Posted on Dec 13, 2023
Sgt Robert Valimont
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Posted in these groups: VA Medical Center
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COL Randall C.
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Edited 11 mo ago
Short answer: Absolutely, assuming you're eligible*.

I saw the various comments and there seems to be a persistent misunderstanding about VA Health care. Many seem to conflate eligibility for VA healthcare with eligibility for FREE VA healthcare.

All veterans (as defined by the VA) are eligible to sign up for VA healthcare. For almost all active duty servicemembers, if you weren't dishonorably discharged, you are eligible (see criteria for full information).

If you're treated for a documented service-connected illness/injury, you are covered for all out-of-pocket expenses. For everything else, how much you would pay* out of pocket will depend on things such as a service-connected disability rating, your income, etc. It could also be affected by which priority group* you are assigned to.
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* Eligibility for VA Healthcare - https://www.va.gov/health-care/eligibility/
* VA healthcare co-pay rates - https://www.va.gov/health-care/copay-rates/
* VA healthcare priority groups - https://www.va.gov/health-care/eligibility/priority-groups/
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Sgt Robert Valimont
Sgt Robert Valimont
11 mo
Thanks for the info, I think VA healthcare would still would be cheaper then a private health ins. Policy.
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COL Randall C.
COL Randall C.
11 mo
Sgt Robert Valimont - It absolutely would be. Frankly there is no reason you shouldn't sign up for VA healthcare if you meet the eligibility for one reason - there are no premiums. The only time you could pay anything is if you use it.

If you have a service-connected disability of 10% or higher, you don't have any copays for outpatient OR inpatient care. In other words, to see a primary care, have surgery, etc.

Even if you had to pay full copays (weren't 10%+ rated, above income levels, weren't in any other category that would put you in a lower priority group), the co-pays are better than most health plans - $30 copay for urgent care, $15 copay for primary care, $50 copay for specialty care, no copays for labs, tests, etc., and if you have to be hospitalized, while the rates are higher, you would go "ouch" instead of "I'm doomed" ($1,600 copay for the first 90 days and $10 per day ... $800 copay and $10 per day for each 90 day period beyond that).

For medications, most copays for the 'preferred generics' would be $15 for a 90 day supply and it goes up for 'non-preferred generics' ($24/90-day) and 'brand-name' ($33/90-day). If you're someone that is taking a lot of medications, then the most you would spend is $700 in a year (copay cap).

Again, EVEN if it was just as a back-up, there is absolutely no reason I can think of you wouldn't sign up for VA healthcare if you were eligible.
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SGT Air Defense Radar Repairer
SGT (Join to see)
9 mo
Sgt Robert Valimont - I went with SS at 62. I also went with a Medicare Part C plan in the last few years when I learned I could a good part of the premium that they deduct from your SS monthly back. The present premiums are $174 and change and I get about $165 of it back. Of course going this route would require you to perform an analysis of your situation. So depending on your VA disability rate, health needs, income and other factors such a plan may be just right or not.

What I wish the VA WOULD DO is hold classes for their Vets as they reach retirement age on what they and Medicare together can do for you. It would also be nice if classes were held to inform Vets locally of what resources are available to them through the VA, local and within their individual state.
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MSG Intermediate Care Technician
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Why not sign up for VA medical now?
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Sgt Robert Valimont
Sgt Robert Valimont
11 mo
Didn't think I could. I've been enrolled in my employers healthcare insurance the last 28 years!
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MSG Intermediate Care Technician
MSG (Join to see)
11 mo
Sgt Robert Valimont to put it in perspective, I work thru the VA and have insurance thru them but I'm also a patient in the VA because I've earned it.
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COL Randall C.
COL Randall C.
11 mo
Sgt Robert Valimont - Unfortunately the misunderstanding about VA healthcare eligibility is something I see time and again.

I think there are very valid discussions about wait-times to get care, differing quality of care between doctors, etc., but there is no reason not to be enrolled in VA healthcare if you're eligible.

One other factor that many are not aware of is that VA healthcare is not "health insurance" as defined by law. There is no "primary/secondary" payer when it comes to VA healthcare. The only 'downside' of that is you could think of VA healthcare as a very restrictive HMO if you want to use it - they will decide when or if you see someone outside of the VA healthcare structure.

If you do have other insurance, the VA sends a bill to your insurance carrier for non-service related conditions it treats, but anything they don't reimburse the VA for doesn't come back to you (so if the VA bills them $2,000 and they only cover $1,250 of it, the other $750 is absorbed by the VA) - you only have to pay your copay (assuming you have one).
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LCDR George Townsend
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VA only gives medical care if you have a service-connected disability. If you have no disabilities, the VA will send you packing...even if you're unemployed and have no other coverage. They did that to me when I was laid off and had no income. I'm a reserve retiree and wasn't getting retired pay (under 62 years of age). VA told me I had to be unemployed for a whole year before they would put me into the lowest priority category for any care. Obamacare is actually a better deal than the VA if you don't have a job (retired) and have low income. Why accept substandard VA care when you can get first-rate civilian health care with no premiums and no co-pay?
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COL Randall C.
COL Randall C.
11 mo
Not completely accurate. If you meet the normal eligibility criteria*, then you are eligible for VA health care no matter their income. You may be eligible based on your VA disability rating, service history, or other factors.

The broad 'base' category of eligibility is if you served in the active military, naval, or air service and didn’t receive a dishonorable discharge, but the specifics are outlined on the website*.

The largest group of those eligible would have served two years on active duty, served the entire period of active duty they were on orders as if a reservist, or those that were discharged from active duty due to a disability.

If you don't meet the standard eligibility, you may be able to become eligible if you were appointed in any component of the military and meet income levels* defined by your zip code and how many dependants you have.

There is no requirement to be out of work for a year, but the individual may have been referring to your exceeding the income limits for your location.
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* https://www.va.gov/health-care/eligibility/
* Eligibility based on income - https://www.va.gov/health-care/income-limits/introduction
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