November 10th, 2020 BY HealthNetwork
If you’re transitioning from military to civilian life, then you’ve likely got a lot on your plate. But healthcare coverage should be one of your top priorities.
Health insurance for veterans comes in a variety of forms. Understanding the options will help you figure out which one makes sense for you.
VA Health Care
VA medical care might be the first thing that comes to mind when thinking about healthcare for veterans. But you may be surprised to learn that full VA care isn’t an automatic benefit for all veterans. Congressional funding actually determines availability.
When you apply for VA health care, you’ll be placed in one of eight priority groups based on various factors like service-related disabilities and income status. Being a Prisoner of War or receiving a Purple Heart automatically qualifies you for higher rankings.
Priority group one receives the top access to care. Depending on availability, those in the lower groups may not be able to receive services at the VA or may be responsible for copays.
Anyone who was honorably discharged from service is eligible to apply.
Even if you don’t expect to qualify for a high priority group or don’t think you’ll need medical care right away, you should still apply for VA health care. That way, you may have benefits in place when you need them. Plus, your priority group status could change over time.
Through VA health care, you may be able to receive free or low-cost preventive care, mental health services, home health assistance and prescription drugs. Both your primary and specialty care may be included.
Medical services are typically delivered at VA health facilities, but some other providers may be covered as well. Depending on your priority group, you might also receive reimbursement for travel expenses to and from appointments.
VA health care can be used with another health plan, including job-based coverage.
Even if you don’t have another plan, VA enrollment counts as minimum essential coverage under the Affordable Care Act.
If you have a permanent service-connected disability, your spouse and children may be able to receive healthcare coverage through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). And they may be able to retain this coverage after your death, too.
CHAMPVA pays out for medically necessary care.
This could include ambulance rides, prescription drugs, mental health treatment and more.
Eligible family members can be enrolled in both CHAMPVA and Medicare as long as they have Part B coverage.
During your military service, you’ve probably been covered by TRICARE. If you’re now retiring from military life, you may choose to continue with TRICARE.
Most retired military personnel and their family members can sign up for TRICARE Prime or Select.
No matter the option, though, you’ll need to pay premiums. Cost depends on the plan you pick and whether you’re enrolling one person or a family. Premium prices tend to increase slightly each year.
If you’re retiring from the National Guard or Reserve, you may be eligible for TRICARE Retired Reserve. This plan offers similar benefits as other TRICARE plans but requires higher premiums.
As you get older, the TRICARE For Life program will allow you to stay enrolled in TRICARE even after turning 65. TRICARE serves as a second payer to handle costs not covered by Original Medicare. You can use your benefits whether you live in the U.S. or overseas. To take advantage of this program, you must be enrolled in Medicare Parts A and B. The Part B premium will be your only enrollment cost.
Important: TRICARE is not an option for all veterans.
It’s available only to retirees. In most cases, that requires at least 20 years of service. If you don’t fall into that category, you’ll need to choose another option for health insurance.
FEDVIP Dental and Vision
If you’ve retired from military service, you and your family members can choose to obtain dental or vision coverage through FEDVIP. These supplemental plans are available to all military retirees, including those who served in the National Guard or Reserve.
Within the FEDVIP program, you may have a variety of vision and dental plans to choose from.
Transitional Assistance Management Program
If you leave the military before achieving retirement status, you’ll need to consider other options for your health coverage. As you go through this transition period, you may qualify for a program that bridges your military healthcare plan and a civilian one.
The Transitional Assistance Management Program (TAMP) is available to people who are being honorably but involuntarily discharged. There are a few other special circumstances that can qualify you for TAMP as well.
If you enroll in TAMP, you’ll continue to receive TRICARE benefits for 180 days at no cost to you.
Continued Health Care Benefit Program
Even if you don’t qualify for TAMP, you may still be able to access TRICARE benefits for a while after leaving military service. By signing up for the Continued Health Care Benefit Program (CHCBP), you can get up to 18 or 36 months of coverage.
Just know that your medical care will no longer be free.
Instead, you’ll pay a premium for your coverage. In exchange, you’ll receive a healthcare plan that’s comparable to TRICARE Select.
You may qualify for both TAMP and CHCBP. After your TAMP period ends, your CHCBP eligibility will begin.
To participate in CHCBP, you must apply within 60 days of losing TRICARE. For those currently using TRICARE Reserve Select, there’s only a 30-day application window.
By the time your CHCBP period ends, it’s important to have another form of health insurance lined up. For those who don’t fall into a high VA priority group and aren’t eligible for retiree TRICARE, non-military health insurance is probably the best choice.
You may receive health insurance through work. Either your employer or your spouse’s workplace might offer options for health coverage.
But if that’s not an option, then you can purchase private coverage. You can do this a few ways:
- Directly from an insurance company
- Through a broker or insurance agency that represents different companies
- From a federal or state health insurance exchange
- Through a private, independent health insurance marketplace (like ours)
You can only buy private coverage during certain enrollment periods. (The current enrollment season is now, actually, and runs through December 15th.)
But if you’re a veteran who’s losing TRICARE coverage, then you may qualify for a special enrollment period within 60 days of losing that coverage.
If you miss that opportunity, you’ll have to wait for the annual open enrollment period in late fall. And as we just mentioned, is happening right now.
Depending on your income, your family may qualify for Medicaid or the Children’s Health Insurance Program (CHIP). Income requirements vary based on where you live. Check with your state’s health insurance department for more information about options for limited or low-income families.
Finally, remember that the Department of Defense Transition Assistance Program (TAP) can guide you through the shift to civilian life. During this program, you’ll learn more about VA health care and your other insurance options for life outside the military.