If you serve in the United States military or have served in the past and are now considered a veteran, you may be eligible to access health care resources offered by the Department of Veterans Affairs (VA).
In the case of veterans that were hurt during their time serving in the military, specialized services are offered, including treatment for post-traumatic stress disorder (PTSD) and radiation. Therefore, the health care programs provided by the VA encompass physical and mental health care coverage that may be accessed in hospitals, clinics or, in some cases, even at home.
As a general rule, however, military servicemembers and veterans are eligible to receive health care coverage from different programs offered by the VA. In addition, family members or dependents of military servicemembers and veterans may qualify to receive coverage through certain VA programs related to health care. To learn more about what programs are offered by the Department of Veterans Affairs and which ones you and your dependents are eligible for, read the sections below.
Federal law requires the Department of Veterans Affairs (VA) to provide outpatient health care and inpatient hospital services to qualifying veterans. In addition to the basic health care programs offered to all veterans, there are also more specialized services that cater to certain veterans’ needs, including the following:
If you served as an active duty member of the U.S. military and were released or discharged under any conditions besides dishonorable discharge, you may be eligible to receive veteran health care benefits. In addition, if you are a current or former National Guard or Reserves member who was called by a federal order to serve and completed the full term, you may also qualify for these health care benefits.
The minimum duty requirement for basic VA health benefits eligibility is two years (24 months), either consecutively or throughout the entire period for which you were called to serve. In general, the enrollment period for this health care program takes place every year.
Each enrollee in the veterans’ health care program receives a veterans’ health identification card (VHIC), which identifies him or her as a participant in the program. The VHIC is particularly important for insured individuals to present to any qualifying providers and practitioners. The benefits of the program include:
Veterans enrolled in this program gain access to health care clinics and medical centers nationwide. Moreover, this VA program has self-service kiosks where applicants can conveniently manage their health care data and facilitate service activities. In addition, this program offers an online portal that contains a patient’s entire health care information. This portal can be accessed through any device and allows easy access and control to personal data related to health and ongoing illnesses.
The VA also provides additional services to veterans across the country. For instance, this program has a telephone number that serves as a helpline for individuals facing a crisis. Moreover, veterans have access to caregivers and work therapy, if needed. There are rehabilitation services for blind veterans or mental health services, such as dealing with post-traumatic stress disorder (PTSD). In the case of housing during medical services, there are community living centers for short and long-term stays. If applicable, interpreter and social work services are also available to patients in need.
The Civilian Health and Medical Program (CHAMPVA) offered by the Department of Veterans Affairs covers some of the expenses of particular health care services for eligible spouses and family members of qualified veterans. However, in addition to meeting certain relationship requirements to the qualifying veteran, these dependents must also not be eligible to receive TRICARE. Conversely, the veteran sponsor of family members receiving CHAMPVA can receive VA health care program benefits.
The CHAMPVA operates in a similar way to a standard health insurance plan. However, this program is typically not the primary payer of medical expenses. In general, the CHAMPVA only pays for qualifying medical costs after Medicare contributes its portion. Therefore, to receive the CHAMPVA, you must also enroll in Medicare Parts A and B, as long as you are eligible.
Overall, the patient cost for most forms of health care, such as hospital stays, emergency room visits, ambulance trips, mental health care and office visits, is typically 25 percent of the full cost of health care. In addition, there is a $50 deductible per individual and a $100 deductible per family. The CHAMPVA pharmacy benefits include home delivery methods for non-urgent types of prescription medicine. On the other hand, in the case of more urgent prescriptions, the CHAMPVA partners with a retail pharmacy network that encompasses more than 82,000 locations.
The primary health care program for active duty military members, retirees and their families is TRICARE. This program is managed by the Department of Defense’s Defense Health Agency. TRICARE provides comprehensive health coverage benefits including a variety of specialized health plans, prescription coverage, mental health care, vision coverage and dental plans. Specialized TRICARE program offerings include TRICARE Select, which allows you to see any doctor you want, and TRICARE Prime, a managed service program. Moreover, additional TRICARE programs include:
In addition, TRICARE also offers case management services for military members and their families under treatment for terminal, high-risk, catastrophic, high-cost or chronic illnesses. Furthermore, TRICARE’s exceptional family member program (EFMP) offers resources for special needs families. TRICARE also runs a program to help keep health coverage consistent and uninterrupted for service members upon leaving service, called Transitional Health Benefits for Recently Separated Servicemembers.