Veterans Health Care Coverage
The Veterans Health Administration (VHA), within the Department of Veterans Affairs (VA), operates the nation’s largest integrated health care delivery system, provides care to approximately 6.7 million unique veteran patients. Read what Veterans can expect when it comes to medical care, dental care, vision and other types of care.
Eligibility and Enrollment
Contrary to claims concerning promises of “free health care for life,” not every veteran is automatically entitled to medical care from the VA. Eligibility for VA health care is based primarily on veteran status resulting from military service. Generally, veterans must also meet minimum service requirements.
However, exceptions are made for veterans discharged due to service-connected disabilities, members of the Reserve and National
Guard, and returning combat veterans. The VA categorizes veterans into eight Priority Groups, based on factors such as service-connected disabilities and income (among others).
All enrolled veterans are offered a standard medical benefits package, which includes (but is not limited to) inpatient and outpatient medical services, pharmaceuticals, durable medical equipment, and prosthetic devices.
For female veterans, the VA provides gender-specific care, such as gynecological care, breast and reproductive oncology, infertility treatment, maternity care, and care for conditions related to military sexual trauma.
Generally the VA provides audiology and eye care services (including preventive services and routine vision testing) for all enrolled veterans, but eyeglasses and hearing aids are provided only to veterans meeting certain criteria.
Eligibility for VA dental care is limited and differs significantly from eligibility for medical care. For veterans with service-connected disabilities who meet certain criteria, the VA provides short- and long-term nursing care, respite, and end-of-life care.
Costs to Veterans and Insurance Collections
While enrolled veterans do not pay premiums for VA care, some veterans are required to pay co-payments for medical services and outpatient medications related to the treatment of nonservice-connected conditions. Co-payment amounts vary by Priority Group and type of service (e.g., inpatient versus outpatient).
The VA has the authority to bill most health care insurers for nonservice-connected care; any insurer’s payment received by the VA is used to offset ‘‘dollar for dollar’’ a veteran’s VA co-payment responsibility. The VA is statutorily prohibited from receiving Medicare payments (with a narrow exception).
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