans often feature costly premiums, deductibles, copayments, coinsurance and other out-of-pocket costs. They can then choose from traditional health care options, home based care or nursing home care when needed. Some veterans may find it beneficial to combine Medicare Part A, which has no additional charge, with their VA benefits, in order to maximize their options.

Health Insurance for Veterans

Veterans who served until retirement or who were retired as medically disabled may be eligible for TRICARE. TRICARE is a more traditional health insurance model and has three tiers of coverage with robust benefits for veterans, their spouses and their dependents. Veterans will have primary care managers who will ensure appropriate access for all their health care needs, and they will receive priority care at military health care facilities. Veterans may also seek care from civilian providers if they choose.

The Transition

Whether retiring or not, all veterans have the option to have a separation physical.; these physicals are required for some discharges and retirees. The physical provides an important baseline and may be important should any disability claims arise. Health and dental records, which can be located at the patient advocate office, should be copied in order to ease the transition whether a veteran is moving to VA care, TRICARE or private insurance.

The Choice

Service members will need to consider their options before leaving active duty. In many cases, former service members and even retirees will be moving on to civilian jobs that offer insurance plans. Opting into both TRICARE and a civilian employer’s insurance plan can provide extra protection against life’s bumps for busy families, particularly if chronic or serious health conditions are present.

In some cases, options may be limited based on the type of separation. Retirees may be able to choose from VA benefits, TRICARE, Medicare or private insurance, while those who voluntarily separate may not be able to opt into any military benefits other than the Continued Health Care Benefit Program, or CHCBP, which is similar to COBRA and allows former service members to purchase up to 18 months of insurance coverage from the date of their separation. Those who are involuntarily discharged will have access to transitional health care for 60 to 120 days depending on the length of their service and may also be eligible to opt into the CHCBP.

How the ACA Affects Health Insurance for Veterans

The Affordable Care Act, or health care reform offers new protections and choices for current and former members of the military and their families. The Affordable Care Act will not affect eligibility for VA health care or TRICARE beneficiates, but it will expand options for dependents up to the age of 26.

Veterans who are currently enrolled in VA health care will also have the option to purchase new or additional coverage in 2014 through the health insurance exchanges, but they will not be required to do so. Tax credits and subsidies can make this coverage more affordable and improve access for those who have pre-existing conditions or who are not eligible for VA health coverage. However, with the full provisions of the Affordable Care Act not being active until 2020, the ramifications are still unclear for certain medical procedures, most notably in regards to elective or cosmetic surgeries.

Veterans can contact their health benefits advisor for personalized advice regarding their unique situation.

This article was written by Chad Fisher. He has covered a wide-range of insurance and financial topics from many different angles. 

(Photo courtesy of Tech. Sgt. Michael Holzworth via Wiki Commons)