Comprehensive Guide to Understanding Health Insurance for Veterans

Did you know that there are over 18.8 million veterans in the US? These brave men and women are lauded for their patriotism and service to the nation.

There are several health care options for veterans. The VA Health Care offered by the Veterans Health Administration is one such option.

However, not all veterans qualify for it. In this article, you shall learn more about VA Health Care and other options for health insurance for veterans.

What Is the Va Health Care for Veterans?

The Veterans Health Care program by the Veterans Health Administration is the most extensive integrated health care system in the U.S.

It has over 1,700 VA medical centers and outpatient clinics. Here, veterans can access preventive, primary, and specialty care.

Medical Services Covered by the Va

VA offers a range of health care services for veterans. They include:

• Outpatient medical services which include surgical, substance abuse and mental health care
• Inpatient hospital catering for mental health, surgical and substance abuse
• Bereavement counseling
• Vocational plus comprehensive rehabilitative services
• Prescription services which include over-the-counter drugs and surgical and medical supplies availed by the VA national formulary system
• Home health services
• Medical device provisions such as prosthetics, orthodontic devices, and hearing aids
• Professional counseling, consultation, training, and mental health services for members of the immediate family or legal guardians of veterans
• Reconstructive surgery required as a result of trauma or disease but not inclusive of cosmetic surgery
• Respite, hospice and palliative care
• Eligible veterans get full travel expenses provided
• Pregnancy vs. delivery services
• Emergency care in non-VA facilities for certain condition

VA also offers gender-specific services. Other than maternal coverage, women also get breast and cervical cancer screenings.

Eligibility and Application

Veterans who served in the active military, air service or navy without dishonorable discharge are eligible for VA .

This is if they enlisted after September 1970 and have served for 24 continuous months or the full period they were called to active duty.

However, veterans are still eligible under the following scenarios:

• Early discharge was a direct result of a disability that was either caused or made worse by your active service
• You served before September 1970
• You were discharged for a hardship

Current or former members of the National Guard or reserves are also eligible for VA.

They must have been called to active duty by a federal order and completed the full period. Those who only had or have active-duty status just for training purposes do not qualify for VA health care.

Can Veterans who got Less Than Honorable Discharge Qualify for VA Health Care?
Veterans who got a dishonorable discharge can apply for a discharge upgrade.

They can qualify for the VA health care if any of the following reasons caused their release:

• Traumatic brain injury (TBI)
• Mental health conditions such as posttraumatic disorder (PTSD)
•  Sexual harassment or assault during military service referred to as military sexual trauma or MST at VA
• Sexual orientation (including under the Don’t Ask, Don’t Tell Policy)

Under the Character of Discharge review process, veterans with a less than honorable discharge may be able to access some VA benefits.

After applying, your record will be reviewed to see whether your service was honorable enough for VA services. You should send all the documents that support your case, similar to the discharge upgrade application.

These reviews may take up to a year. It is advisable to get an advocate to collect and submit evidence for you depending on the complexity of your case. The Veterans Service Association (VSO) can do this for you.

Veterans may not require VA character of Discharge review or a discharge upgrade to access VA benefits in some cases.

In such conditions, a veteran must have mental health problems such as PTSD linked to their service or a case of MST.

Alternative Options for Health Insurance for Veterans

Fortunately, there are other options for veterans who do not qualify for VA.

Private Insurance

With private insurance, veterans can receive non-VA healthcare. This is an option for those who are ineligible for VA.

The method of enrolling for private insurance depends on the state the veteran lives in. For instance, veterans in New York can purchase health insurance through the Official Health Plan Marketplace.

Veterans can still take up private insurance even if they are under the VA health care system. You can use the VA health care program for non-service related treatment.

However, the VA is required to submit health services claims to the third-party insurance carrier.

This approach can be beneficial for a veteran if they qualify for one of the priority groups. They will receive treatment, but it won't be charged at a dollar for dollar rate.

Medicaid and Medicare

Medicaid and Medicare are a source of supplementary healthcare for veterans. It is especially crucial for the elderly or those with low incomes or special needs.

The benefits of Medicaid and Medicare to veterans include:

• Their spouses and children are also covered
• VA healthcare will typically have no out of pocket costs
• Access to outside healthcare facilities based on Medicaid coverage
• Assists with long-term expenses such as homecare
For veterans to use Medicare and VA care in conjunction, they must:
• Be older than 65 years old
• Diagnosed with End-Stage Renal Disease
• Be deemed disabled
• Be Receiving Social Security Disability Insurance benefits

Medicare costs depend on the amount of work credit the individual has earned by paying into the federal system through the payroll tax. Veterans can access treatment in any facility that accepts Medicare.

Tricare

Tricare is a health insurance program with 11 Tricare plans depending on the individual’s category. Eligible members include:
• Active service members
• Retired service members
• National Guard and reserve members
• Members of the Defense Enrollment Eligibility Reporting System
• Medal of honor recipients
• Survivors
• Service member families and former spouses

With Tricare, veterans can also seek medical attention from military hospitals and public medical facilities under the network.

Why Veterans Should Have Health Insurance

The importance of health insurance for veterans cannot be overstated. With a healthcare plan, you can have peace of mind knowing that you can have access to quality medical care without having to pay out of pocket.

Senior Veterans Care Network is a company that ensures veterans get the benefits they deserve without delays. Check out this page to learn more about the benefits veterans are entitled to.