Veterans Benefits | Military Benefits

How VA Health Care Works with Other Health Insurance

The Veterans Health Administration offers first-class health care to eligible veterans. Enrollment in VA health care fulfills the Affordable Care Act (ACA) coverage requirement, so there is no need for an add-on insurance plan.

While the VA is at the core of health care for veterans – including veterans with disabilities or low income – civilian health care also plays a vital part in your overall care. In fact, a recent report (2020) by the National Center for Veterans Analysis and Statistics showed that less than half of all veterans used any VA services or benefits in 2017.

That means at least half of all veterans used some other health care—a private insurance plan, Tricare, Medicare or Medicaid—for at least some of their care.

What Does VA Health Care Cover?

The Department of Veterans Affairs health care benefits packages may include:

Outpatient and inpatient preventive, primary and specialty care, mental health care, prescriptions, home health care, extended care and geriatrics, and access to prosthetics and medical equipment, including hearing aids and eyeglasses
Women veterans can get prenatal care, maternity coverage, breast and cervical cancer screenings, and primary care.
Vets and their family members can also visit community-based centers to receive outpatient and inpatient counseling, referral, and outreach services at no cost. (You may, however, pay small copays for prescriptions and some medical treatments).

Other services the VA covers:

Screening tests
Immunizations
health care assessments and education programs
Dental care (if eligible)
Hospice, respite care, or palliative care
Rehabilitative services
Bereavement counseling
Reconstructive surgery, excluding non-medical cosmetic surgery
Pregnancy and delivery services. Veterans must pay for all care after birth.

Services the VA does not cover:

Abortions and abortion counseling
Cosmetic surgery, unless medically necessary as determined by the VA
Gender alteration or sexual trauma counseling
Drugs and medical devices not approved by the FDA
Spa and health club memberships
In-vitro fertilization
Services not ordered by licensed professionals
Private-duty nursing
Emergency care in non-VA facilities

How the VA works with Tricare

TRICARE is a health care platform for uniformed active-duty service members, retired service members, reservists, members of the National Guard, survivors of fallen service members, and military-dependent family members.

The Affordable Care Act (ACA) Most Tricare plans to meet the minimum essential coverage (MEC) requirements for the Affordable Care Act.

However, if you are switching to new Tricare coverage or losing your current Tricare eligibility, review your options to avoid any penalties for not meeting MEC requirements.

Active duty service members, military retirees and their families who have Tricare Select meet ACA’s minimum requirements. Service members who qualify for Tricare For Life and have a Medicare Part B plan also meet minimum requirements.

Every VA facility has a Tricare point of contact (POC) and an established check-in process. When you register for a service, be sure to tell the VA provider that you are using your Tricare benefit.

If you don’t, you may be charged higher out-of-pocket costs or payment may be denied.

VA Health Care for Tricare Beneficiaries

For primary care services, some VA facilities will see Tricare beneficiaries. Prior to making an appointment, check with your regional contractor to see if you can enroll with a VA Tricare provider.

Keep in mind that primary care with Tricare and the VA are separate, and you can’t use both. That means that eligible beneficiaries can choose to use either their VA or Tricare benefits for each separate treatment of care.

Supplemental insurance pays after TRICARE pays its share of the bill. In other words, Tricare reimburses you for medical expenses paid out-of-pocket to civilian providers.

Tricare Referrals for VA Health Care

If you want to obtain specialty care at a VA facility and you’re enrolled in Tricare Prime, you must have a referral. If you’re enrolled in Tricare Select, a referral is usually not required, but prior authorization might be required for some services.

VA Prescriptions for Tricare Beneficiaries

Prescription drug coverage is available to all Tricare beneficiaries through the Tricare Pharmacy Program. You can get your prescriptions filled at any Tricare retail network pharmacy, military pharmacies, non-network pharmacies and through Tricare Pharmacy Home Delivery. If you have a non-covered drug, you may have to pay the full cost of the prescription out-of-pocket.

One of the easiest ways to get your VA prescriptions filled is online through My HealtheVet, by phone on the Rx Refill mobile app, or through the mail.

Also, by law, the VA must bill private health insurance providers first for medical care and prescriptions you receive for non-service-connected conditions. So, if you are an enrolled vet, you can update your health insurance information by using the online Health Benefits Renewal (10-10-EZR) form at www.vets.gov/health care/apply/.

If you only qualify for premium-based coverage, you must obtain one of the options below or purchase other qualifying health coverage to meet the minimum requirement.

