Posted on Apr 9, 2024
What are some considerations when deciding between using VA healthcare versus a private plan?
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I'm a veteran thinking about enrolling in VA healthcare but also have civilian health care with Blue Cross Blue Shield. What are some considerations that should go into this decision?
Veterans Affairs (VA)
Healthcare
Disability
Caregiver
Posted 8 mo ago
Responses: 42
First, if you're eligible*, there is no reason you wouldn't enroll in VA healthcare. There are no premiums that you would pay.
One big caveat. While all veterans who have met the basic criteria (i.e., 24 continuous months of active duty, reservist ordered to active duty, etc.) can enroll in VA healthcare, if you are a "Priority Group 8"*, don't have a service-connected disability (or don't have a rating of 10%+) and don't meet income thresholds, then you aren't eligible for treatment (you'll be in the system, but currently won't be able to get treatment for non-service connected issues).
If you are the only person that you need to consider healthcare for, and you're eligible for VA healthcare, the other considerations about getting BCBS come down to really one main factor - flexibility.
VA healthcare means you will be treated at a VA medical center or though the community care program. You can't go to a non-VA doctor unless the VA refers you there. BCBS on the other hand can be used at any participating doctor.
If you're looking at it from a purely cost basis, VA healthcare will usually win out because there are no premiums and in most comparisons, the co-pay* rates will beat out BCBS rates (even if they don't, remember - no premiums).
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* VA health care eligibility - https://www.va.gov/health-care/eligibility/
* VA co-pay rates - https://www.va.gov/health-care/copay-rates/
* VA priority groups - https://www.va.gov/health-care/eligibility/priority-groups/
One big caveat. While all veterans who have met the basic criteria (i.e., 24 continuous months of active duty, reservist ordered to active duty, etc.) can enroll in VA healthcare, if you are a "Priority Group 8"*, don't have a service-connected disability (or don't have a rating of 10%+) and don't meet income thresholds, then you aren't eligible for treatment (you'll be in the system, but currently won't be able to get treatment for non-service connected issues).
If you are the only person that you need to consider healthcare for, and you're eligible for VA healthcare, the other considerations about getting BCBS come down to really one main factor - flexibility.
VA healthcare means you will be treated at a VA medical center or though the community care program. You can't go to a non-VA doctor unless the VA refers you there. BCBS on the other hand can be used at any participating doctor.
If you're looking at it from a purely cost basis, VA healthcare will usually win out because there are no premiums and in most comparisons, the co-pay* rates will beat out BCBS rates (even if they don't, remember - no premiums).
------------------------------------
* VA health care eligibility - https://www.va.gov/health-care/eligibility/
* VA co-pay rates - https://www.va.gov/health-care/copay-rates/
* VA priority groups - https://www.va.gov/health-care/eligibility/priority-groups/
Eligibility for VA health care | Veterans Affairs
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MAJ (Join to see)
I've had better luck with quality of care with Civilian Medical facilities close to me than going to a VA medical hospital. With my disabilities I get in quicker, I'm seen by the same PCM keeping my medical history with the physician consistent and who knows all my issues. The referral system through my civilian medical facility is faster than the VA as well. I'm willing to pay the CoPay for these conveniences. Lastly the VA hospital I have to go to is almost an hour away from me, whereas my civilian medical facilities are right down the road. Somethings to think about.
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SGT Lorenzo Nieto
Man I wish I had doctors that really cared, all I get is 12 types of medicine and have a nice day.
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LTC Stephen B.
MAJ Byron Oyler - I agree, VA care definitely gives options but price isn't always the discriminator. I tried to avoid the VA hospital in DC mainly because there are so many vets there with no other option and I didn't want to be the reason someone is delayed in their care. Now that I'm away from the national nuke missile bulls-eye, I'll use the VA for some service connected stuff, but time from the first call to actually being seen can be 6 months or more. Took me four months just to get a PCM assigned then another 3 months for an appointment so I could get a referral. Another 2 months for the referral and the follow-up with the PCM will take another 4 months. More urgent things that pop up I can get a Tricare appt at a private medical clinic in about a week. Tricare for life is good until you're 65. Then you get bounced into Medicare with Tricare falling back to the secondary payer.
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CPT Lawrence Cable
I agree with the good Colonel. I'm a Priority Group 1, so I've migrated most of my healthcare over to the VA. I had to get a Primary assigned to get a referral to the hearing lab, but the Hearing Aids the VA provide are excellent and it would have pushed my finances at the time if I had to purchase them. I still have a Medicare Advantage Plan since I travel a lot and I don't get dental from the VA. (Advantage Plans cost you the Part B premium and whatever they charge for any upsells, my premium is $28).
VA Priority Group 1 has no Drug or Outpatient Co-pay, and I believe the first 3 urgent treatment visits are no Co-pay. I haven't had to use the Urgent Treatment side.
Lexington does have two major VA facilities that are within about 20 minutes of where I work, about 40 minutes from the House. The only downside I would have is that the system is bureaucratic and sometimes you have to wait to get an appointment, but the Civilian Hospitals usually have waiting times these days and VA does put me into bankruptcy. The upside beside cost is that I have seldom waited more than 15 minutes from the time of my appointment.
VA Priority Group 1 has no Drug or Outpatient Co-pay, and I believe the first 3 urgent treatment visits are no Co-pay. I haven't had to use the Urgent Treatment side.
Lexington does have two major VA facilities that are within about 20 minutes of where I work, about 40 minutes from the House. The only downside I would have is that the system is bureaucratic and sometimes you have to wait to get an appointment, but the Civilian Hospitals usually have waiting times these days and VA does put me into bankruptcy. The upside beside cost is that I have seldom waited more than 15 minutes from the time of my appointment.
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I have Tricare for Life plus MEDICARE but I still use the VA whenever possible. I believe they are a little more in tune with the Veteran community.
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CDR Mel Willard
VA is very good but in my 89th year waiting for 4-6 months for an appointment in many situations is very frustrating. I also get many cancellation/reschedules.
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CSM Thomas McGarry
I also have Tricare for Life and MEDICARE and was using the VA for some of my care until Covid became a thing, I had and appointment with a urologist because of an elevated PSA at the VA which they cancelled on four consecutive times, finally after the fourth time I asked what was going on and was told that the VA was only seeing patients on an emergency basis. The care at my local VA was always good but after that I pulled all my records and now go to only civilian practitioners now though I guess I am still registered with the VA.
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MSgt Alfred Gronroos
I have Tricare for life but use the VA exclusively. I found a VA that is helping me in Prescott AZ.
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I love BCBS because everyone takes it.
It doesn't hurt to enroll in the VA but if you only use the VA you have to go to the VA so it depends how close you are to them. I have to drive past maybe 10 hospitals to get to my local VA where I can walk to a doctor that takes BCBS.
It doesn't hurt to enroll in the VA but if you only use the VA you have to go to the VA so it depends how close you are to them. I have to drive past maybe 10 hospitals to get to my local VA where I can walk to a doctor that takes BCBS.
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MSgt Alfred Gronroos
I started using the VA medical when I had no insurance. And I found this one to be very patient orientated. I can see why you would use the BCBS. Enroll in VA so if and when it ever needs to be utilized it's ready for you.
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