Learn About Veteran Health Insurance

Finding suitable health insurance is often a priority for returning veterans and their families.

A plan suiting your needs is essential, particularly if you have ongoing health issues or disabilities related to your service.

For some, the VA health care plan is a viable option. For others, options such as the TRICARE program, the CHAMPVA program, or private marketplace insurance are the answer.

For any health insurance plan, you must determine your eligibility. Many medical programs designed to benefit veterans have strict eligibility requirements.

You are commonly asked to prove you have a suitable service record and that you meet income guidelines for the program.

The nature of your medical needs affects the programs for which you qualify.

Veterans with dependents may wish to search for health insurance covering their entire household.

Often, you find the best option involves combining different medical programs to meet your needs.

Learn About VA Health Care Benefits

The VA health insurance plan is useful for many veterans. You must meet various eligibility requirements to enroll.

If you are considered eligible, it covers several types of care. Any medical treatment required as a result of your service is available free of charge.

This includes care for medical conditions worsened as a result of your service, even if they were not caused by it.

Non-service-related medical treatment is available, but this requires co-payment.

Your circumstances, including factors such as your income, affect the priority group in which you are place.

The group determines when you are enrolled based on your need, as well as determining other details of your plan such as co-payments.

The services provided include the following:

  • Preventative care, including immunizations, assessments and screenings. Health education is covered under this area.
  • Inpatient care, including prescriptions, medical and surgical treatments, mental health and substance abuse services.
  • Outpatient care, including primary care, speciality care, surgery, and mental health services.
  • Women’s health care, including examinations and screenings.
  • Long-term care options, including home care and nursing home services.

Learn About Co-payments

While the VA health insurance plan pays for medical treatments related to your service, other medical treatment must be paid for separately.

This is one of the reasons some veterans choose a combined insurance plan. Further details on this are found within the following sections of the overview.

Co-payments are required both for VA medical treatment and the community care program.

Your co-payment varies depending on several factors, such as the level of care you require, and the period you need treatment within.

Medication co-payments are subject to variation. In determining these factors, you may discover you are exempt from the co-payment requirements.

Learn About Community Care

If the VA is unable to provide for your health care, you may be able to benefit from the VA community care program instead.

This means the medical care itself is provided by community partners in your local area, although it is still paid for by the VA health insurance program.

This program includes a variety of services, including the Veterans Choice Program, which is intended to help veterans who are unable to access a VA health center.

To participate in this program, you must meet one or more of the eligibility requirements:

  • You cannot obtain the services you need through the VA.
  • You must travel 40 minutes or more to reach a suitable VA medical facility.
  • You must use a boat, ferry or air travel to get to your nearest VA medical facility.
  • You cannot obtain an appointment at a VA medical center within 30 days.

You must obtain authorization from the VA to use the community care option. The VA helps determine your eligibility and finds a provider for your needs.

Learn About TRICARE 

This program is used by many members of the military, both current and retired, as well as their dependents.

Many different health insurance plans are offered through the program, some of which can be combined with other types of insurance.

If you meet the eligibility requirements, choose a plan that best meets the needs of you and your family.

The plans available to you vary depending on your personal situation, including the branch of the military in which you have served.

The services included in your plan are affected by your eligibility. As a veteran, your plans may be different to those offered to currently active members of the military.

To apply for TRICARE, you must be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS).

Keep your details up to date on the system to maintain eligibility.

Learn About CHAMPVA

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is like TRICARE, but is run by the VA. This provides care for the dependents of Veterans who meet certain eligibility requirements.

The veteran in question must be determined to be disabled as a result of service, was considered completely disabled at the time of his or her death or died as a result of service.

The dependents cannot be eligible for TRICARE as well as CHAMPVA.

CHAMPVA offers a variety of health care benefits to those deemed eligible. If you are eligible for Medicare, you must sign up for this to continue obtaining CHAMPVA benefits.

CHAMPVA does meet the necessary requirements for ACA coverage on its own.

Learn About Combined Health Care

Some veterans wish to use a combined health insurance plan. This means if you are eligible for VA health care, you may sign up for the program while benefiting from your other insurance plan.

Use a private medical insurance option, TRICARE, Medicaid or Medicare, while using VA medical care.

Those who can obtain private health insurance, as well as VA health benefits, use their private insurance as a subsidy.

When receiving treatment for a non-service-related health issue, the VA bills your insurance company instead of requesting a co-pay directly from you.

If you plan to combine your health insurance plans, each of your medical teams should be aware of your plan.

They must each have the information necessary to coordinate your care.