Tricare Plans that meet minimum coverage requirements include:

TRICARE for Life
TRICARE Prime
US Family Health Plan
TRICARE Young Adult
TRICARE Prime Remote
TRICARE Reserve Select
TRICARE Retired Reserve
TRICARE Prime Overseas
TRICARE Standard and Extra
TRICARE Standard Overseas
TRICARE Prime Remote Overseas
Continued Health Care Benefit Program
Transitional Assistance Management Program

How VA Health Care Works with Civilian Health Insurance

If you have other health care coverage, like private or civilian insurance plans—Tricare, Medicare or Medicaid—you can still receive your VA health care benefits together with these plans.

However, if you are a veteran who is not enrolled in VA benefits, you can get civilian coverage through the Health Insurance Marketplace.

Plans vary by price, quality and benefits. Plus, your VA benefits can co-exist alongside civilian health care.

Veterans applying for VA medical care must provide information about other health insurance coverage, including if you’re covered under your spouse’s health care insurance coverage or coverage provided by your current job.

Creditable Coverage for Medicare Part D

If you are enrolled in the VA health care system, you already have creditable coverage for Medicare Part D. However, your family members can not receive creditable coverage since only veterans can enroll in the VA health care system.

The Civilian Health and Medical Program (CHAMPVA)

The Civilian Health and Medical Program (CHAMPVA) may provide health care benefits for eligible VA beneficiaries. With this program, the VA shares the cost of covered health care services performed by a primary physician.

However, to receive benefits, your beneficiaries can not be entitled to health care under another health insurance plan, such as Medicare, Medicaid or Tricare. This program also fulfills the minimum essential coverage requirement for the Affordable Care Act (ACA).

Beneficiaries who are eligible for health care under the CHAMPVA program must be spouses or children of:

Veterans (living or deceased) who have received a 100% permanent and total (“P&T”) rating from the VA for a service-related disability.
Veterans who died in the line of duty or from a service-connected disability.
Veterans who died while serving but cannot enroll in CHAMPVA or are not eligible for Tricare

Moreover, if a surviving spouse remarries before turning 55, they will lose their CHAMPVA benefits.

VA Health Care FAQs

If you get accepted for VA health care, should you give up your civilian or other health care?

If you give up other health care coverage when authorized for VA coverage, you’ll likely save money on premiums. However, there are risks.

The VA doesn’t typically provide care for your family members. Also, if you cancel your current Medicare Part B plan, you can’t reclaim this coverage until January of the following year. Plus, you might have to pay a penalty when you reinstate coverage.

Can you use your Health Reimbursement Arrangement (HRA) or Health Savings Account (HSA) to help defer the cost of VA care for non-service-related conditions?

The VA will bill High-Deductible health care Plans (HDHPs) such as HRAs and HSAs for non-service-related conditions. Also, if you have an HDHP tied to your HSA, you can use your HSA plan to help pay VA copays.

Does the VA need your permission to bill your other insurance if related to a sensitive diagnosis?

The VA is required by law (the VA MISSION Act of 2018) to bill any other health insurance provider if the care you receive is related to a sensitive diagnosis, such as HIV testing and drug or alcohol abuse, without the need to obtain your permission.

How a U.S. Government Debt Default Impacts Military Members and Veterans

by Kathryn Pomroy

On Oct. 7, the United States Senate agreed to extend the federal debt limit through the end of December, averting an unprecedented debt default.

The debt ceiling is an obligatory borrowing limit self-imposed by the U.S. government. In the past, it has been either raised or postponed to prevent the U.S. from defaulting on its debt.

The cap on the debt ceiling is $28.4 trillion. In July, the national debt stood at $28.43 trillion. If Congress does not raise the debt ceiling by Dec. 15, the government will default on its obligations for the first time in history.

If that ever happens, what would it mean for U.S. service members and their families?

What does a government shutdown mean?

When the federal government shuts down, nonessential offices close due to the lack of funding, usually caused by a delay in the approval of the federal budget or because the U.S. has lost the ability to borrow (by surpassing its debt ceiling). If this happens, the shutdown will remain in effect until Congress passes legislation to raise the debt ceiling.

Historically, some agencies remain open during a government shutdown—the FBI, Drug Enforcement Agency (DEA), the Transportation Security Administration (TSA), Federal Reserve, and U.S. Post Offices. If these services were interrupted, “it would endanger the health, life, or personal safety of the public,” as laid out in the Constitution.

How the military impacts the economy

The Department of Defense (DOD) pours billions of dollars every year into the economy by operating more than 420 military installations in the 50 states, the District of Columbia, Puerto Rico and Guam.

This spending sustains communities and offers employment across a range of industries. States benefit from defense contracts, while pensions and other benefits provide service members and their families a reliable source of income.

How a shutdown could impact the military community

In an October 6 statement, Secretary of Defense Lloyd J. Austin III said, “if the United States defaults, it will undermine the economic strength on which our national security rests. It would also seriously harm our service members and their families.”

