Navigating through health insurance options as a veteran can seem like a daunting process, but it is one that is worthwhile and important to do so. Some of the best care in the United States is provided through veterans’ health insurance and plans may even be subsidized by the United States government. With the Affordable Care Act, all Americans are now required to obtain health insurance, including veterans.
Therefore, it is important that you review your options in order to make an informed decision and obtain the level of health care that you need. Finding the best health insurance program can be challenging as the health care system within the United States is remarkably complicated. Even the Department of Veterans’ Affairs (VA), which manages the majority of the veteran programs that are available, can still be rather complicated. Additionally, the health coverage that you might qualify for will depend on a variety of factors, including:
- The branch of the armed forces that you served within.
- Whether or not you were disabled while serving in the armed forces.
- The severity of your disability, when applicable.
- Your personal financial situation.
In the sections that have been provided below, you will find further details about the potential veterans’ health insurance options that may be available to you.
TRICARE Health Insurance
TRICARE health insurance was formally referred to as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). While the name of the program has changed, TRICARE health insurance is still available to all active duty and retired services members as well as their families. However, TRICARE is not available to all veterans from the National Guard or Reserves. Retired reserve or guard members will need to meet additional qualifications in order to qualify for TRICARE health insurance.
For retired uniformed service members, TRICARE offers a variety of health insurance plans. When selecting a plan, it is important to review all of your options in order to determine which plan will suit your needs and the needs of your beneficiaries. It is also worth knowing that the availability of TRICARE plans can vary by location. If you are a veteran, you may be eligible for the following TRICARE programs:
- TRICARE Prime – TRICARE Prime is a health insurance plan that is mandatory for active-duty service members, but considered optional for retirees. The plan’s benefits include low to no copayments for a number of medical services as well as medications. However, in you will be required to stick to TRICARE network providers as you will be required to pay a point-of-service fee if you choose to go outside of the TRICARE network. If you are retired from the armed forces, you can expect to pay an annual enrollment fee for TRICARE prime, however, you will not be required to pay a deductible before coverage will begin.
- TRICARE Select – TRICARE select offers a greater level of flexibility in the physicians that you choose to see as there is at least some coverage for out of network physicians. However, you will need to provide a copayment with each visit to a physician’s office, regardless of whether or not the physician is in network. There is no enrollment fee for TRICARE Select and the annual deductible will be no more than $300 per family. This plan may offer you the most benefits if you do not want to switch to the primary care provider that TRICARE Prime provides or if you have another form of health coverage in addition to TRICARE.
- U.S. Family Health Plan – Similar to TRICARE Prime, the U.S Family Health Plan is available through a variety of local health care networks. However, only certain regions within the country are able to offer this plan, such as the D.C. area, parts of South Texas and Louisiana, the New England Area and Puget Sound in Washington. Expenses and coverage options are comparable to that of TRICARE Prime.
- TRICARE For Life (TFL) – This program provides additional coverage options to a Medicare health insurance program. If you are a veteran and you are already enrolled in Medicare Part A and you have opted to pay for Part B premiums, you will automatically be enrolled into TFL. TFL will provide coverage for any medical services that your Part A and Part B plan does not provide coverage for.
- TRICARE Select Overseas – Select Overseas may be the only option for you if you live outside of the United States. With this program, you can choose in-network and out-of-network providers. However, you will be expected to pay a deductible and either a co-payment or a cost share for any of the medical services that you receive.
Department of Veterans’ Affairs Health Insurance
The medical coverage that you can obtain through TRICARE largely depends on the type of plan that you select. However, VA health insurance qualifications can be far more complicated. Your eligibility for a VA health insurance program will depend on the length of time that you serviced, where you served, whether or not you were disabled while in service and how severe the disability that you sustained is. Your income level and the number of dependents that you have will also effect whether or not you will qualify.
In order to meet eligibility requirements for VA health insurance, you cannot have been dishonorably discharged from the service. If you enlisted after September of 1980, you must have served a minimum of 24 continuous months, or the entire period in which you were called to duty. Veterans that earned rewards or have a service-connected disability will have a greater chance at being considered eligible. Veterans who meet eligibility requirements may receive the following healthcare services:
- Preventative care.
- Inpatient care.
- Ancillary services.
- Specialist care services.
- Emergency medical care.
- Mental Health care.
The only way that you will know whether or not you will qualify for VA health insurance, as well as the costs that you might pay for coverage, is by completing the application process. The amount of time that you may be required to wait for coverage to begin will be determined by your eligibility for VA health insurance as well as whether or not you are disabled and your income levels.