One of the most common questions asked about military health services is “Do veterans get health insurance for life?” Some veterans are entitled to these kinds of benefits, but many are not.
The Department of Veterans Affairs (VA) is deeply invested in maintaining the health of military service members and their families during their periods of service in the United States military and throughout their lives. To this end, the VA manages a suite of programs through which veterans and their families can access free or reduced-cost health care and dental insurance.
The availability of veterans insurance coverage and the costs of care are based on numerous factors. These include veterans’ service histories, health conditions, disability statuses and incomes. Family eligibility depends on their veterans’ eligibility as well as their relationships to their veterans. When veterans and their families apply matters, as well. Veterans who apply promptly upon separating from the military are exempted from exams and other preliminaries required of veterans who wait to enroll.
VA healthcare eligibility criteria are different for each program. Eligibility determinations are made based on:
VA medical coverage, like private commercial insurance, is customizable. Veterans and their families can choose the plans and levels of care most appropriate to their needs. The actual costs associated with each plan are determined by which plans veterans and their families select, how they use them and their income eligibility.
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For example, disabled veterans may receive VA insurance coverage free of charge, but only if they receive their care through VA facilities or contractors. Outside of emergency services, they could be liable for the costs of any unauthorized care they receive. Similarly, veterans and their families in low income households might fall below the VA copay income threshold and pay nothing for their medications or services. Another household on the same plan with a higher income might be subject to VA copays and monthly premiums.
The VA provides several online tools as well as counseling delivered by department representatives to assist families is selecting the best plans for their needs.
The VA healthcare enrollment process can be initiated online, in person, by phone or by mail. Applicants must submit their signed and completed application forms and, in some cases, financial, service and household-related information. Applicants who are unsure if they are already enrolled in VA health care can check their service branch’s online portal for their status or contact their local or regional benefits center for assistance.
Veterans may be able to apply for VA health care and dental benefits at the same time, depending on which program they are attempting to enroll in. They can typically enroll themselves and their families at the same time using a single form, as well.
For veterans in some priority groups, VA dental benefits are available free of charge. Veterans with dental conditions that were acquired or aggravated by combat or their military service also typically qualify for free dental services, at least to some extent.
Most veterans who do not fall into one of those two groups must purchase veterans dental benefits for themselves and their families independently. VA plans make dental insurance for veterans and their families available at reduced cost. Like VA health care plans, dental plans may be “stacked” with other forms of insurance or health care for maximum benefit.
Veterans home care is a medical benefit that former service members have access to in case they require it. VA home health care is available for those who are temporarily or permanently housebound and unable to visit a VA medical facility due to health, distance or geography. The services provided under home health care include assistance with daily tasks such as cleaning and cooking in addition to primary medical care, social work and case management.
Additional benefits of VA home care also extend to caregivers of veterans. Family members are able to receive education and training in order to better serve their loved one. And some caretakers may even be eligible for health insurance, stipends or reimbursements for the cost of travel and other perks to aid them in providing continuing care to the veteran.
TRICARE enrollment offers health insurance benefits for servicemembers in the United States military and their families. TRICARE coverage is open to members of Active Duty, the National Guard and the Reserves, as well as former servicemembers who have retired from military service. Families may qualify if they are spouses, former spouses, dependents (including dependent parents or in-laws) or survivors of servicemembers.
Veterans and their families can find out how to sign up for Tricare online, by phone or by mail. Only one form is necessary to register the entire family. TRICARE enrollment forms are region-specific, and it is important that applicants select and submit the correct forms for prompt processing. Regional coordinators are available to assist applicants with questions.
TRICARE medical insurance eligibility criteria is mutually exclusive with CHAMPVA eligibility. Potential enrollees cannot qualify for both and should discuss any questions they have with VA representatives before applying. TRICARE “stacks” with Medicaid, Medicare and private insurance, where available.
Enrollees can select from 11 different TRICARE coverage plans. Not all plans will be available to all enrollees, depending on where they live or are stationed and other eligibility factors. Standard coverage in all TRICARE plans more than satisfy the minimum coverage requirements established by the Affordable Care Act. TRICARE plans offer varying levels of pharmaceutical and dental coverage, both of which may be purchased separately.
TRICARE copays, premiums and deductibles are determined by policy holders’ enlistment status, the types of care they pursue and where services are rendered. Active service members, for instance, pay no out-of-pocket costs for care. Family members of active service members who follow their plans’ referral requirements and receive within-network care pay nothing out of pocket. The same family members can expect to pay out of pocket if they go out of network or do not request referrals.
Related Article: Eligibility for VA Health Care Benefits