Military programs and benefits would also be affected shutdown would also impact a list of military benefits:

Survivor Benefit Plan (SBP) Annuity Payments
GI Bill payments
Military Pay for Retired Veterans
VA Disability Compensation
Dependency and Indemnity Compensation (DIC)
Survivors Benefits

Worst case scenario, nothing is paid until the debt ceiling is raised. Best case scenario is that military benefits are repaid as funds become available,

Do past shutdowns predict the future?

In 2018, the U.S. federal government shut down from December 22 through January 25, 2019. It was the longest government shutdown in history. During this shutdown, military servicemen and women were advised of these possible outcomes:

Military pay in a government shutdown

The government advised reservists, active members of the Coast Guard and the National Guard to work during the 2018 shutdown. However, unless Congress passed legislation to exempt military wages during the shutdown, they would not be paid. Retired military personnel and Survivor’s Benefit plan recipients would still receive payment.

GI Bill benefits and VA disability pay

During the 2018 government shutdown, GI Bill benefits and VA disability pay were not affected. Yet, the VA warned that if the shutdown of 2013 extended for more than a few weeks, checks to more than 5.1 million veterans would likely be delayed.

Medical care on- and off-base

Military hospitals, clinics and dental offices would remain open during the shutdown, but only for emergencies. The shutdown would not impact off-base medical care.

On-base schools and child care

On-base child care centers considered essential would remain open to military families. Schools would also remain open, but all extracurricular activities would be canceled.

Military troops killed in action

During the Jan. 2018 shutdown, the Pentagon’s $100,000 death gratuity paid to family members of troops killed in action would be delayed, as would military-funded travel for the transfer of their loved ones.

Military travel and change of station moves

Any plans for personnel and families preparing for temporary travel (TDY) or scheduled to make a permanent change of station (PCS) were put on hold until after the shutdown. Any military personnel already traveling were asked to return to their duty station until the shutdown was resolved.

How to prepare for a government shutdown

It’s likely the Treasury will prioritize payments to all government agencies until the debt limit is raised. Where payments to military personnel fall on that list is anyone’s guess. It’s possible that payments and benefits could be delayed for weeks.

However, Sen. Jim Inhofe, R-Okla., the ranking member of the Senate Armed Services Committee, maintains that “disruptions to military pay and benefits are “not going to happen.”

Even so, it’s worth preparing for the worse. The Department of Veterans Affairs (VA) encourages veterans and their families to use VA services while the government discusses its plan for the federal budget. The VA compiled a list of points to consider during the 2019 shutdown that may be worth looking over in the off chance a shutdown occurs.

IRIS and The GI Bill Help Portal To Be Replaced By Ask VA

by Christy Van Drunen

The Department of Veterans Affairs is making it easier for veterans to ask questions and get answers, according to a Sept. 20 announcement on the VA’s website. But that means two familiar portals, the Information Routing and Inquiry Service (IRIS) and the G.I. Bill Help Portal, are going away.

The new service, Ask VA, goes live on Oct. 18. It will serve as a single, streamlined online service for all veterans and members of the military community. Ask VA will route veterans’ questions directly to the appropriate benefit office for faster assistance, the VA said.

Do I Need to Sign in to Ask VA?

You do not need to be signed in to VA.gov to use AVA, but if you want to track a specific question, you’ll need to verify your identity. Verified users can track and follow up on past questions and don’t have to give all of their information each time they ask a new one.

How to Become a Verified Ask VA User

To access verified user features on AVA, proof of identity is required. You’ll need to create an account on one of the following sites to verify your identity:

ID.me

My HealtheVet

Premium DS Logon: To create a Premium DS Login, you’ll have to sign in to My HealtheVet using your Premium DS Logon or ID.me user ID and password. Once signed in, click “Upgrade Now” on the top left of your screen.

Saved questions in IRIS and the G.I. Bill Help Portal will disappear

Once Ask VA comes online on Oct. 18, IRIS and the G.I. Bill Help Portal will be deactivated, so veterans will no longer be able to use that service to ask questions.

Any questions you’ve previously asked in the old portal will no longer be accessible. So, if you want to follow up on something, the VA recommends submitting a new question through Ask VA.

VA opens eligibility for veteran benefits to service members discharged under ‘Don’t Ask Don’t Tell’

by Brittany Crocker

Air Force Pilots pose with pride flag before flyby — Maj. Tyler McBride, 62nd Fighter Squadron F-35A Lightning II instructor pilot, and Capt. Justin Lennon, 56th Training Squadron F-35 instructor pilot, hold an LGBTQ+ Pride flag after a Pride Month flyby June 26, 2020, at Luke Air Force Base, Ariz. McBride and Lennon performed the flyby over Luke AFB to celebrate and highlight the LGBTQ+ community. The month of June is recognized nationally as LGBTQ+ Pride Month to reflect on the history and heritage of the community. (U.S. Air Force photo by Senior Airman Leala Marquez)

The Department of Veterans Affairs announced Monday that it would open eligibility for all VA benefits to veterans discharged for their sexual orientation, gender identity or HIV status under the “Don’t Ask, Don’t Tell” policy.

