What You Need to Know About VA Health Care Benefits and Private Insurance Coverage

VA Health Care Benefits

It’s frustrating to be confused on a topic as important as health insurance coverage. When you’re dealing with expensive medical bills and coverage questions, it’s important to understand what type of coverage you need and what type of coverage you have. 

For military veterans, there is an entirely new layer of questions associated with VA benefits and how those interact with private insurance plans. Can you have both VA health care and a private insurance plan? Do you need both? Where can you get private insurance in addition to your VA benefits? 

Luckily, those questions all have answers.

Can You Have Private Health Insurance and VA Benefits?

The short and sweet answer to this question is yes, you can have both private health insurance and VA benefits. Things like private insurance and Medicare are complementary to veteran’s benefits, so you don’t have to choose one over the other. 

VA health care is not insurance. It is simply a benefit. You won’t have to worry about canceling a plan and accepting the other instead. It’s a benefit designed to coexist with your other health care providers, so having insurance already will not affect whether you can receive care at a VA facility or get help with medical bills related to service injuries. 

In reality, many veterans receive VA health care and Medicare, as well as maintain a private insurance plan. You are allowed to have all three and it will not affect your ability to qualify. In fact, there are many scenarios in which having more than one will benefit you.

Do You Need Private Health Insurance if You Have VA Benefits?

Veterans with VA benefits are not required to get private health insurance. Under the Affordable Care Act, certain types of VA health coverage meet the requirements of having “minimum essential health coverage.” 

However, you might want to consider having private health insurance on top of VA benefits for one of several reasons.

  • In-network: While the VA does cover preventative care, health exams, and emergencies (as long as you fall within their guidelines), they generally require that all health care be provided in a VA facility. Without Medicare or your own private insurance, an emergency situation or treatment outside of a VA hospital may cause you to rack up medical bills and debt.
  • Family and dependents: The VA also does not typically extend its benefits to family members and dependents. A lack of private insurance means no coverage for your family. 
  • Future funding: The VA relies on funding from Congress. How much money Congress is able to spend on providing benefits to veterans depends on what is allocated to them in the congressional budget. Veterans in lower priority groups may not always receive their benefits from the VA. 
  • Start dates and penalties: For Medicare, if you cancel it, you won’t be able to get it back until January of the following year. While veterans don’t require private insurance along with their VA benefits, it can be helpful to have both. 

Going without insurance can potentially leave you vulnerable to the full cost of treatment, and subject to all the billing, collections, and lasting financial damage that comes with it.

It may be cheaper for you to not pay for private health insurance, but there are a lot of good reasons to have both.

Where Can Veterans Get Private Health Insurance?

If you’d like to combine your VA benefits with private health insurance, there are a few ways you can go to receive extra assistance:

  • Through an employer: Many employers offer health insurance plans for employees. This is a pretty common way to be insured. Whether you are insured through your own employer, or through a spouse’s employer, you can obtain health insurance in addition to your VA benefits. For military members, TRICARE would be the most commonly used insurance provided through the military.
  • With state exchanges or individual markets: Health insurance marketplaces, or state exchanges, are organizations in each state where people can purchase private health insurance. It’s an option for those who don’t have employer health insurance.
  • Qualifying for Medicare and Medicaid: Medicare and Medicaid are social insurance programs managed by the state and based on income. Medicare is an option for those 65 and older or those who have a severe disability without consideration of income. Medicaid is a program that provides health coverage for those with a very low income. You can be eligible for both Medicare and Medicaid.

VA benefits, though they are not insurance, are considered to meet the minimum required health care coverage under the Affordable Care Act. For some veterans, it’s enough. For others, it is not. 

Fortunately, it’s perfectly fine to double (or even triple) up on insurance coverage. Whether you go through an employer, go through an insurance marketplace, or qualify for Medicare or Medicaid, there are ways to find an insurance option that complements your VA benefits.

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