Even though many face significant health challenges, some veterans do not have access to adequate health care. This can be due to several factors, including a lack of understanding about available options.
There are a few ways that veterans can access free health care. One of these is through a medical benefits package.
Veterans with a service-connected disability are entitled to health care benefits. Veterans can apply online or in person for these benefits.
Veterans receive full medical and dental services, medications, hearing aids, prescriptions, prosthetics, home renovations, and other care at VA healthcare facilities such as Spartan Wellness.
In general, higher priority group veterans pay less than other enrolled Veterans, but even this differs by facility and region. This is because many rural facilities may have a more limited range of providers. Veterans in higher priority groups may also have to make copayments and allow VA to bill their private insurance for reimbursement. In multivariate analysis, uninsured veterans were more likely to report no physician visit in the past year and to have trouble affording a doctor, compared with those who use the VA or have other health coverage.
Most veterans enrolled in the VA healthcare system qualify for cost-free care. However, some are required to pay modest copays for health care and prescriptions.
The eligibility requirements for VA healthcare depend on several factors, including time in service and character of discharge, specific disability ratings and priority groups. Veterans at lower priority levels, including those living in rural areas and with incomes below the poverty threshold, have higher costs associated with their treatment.
To ensure VA can meet the demand for its services, officials are working to address these challenges. For example, the agency is expanding telehealth services and making it easier for veterans to visit community care facilities outside VA hospitals. The goal is to improve access and reduce variability in the patient population across VA’s footprint.
Veterans can get low-to-no-cost health care from VA if they meet eligibility requirements for time of service and character of discharge and are assigned to a priority group. There are eight different groups based on veterans’ income and other factors that affect their ability to seek treatment.
Priority groups range from one to eight, with 1 being the highest priority. When veterans apply for enrollment, their eligibility will be verified, and the priority level will be assigned. Depending on their priority group, the VA may also reimburse a veteran for travel costs to a medical appointment.
Veterans typically pay a $15 copayment for primary care outpatient visits and a $50 copayment for specialty care. Prescription medications are free for most enrolled veterans, but if you have Medicare Part D or another insurance plan that covers certain drugs, you may be required to pay a copay.
The VA benefits explorer tool helps you quickly see what benefits you can receive and how much you might be required to pay for copays. If you are a catastrophically disabled veteran with an income below the applicable pension threshold, you are exempt from outpatient and prescription medication copayments. Inpatient care copays vary by priority group. Veterans in priority groups 2 through 6 must pay an annual cap on medication copays. Medication copays are free for those in priority group 1. The yearly cap applies to a maximum of 90 days of medications.
There are various health insurance options for veterans, including the VA, Medicare, TRICARE and your state’s insurance marketplace. When you carry private health insurance, it can help you avoid some of the out-of-pocket costs associated with receiving healthcare through the VA system.
VA provides a standard medical benefits package to all enrolled veterans, including mental illness, women’s health, sleep disorders, maternity care, and more. But the most important thing is to find a plan that meets your unique needs. And remember that, according to self-reporting in the ACS survey, more than 1 in 3 Veterans who use VA health services also have other public coverage such as Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) and individual state health plans.