Veteran Health Insurance: The Ultimate Guide
In 2016, out of veterans who were of working age (19-64), over 500,000 did not have health insurance, according to statistics from the U.S. Census Bureau. This high number of uninsured veterans is surprising, considering the vast array of health insurance options available to many former military members. Several health insurance possibilities exist for veterans. These options include insurance that has been provided or granted in relation to their service, private plans (such as through an employer), and larger government options (such as Medicaid). Even though the options exist, veterans still may not be aware of them or how to actually obtain health insurance. For veterans and their families, it is important to understand the types of health insurance that are available to them, as well as the necessary steps and procedures to enroll in these programs and receive benefits.
Veteran Health Insurance Plans and Options
The types of health insurance that a former military member qualifies for depends on various factors, including a veteran’s own service record. Here are some of the common health insurance options available to veterans.
TRICARE is a comprehensive veteran health insurance program that provides coverage to many former military members and their families. Eleven health insurance plans are listed on TRICARE’s Health Plans page, each offering a unique level and range of benefits. For example, active duty service members must enroll in one of four TRICARE plans, while retired members and their families can enroll in one of four TRICARE plans and the US Family Health Plan, depending on where they live. The TRICARE Plan Finder is a tool to find the best plan for a veteran’s situation. Dental and vision coverage are also offered as part of TRICARE. According to the TRICARE website, to qualify for TRICARE, an individual must be one of the following:
- Uniformed service member or a family member
- National Guard or reserve member, or a family member
- Survivor or former spouse of a veteran
- Medal of Honor recipient or a family member
- Additional individual enrolled in the Defense Enrollment Eligibility Reporting System
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a program that’s similar to TRICARE in the benefits offered. However, CHAMPVA is offered by the U.S. Department of Veterans Affairs (VA), while TRICARE “is a regionally managed health care program for active duty and retired members of the uniformed services, their families, and survivors,” according to CHAMPVA’s website. To qualify for CHAMPVA, an individual mustn’t be able to qualify for TRICARE. Below are the eligibility requirements for CHAMPVA, as listed on its website:
- The spouse or child of a Veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office.
- The surviving spouse or child of a Veteran who died from a VA-rated service-connected disability.
- The surviving spouse or child of a Veteran who was at the time death rated permanently and totally disabled from a service-connected disability.
- The surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).
Those who do qualify for CHAMPVA are eligible for inpatient and outpatient services, nursing and mental health services, and more. The VA has a list of necessary documents and items needed to complete a CHAMPVA application for veteran health insurance.
VA Health Care
VA health care enables veterans to receive health services, such as regular checkups, appointments with specialized practitioners, and access to home care treatment, according to the VA website.
VA health care has more specific eligibility requirements than TRICARE and CHAMPVA. For example, those who served in the military, air, or naval service and didn’t receive a dishonorable discharge may be eligible, depending on when they served. As stated on the VA website, “If you enlisted after September 7, 1980, or entered active duty after October 16, 1981, you must have served 24 continuous months or the full period for which you were called to active duty, unless any of the descriptions below are true for you.” Information regarding filling out an application, necessary items, eligibility requirements, and potential services covered are available on the VA site. Individuals who apply for VA health care will also be assigned to one of eight priority groups to help ensure that those “who need immediate care can get signed up quickly.”
While not a program only intended for veterans or offered by a veteran or military office, Medicare is still a program where veterans can obtain health insurance. According to the U.S. Department of Health and Human Services, “Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).” What services or treatments are covered and how much they cost vary depending on the type of plan a Medicare recipient qualifies for. However, the benefits that can be covered under Medicare packages include advance care planning, diagnostic laboratory tests, and home health services. Eligibility and premium costs can vary from person to person, but Medicare does offer an Eligibility & Premium Calculator that can help individuals understand what they can expect to pay and what services they may receive.
Veterans may also qualify for or enroll in private insurance plans, such as a plan offered through their employers or a plan that they choose to enroll in through an open marketplace option, such as those provided by the Affordable Care Act. Private options for a veteran’s health insurance may cost more and offer different benefits than what’s provided through programs such as TRICARE and CHAMPVA.
Veteran Hospitals and Clinics
In addition to the various health care programs offered to veterans, former military members also qualify to receive health services and treatment.