The Clinton administration enacted the policy on Dec. 21, 1993. It remained in effect for nearly 18 years until its repeal under the Obama administration in September 2011.

“Today, the Department of Veterans Affairs is working to reverse the harm done to all LGBTQ+ Veterans,” wrote Kayla Williams, the VA’s assistant secretary of the office of public and intergovernmental affairs, in a VA blog post. “It also recognized what so many of us already knew to be true: That one’s ability to serve in the military should be measured by character, skills and abilities, not who one loves.”

“Although VA recognizes that the trauma caused by the military’s decades-long policy of discrimination against LGBTQ+ people cannot be undone in a few short months, the Biden administration and Secretary (Denis) McDonough are taking the steps necessary to begin addressing the pain that such policies have created,” Williams wrote. “LGBTQ+ Veterans are not any less worthy of the care and services that all Veterans earn through their service, and VA is committed to making sure that they have equal access to those services.”

More than 100,000 service members have been discharged because of their sexual orientation or gender identity,” President Joe Biden said in a written statement marking the 10th anniversary of the policy’s repeal.

He said nearly 14,000 service members were discharged under the policy, which lawmakers and interest groups like the Human Rights Campaign called discriminatory.

Many of those received ‘other than honorable’ discharges, which excluded them and their families from benefits and services like VA home loans, VA health and disability benefits, education benefits like the GI Bill and the right of all veterans to be buried in a national cemetery, according to Biden.

VA medical health coverage the discharged veterans are eligible for may soon include gender confirmation surgery. Veterans Affairs Secretary Denis McDonough announced at a pride event in June that he was working to make the surgery available to transgender veterans.

Five Ways Veteran Readiness and Employment Can Help You Reach Your Goals

by Kat Friedrich

If a service-connected disability has sidelined you from continuing your military career as planned, transitioning into the civilian workforce may feel like being dropped into unfamiliar territory.

But you don’t have to navigate it alone. The Department of Veterans Affairs (VA) provides Veteran Readiness and Employment (VR&E) program services to veterans and service members who have been injured in the line of duty.

“Once you apply, we’re going to call you up and provide you with a program orientation,” said Will Streitberger, executive director of the VR&E program, in a video for the VA’s Military to Civilian #TransitionTalk series. “From that point on, you’re going to start what is called the entitlement process, where you’ll sit down with a counselor and explain your life situation.”

Through a series of questions, the counselor will determine whether or not you have a barrier to finding employment, Streitberger said.

Such barriers, according to the VA website, are factors that make it difficult for you to pursue and keep jobs for which you are qualified. The program aims to help veterans make strategic decisions to work around them.

Streitberger said the next phase of the program, evaluation and planning, helps veterans figure out what their next goals are and how to achieve them.

Once in the VR&E program, a counselor will guide you to one of five program options that will help route you toward your future in the United States job market.

Veteran Readiness & Employment Tracks to Navigate the Job Market

The VA provides five routes for veterans who are having difficulty securing and maintaining employment due to service-connected disabilities.

The program’s reemployment track helps veterans who want to return to work with a previous employer.
If you’re feeling entrepreneurial and motivated, you can join a self-employment track where you can learn business skills like finance, marketing and planning. Staff will provide you with feedback on your business plans and goals.
If you want to fast-track your entry into the job market, you can participate in the rapid access to employment track, which provides job searching tools and advice.
The program’s long-term services track provides start-to-finish assistance with transitioning into a new career – including career assessment, higher education and on-the-job training like apprenticeships, if needed.
If your living with a disability makes it too difficult for you to pursue your work goals or engage in everyday activities or social environments, the VR&E program offers an independent living track. This track provides assists you with making accessibility modifications to your home, connecting with community resources in your community and improving your quality of life.

How to Apply For the Veteran Readiness and Employment Program

If you’re living with a disability that could be a barrier to civilian employment, you can apply for VR&E services even if you’re still in the military, as long as you’re under medical review, awaiting discharge, or have a pre-discharge rating of at least 20%.

If you’ve already left service and have at least a 10% disability rating from the VA, you can apply within 12 years of separating if you weren’t dishonorably discharged. You’re still eligible for the program after 12 years for serious injuries, according to the VA website.

To apply, you can fill out VA Form 28-1900 online, visit your regional VA office, or mail the form to:

Department of Veterans Affairs

VR&E Intake Center

P.O. Box 5210

Janesville, WI 53547-5210

You can also call the VA call center at (800) 827-1000 with questions or to apply for VA benefits.