Claire Smith Last Updated On: August 1, 2023

Understanding VA Health Insurance Plans

Leaving the military can be a difficult transition for many reasons, and one of those is the need to now pay for healthcare. In the military, you have access to complete free healthcare coverage, so having to start paying for coverage and navigating plans can be a shock.

You might be asking yourself, “what’s a premium?” and wondering “are health insurance premiums tax deductible?”, in which case, you’re not alone. Many veterans and families experience this, which is why you’ll want to keep reading to understand your options.

You’re going to want to plan well in advance for this transition and start researching your options. After all, going without healthcare coverage for any period of time can be incredibly expensive.

Before choosing the right veterans health insurance option for you, here’s what you should consider:

  • Healthcare needs: Are you looking for coverage for a single person or for a family? Do you need to ensure you have access to a certain medication or doctor?
  • Budget: It can be a rude awakening to suddenly have to factor health insurance into your budget, but it’s important that you start budgeting for it now. A single person should budget anywhere from $100-$500 per month, while a family should expect to pay even more.

Knowing what you need and can afford can help you better research what’s available and find the right fit for you.

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VA Health Insurance Coverage

Providing easy access to the largest integrated health care system for veterans, VA health insurance makes sure you have coverage for what matters most when you need it. Get coverage for:
  • Regular check-ups with your doctor
  • Appointments with specialists (e.g. cardiologists, urologists, gynecologists)
  • Home health care
  • Eldercare
  • Physio and physical therapy
  • Massage therapy
VA health insurance also takes care of prescriptions, prosthetics, and medical equipment. Crucially, your VA health insurance covers appointments with mental health providers as well.

Understanding The Basic Medical Benefits Package

The VA Department’s Medical Benefits Package is available to all veterans who are enrolled with the department. This comprehensive package includes access to:
  • Preventive care
  • Primary and specialty care
  • Diagnostic imaging
  • Inpatient and outpatient care
Depending on their qualifications, some veterans may also be eligible for additional benefits, like dental care.

Who Is Eligible For VA Health Insurance Options?

All veterans who are enrolled for VA health care are eligible. You can enroll online at the Department of Veteran Affairs website

Once you are successfully enrolled, you are placed into veteran priority groups to ensure you are getting the level of care you require.

VA health care priority groups are as follows:

  1. Groups 1-3: Includes service-connected veterans with a disability rating, as well as former POWs and those awarded the Purple Heart or Medal of Honor. 
  2. Groups 4-6: Includes veterans with other eligibilities based on combat status, medical conditions, income, and environmental exposures. 

VA health care’s Basic Medical Package for Veterans can cover anyone who served in and was separated from active military service for any reason other than dishonourable discharge.

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Other Eligibilities

If you are a current or former Reserves or National Guard member who performed active duty as a result of a Federal order and completed the full period for which you were ordered or called to be active, then you may also be eligible for VA health care benefits. 

If you are a combat veteran who has served in a theater of combat operations after November 11, 1998, you can enroll in priority group 6 within five years from the date of discharge and receive free health care services as well as nursing home care for conditions that may be related to your military service.

If you were released or discharged from the active military, naval, or air service but you did not enroll to receive hospital care, medical services, or nursing home care during the legally specified five-year period, you’ll have one year from the period from the date of enactment of the Clay Hunt SAV Act (February 12, 2015) to enroll for VA health care. Note that this is only applicable to those released or discharged after January 1, 2009, and before January 1, 2011. 

If you served active duty at Camp Lejeune for no less than 30 days between August 1, 1953 and December 31, 1987, you are eligible for care and treatment of certain medical conditions, regardless of your enrollment status. Additionally, you’re entitled to free health care related to those conditions or illnesses. 

Get more information about this program for Camp Lejeune veterans here.

The Benefits of VA Health Insurance Coverage

Medicare has its benefits, but it doesn’t compare to coverage offered by VA health insurance. In fact, under Medicare, up to half of health care costs go unpaid for older adults. 

What’s more, Medicare is limited in terms of what services and supplies it covers, and the associated co-payments and deductibles are substantial. Thankfully, for veterans who are eligible, VA health insurance can pick up where Medicare leaves off. 

That’s right: you may qualify for both Medicare and VA health insurance, providing you with free or extremely low-cost health care solutions and priceless peace of mind. 