VA Medical Center
According to the VA website, “The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,255 health care facilities, including 170 VA Medical Centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program.” VA Medical Centers are located in all 50 states and U.S. territories and can provide a range of care to veterans depending on the afflictions they’re facing. For example, a veteran visiting the Birmingham, Alabama, VA Medical Center can receive a range of services in fields and practices such as cardiology, geriatrics, social work, and substance abuse treatment. A veteran visiting the Syracuse, New York, VA Medical Center can receive services such as acupuncture, dialysis, general surgery, and radiology and diagnostic imaging. The range of services across all VA Medical Centers is expansive, but veterans should research to see if a particular location or facility offers the treatment they need.
VA Community-Based Outpatient Clinics
VA community-based outpatient clinics can help provide fundamental but necessary health care services to insured veterans. “In addition to the primary care mission, they may include very basic Laboratory, Pharmacy, and Radiology functions,” according to an informational guide from the VA. Similar to VA Medical Centers, outpatient clinics may range in the individual services they offer. For example, according to the VA Greater Los Angeles Healthcare System’s list of services, different services are offered at different clinics and organizations.
Vet Centers provide helpful health services to veterans that focus more on social and psychological services, such as helping veterans readjust to life at home after serving in the military. Specific services offered by these centers include individual and group counseling, alcohol/substance abuse assessments, and outreach and community education, according to the VA website. To qualify for Vet Center services, veterans need to have served “in any warzone or area of hostility/combat,” according to the VA website, although there are exceptions for other individuals who may also be able to use the Vet Center program.
Non-VA/Military-Affiliated Hospitals and Health Organizations
Similar to how veterans can enroll in nonmilitary-affiliated health insurance programs, they can also take advantage of health care services offered by facilities and organizations that may not be associated with the military. For example, veterans may still be able to use their TRICARE benefits at a hospital that isn’t part of the VA or refill a prescription at a commercial pharmacy that holds no VA affiliation. The cost for a certain type of care or treatment may vary from what’s offered at a VA center, so veterans should research accordingly to see if one type of facility offers more comprehensive or affordable care than another.
Resources for Veteran Health
In addition to the different medical facilities and insurance options available to veterans, other resources can assist them with their health care needs.
The VA offers various mobile health apps for veterans that can assist them in their daily lives. These apps include a mood coach, an app that helps veterans receiving cognitive processing therapy to manage post-traumatic stress disorder (PTSD), and an app that can help veterans to quit smoking.
There are several support groups for veterans who may be facing or struggling with PTSD. “Peer support groups can help you cope with memories of the trauma or other parts of your life that you are having trouble dealing with as a result of the event,” according to the VA website. Where a veteran chooses to participate in such groups can vary. For example, a church or a religious institution in a veteran’s city may offer a support group, while a community center in a small town in another state may offer another.
The VA provides several screening tools that can help veterans determine if they may be suffering from conditions such as PTSD, depression, and alcohol and substance abuse. Veterans can complete a PTSD screening questionnaire to determine if they have symptoms of the disorder. There’s a similar depression screening questionnaire to determine if they have symptoms or signs of depression. It’s important to remember that these screening tools aren’t an exhaustive method of proving if a veteran has a certain affliction, nor can they provide a diagnosis. These resources are meant to help veterans understand if they have signs or symptoms of these conditions—and if so, then it may be beneficial for them to consult a mental health practitioner.
Health Education Resources
When not being treated for certain conditions, veterans can also benefit from the various health programs for veterans. These programs include information about how to prevent disease, how to maintain strong mental health, and how to lose and keep off weight.
The health education resources are also useful in helping veterans understand their specific benefits. For example, the VA dentistry website is dedicated solely to helping veterans understand and navigate their dental care benefits. The VA also provides helpful information for veterans to understand their telehealth services, and how it can be used to keep healthy.
Ensure a Healthy Future: Obtain Veteran Health Insurance
Several options are available to veterans for health insurance as well as the services offered by health facilities. But even though these options exist, veterans may not know what may be available to them or how to receive coverage. Understanding the differences between these facilities and insurance plans, as well as the unique benefits they each provide, can help veterans achieve a healthy, fulfilling future.