Veterans health care needs are often unique. Complications from service and combat-related injuries, conditions and disabilities can leave veterans with extensive and expensive care needs.
VA health care benefits and programs are specifically designed to meet those needs. They empower veterans and their families by providing them with the resources needed to overcome physical, mental, emotional, economic and geographic challenges to care. The VA maintains more than 200 facilities across America at which veterans can receive services. It contracts with independent service providers to ensure that all veterans have access to care, even if they are unable to reach a VA facility.
Enrolling in VA health care can be a simple process. In most cases, the VA makes eligibility determinations in a week or less. Once enrolled, veterans get health insurance for life unless or until they elect to cancel their coverage. Supplemental programs extend VA health benefits to veteran caregivers and families, as well.
VA medical benefits eligibility is determined by former servicemembers’ discharge statuses, health conditions or disabilities, service histories and household incomes. Many veterans are eligible for VA healthcare at no cost to themselves. For example, former Prisoners of War and veterans rated as 100 percent disabled as the result of military service qualify to receive comprehensive medical and dental care free of charge.
Veterans with service-related disabilities or conditions rated as less than 100 percent generally qualify for free care related to their disabilities only. This applies to both standard medical care and dental care. Unrelated conditions or health needs may not be eligible for coverage under VA medical policies. Veterans will need to select and purchase reduced cost VA health insurance to cover their non-service-related care.
Veteran do not typically meet VA healthcare eligibility criteria if they were less than honorably discharged or failed to complete their contracted terms of service for reasons other than authorized early separation. Some veterans may be eligible for VA health benefits solely on the basis of extreme need or income.
VA insurance coverage incorporates and addresses all of the services and categories required by the Affordable Care Act. This includes, but is not limited to:
VA health insurance costs vary. Some veterans will qualify for complete coverage and pay no expenses out of pocket. Other veterans will qualify for free services related to some conditions, but will be required to pay out of pocket for other services. Veterans with no disabilities or service history to qualify them for free services may purchase VA health insurance plans for which they will pay premiums and copays. Depending on veteran income and the types of services requested, copays generally range from $2 to $50.
Related Article: Eligibility for VA Health Care Benefits
Veterans who enroll in VA insurance coverage are assigned Care Teams to assist them in managing their needs. Care Teams are interdisciplinary and work to coordinate the various types of care veterans’ receive for maximum efficiency and effectiveness.
It is the Department of Veterans Affairs’ stated goal for the VA healthcare enrollment process to take no more than one week upon receiving completed applications. Enrollment may delayed as long as year, however, if veterans need to seek an upgraded discharge status or other prerequisite before qualifying.
Most veterans can apply for VA health care at any time, although some deadlines apply. For example, veterans who wish to roll their active duty plans into veterans health care plans must do so within a certain amount of time after separating from the military. Likewise, veterans who fail to enroll or transfer from active duty plans in time may be subject to health exams not required of enrollees who acted more promptly.
Veterans can apply for VA medical benefits online, in person, by phone or by mail. The VA recommends online applications for applicants’ speed and convenience. Applicants can use the same form to apply for medical and dental benefits and only need to apply once to receive both eligibility determinations.
All applicants will receive notice of their eligibility or ineligibility in writing, with an explanation. Applicants whose VA health care applications are declined will have the opportunity to appeal the decision.
Veterans may qualify for medical benefits but not for dental benefits. In that event, veterans are free to select dental coverage options only through VA-sponsored plans. VA medical and dental plans and benefits can often be stacked with private insurance, Medicaid or Medicare for more complete coverage at minimal cost to enrollees.
Home health care for veterans is available for VA medical benefits enrollees who are housebound, permanently or temporarily, or who are unable to reach VA facilities due to distance, geography or health. Qualifying veterans may receive primary medical care, social work and case management services, personal care assistance and homemaking assistance in home. This care may be provided by professional contract services, by VA teams via Telehealth technology or by spouses and family.
Veterans may request VA home care for short or long-term periods, depending on their needs. VA Care Teams will work with veterans to determine the best combination of services with the goal of enabling them to remain in their homes and communities safely for as long as possible.
The VA offers a diverse array of education, training, support and respite programs for family members providing home health care for veterans. In some cases, caregivers may be eligible for VA-sponsored health insurance, stipends, travel cost reimbursement and other resources that facilitate their ability to provide constant and consistent care.
Finally, veterans suffering from terminal illnesses may elect to receive in-home hospice care services with the approval and support of their Care Teams.
The CHAMPVA health insurance program extends VA health insurance options and discount pricing to veterans’ families. Not all families will qualify for CHAMPVA. CHAMPVA and TRICARE are mutually exclusive, but generally stack with other insurance programs including private insurance, Medicaid and Medicare. VA family health care eligibility is assessed similarly to veterans medical benefits eligibility but must be applied for separately.
Related Article: VA Health Care Benefits for Family Members of Veterans