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Here Are The Major Benefits of VA Health Insurance:

Coverage for health-care services not covered by Medicare, including:
  • Regular check-ups and preventive care
  • Dental care
  • Long-term nursing home residential care
  • Long-term in-home care
On average, VA health insurance also has lower deductibles and co-payments than Medicare, so you save on costly treatments and even prescription drugs.

Know Your Options for Health Insurance for Veterans And Their Families

Whether you want to learn about VA health insurance options for yourself or a loved one, it’s important to know that—just as the health care needs of every veteran are different—there are a variety of different coverage options. VA health care is only one of them, with more than 9 million of 18 million US veterans taking advantage of its many benefits. 

This said, while VA health care works for many, it may not be the best or only option for you. 

Here are all your options, starting with a recap of VA health care.

  1. VA Health Care: Affordable with the flexibility to use with other insurance or alone, VA health care services are, for the most part, provided in VA medical facilities and are exclusively for veterans. Within the VA health care system, all service-related care is free.

  2. Medicaid: Medicaid is widely used as healthcare by lower-income individuals and among this population, it is the largest source of coverage. Medicare eligibility varies depending on your state, but in general, offers free or low-cost coverage. There is no open enrollment period for Medicaid, so veterans can enroll whenever they’d like.  Note that Medicaid doesn’t cover any services at VA medical facilities, but if you have TRICARE—another health care option—Medicaid can be the secondary payer.

  3. Medicare: Provided by the federal government for people 65 and older, as well as for some adults who have disabilities, Medicare health insurance is also available to veterans in the right age bracket. However, veterans need to enroll for Medicare within THREE months of OR three months before they turn 65. Medicare can work with TRICARE with the TRICARE for Life program becoming available when you enroll in Basic Medicare. Using this system, Medicare works as your primary insurance TRICARE will pay for deductibles and coinsurance. This said VA health care and Medicare do not work in tandem. Medicare will only pay for care at a non-VA facility.

  4. TRICARE: TRICARE is coverage provided by the Department of Defense for personnel on active duty and the families of this personnel. It is also available to military retirees with 20 years of service or more, as well as their dependents. You can use TRICARE as stand-alone coverage or with other health insurance. If you’re a veteran who wishes to enroll with TRICARE, you must also be registered in DEERS— the Defense Enrollment Eligibility Reporting System.

  5. State Health Care Exchanges: Thanks to the Affordable Care Act, exchanges allow veterans to purchase veteran health insurance plans via one of the health care exchanges that available in their state. A person has to be completely uninsured to qualify for this low-cost option, however, meaning you can not have VA health insurance plans or any other coverage. So, you’d need to end your VA coverage and allow for a gap in insurance before you could enroll in an exchange plan. The good news is a veteran’s coverage under a VA plan does not affect their family’s ability to receive exchange subsidies.

  6. Employment Insurance: If you are a veteran working in the civilian workforce, your place of work may provide health insurance. This option is the largest and most common form of coverage for veterans under the age of 65. You can receive both VA insurance and employment-based insurance, with the VA billing this private insurance for care-acquired at VA facilities. 

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Veterans Health Administration

The Veterans Health Administration (VHA) is a healthcare system that provides primary care, medical care, social support services, mental health services, and more to veterans. You may qualify based on your income, military service, and if you have a disability. If you qualify and can get care from VHA, it’ll likely be free or more affordable than other options to you. 

Best Health Insurance for Veterans and Their Families

The truth is that leaving military life can be tough on you and your family, but health insurance can be the least of your concerns with a little research and preparation. And ensuring you and your family have the coverage you need is critical, so start preparing well before the transition happens to ensure you’re ready. 

FAQ

The Basic Medical Package for Veterans is a comprehensive medical care package facilitated by the Department of Veteran Affairs that provides coverage for regular preventative care, specialty and primary care, in-patient and outpatient services, and diagnostic imaging. There may be other benefits available, depending on each veteran’s singular circumstances.
 

VA health care facilitates free care for any conditions that were caused or made worse by or during your military service. Veterans with serious disabilities or injuries are eligible to receive all medical care for free—not just the medical care associated with injuries. Also, if your disabilities are classified as 50% or greater, or if you are a former POW, your VA care is free.

Veterans with lower income may receive more care. Other groups may be eligible for free coverage.

No, your VA Health insurance coverage does not have to be your exclusive provider for your medical care needs.
Yes. VA health care can be used alone or in conjunction with federal health care (TRICARE, Medicare, and Medicaid) and private health plans. State exchange health care is a notable exception. You cannot receive these subsidies if you have VA health care.

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