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What is VA health care?

Keep in mind...
  • Veterans Health is the national healthcare program for veterans
  • It consists of hospitals, healthcare facilities, doctors, specialists, and research organizations
  • The Veteran’s Health Administration administers Veterans Health; it is the nation’s largest Healthcare System
  • Veteran’s Health is not insurance, but it works with insurance like Medicaid,
    Medicare, and Marketplace plans

Veterans Health is the federal government’s system for providing medical care for eligible ex-military personnel. It is an integrated system of guaranteed coverage and medical care. The federal government operates Veteran’s Health and thousands of related medical and research facilities.

VA health is primary care and some limited financial assistance. Operating as an HMO style of managed care, the primary care physicians help discover and deliver the needs of each veteran by direct care and referrals to specialists in the VA system.

If you need coverage but don’t qualify for VA health insurance, enter your zip above to compare private health insurance rates.

VA Health Managed Care

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The VA health system uses the primary care physician as a key function of providing care and organizing resources needed for each veteran. The benefits of the primary care physician run to both the system and the veteran.

The veteran gains the benefit of medical care from a physician dedicated to following his or her progress. The basic familiarity with the veteran’s medical situation is a strong advantage.

The Individual Mandate

The Affordable Care Act has a rule that applies to every eligible citizen and lawful resident. Everyone must get and keep qualified health insurance or face a tax penalty for failing or refusing to do so. Health plans sold on the Obamacare Marketplace, and state exchanges will pass review.

Those not required to file taxes or are otherwise exempt from the mandate do not have to pay the penalty. The law applies to ex-military personnel, and those not covered by the Department of Defense may be covered by the Veteran’s health programs of the Veteran’s Administration.

Qualified Health Insurance

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Qualified health insurance is more than the premium paid and details of costs and fees; qualified health insurance must have the minimum value, essential health benefits, and protections against excessive costs.

Qualified coverage has at least 10 essential benefits, a minimum actuarial value, and meets the specific criteria in the Affordable Care Act such as deductible and out-of-pocket limits.

VA Health Coverage Meets the Mandate

Those enrolled in TRICARE or Veterans Health with the Veteran’s Administration meet the requirements of the individual mandate. These enrolled veterans do not have to pay the individual shared responsibility payment.

Veterans Health has the essential benefits and minimum effective value required of health plans that pass ACA review. Eligible veterans include those that served in the military and received other than dishonorable discharge.

VA Health

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All veterans get the VA Basic Medical Benefits package. This is a comprehensive medical care package that includes prevention services, primary medical care, specialties, diagnostics, and inpatient and outpatient services.

The services for veterans have the following group priorities:

  • Priority Groups 1–3 includes service -connected Veterans, Purple heart Recipients, disabled Veterans, and Medal of Honor recipients.
  • Priority groups 4–8 are the other eligible persons based on medical conditions, income, combat status, and environmental exposures.

Enrollment in Basic Benefits

Enrollment is a key step to VA health benefits.

Veterans that served after 1998 in combat zones can apply by telephone without using a signed, paper application.

Veterans can enroll four convenient ways as described in the below-itemized list.

  • Online
  • In-person at any VA office location
  • Mail
  • Telephone

My Healthevet

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Veterans can establish a direct web portal connection as well. This service permit vets to follow their medical and treatment information and to input data and requests. It can help keep medications current, prescriptions refilled, and an up-to-date listing of appointments, exams, and treatments.

The portal works with prevention and wellness services including health assessments and library information on health issues. The portal helped vet connect to the VA and the greater community of veterans.

Mental Health Resources

The health needs of veterans, like the rest of the population, include mental health screenings, detection, and medical services. For vets, this includes post-traumatic stress and related illnesses. Mental health care includes self-help resources, relationship resources, and caregiver support.

There are several outreach initiatives, hotlines, and emergency services to support vets in crisis.

Primary Care

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The Veterans Administration has a major reform and adjustment in process. The Primary Care Services management in the VHA directs a top to bottom set of improvements aimed at making the veteran the center of actions. This patient-based approach called the PACT system.

It was developed from the Patient-Centered Medical Home (PCMH) Model, and it provides an opportunity for each veteran to have a substantial voice in his or her health, treatment, and long-term physical and mental health care.

The Patient-Centered Goals

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The patient is the center of the PCMH model. The veterans have individual needs but also some common experiences that deeply affect health and create lifetime needs. A patient-driven approach is a key to meet the need of veterans.

The management response includes a team that can address a comprehensive view of the veteran. This view is a whole-person view. The system has scarce professional resources and limits; it must be efficient to cover all veterans and avoid waste.

Communication is a bridge between the veteran, the team and the entire VA health system. Communication must be active and tied to coordination of the necessary healthcare services.

Time for Change and Innovation

The VA health delivers primary care, prevention, and wellness services to veterans. Due to demands for change and the need to accommodate new views on medical care management, the VA as set on a path of innovation and continuous self-assessment.

The new direction used a model called the patient-centered medical home and carried out through a long-term care system called PACT.

The Elements of PACT

The patient home concept alters the focus of medical care from the traditional measures of volume and services rendered to the alignment with the individual’s path to success. Putting veterans more in charge of their journey to good health was an important and dramatic decision.

The list below describe the elements of the PACT system.

  • Partnership involves the veteran and his or her health professions team
  • Access is the goal of providing all of the resources the veterans needs to succeed in short-term care and long-term healthy living.
  • Coordinated Care
  • Team-based Care with the veteran as the center, the team-based care system brings resources together in a unified application of resources.

Primary Care for Women Veterans

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There are gender-specific benefits and services that apply to women veterans such as reproductive health and prenatal wellness. The same is true of prevention services as many tests, vaccines, and early detection screenings focus of illnesses and diseases of the female.

Women in the military have been a sometimes contentious issue, but today, women serve in all branches and roles including combat missions.

Veteran’s Family Outside coverage

The Affordable Care Act provides health insurance for veterans and their families not enrolled in veterans health programs.

The Affordable Care Act Marketplace and state exchanges provide affordable health insurance that everyone can purchase during the open enrollment periods.

After Open Enrollment

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Veteran’s and family members can purchase qualified health insurance after the open enrollment period if they can find a policy reason that fits their situation. The below-listed items are qualifying events called life events.”

  • Marriage
  • Divorce
  • Moving to a new location
  • Childbirth
  • Loss of coverage as a dependent at age 26.

VA Health and Other Health Insurance

When VA health provided care that could have come from private or other public programs, the VA must bill those other sources. VA can provide treatment or care requested by a Veteran for non-service or non-service connected conditions.

If those services are covered by either public or private insurance, then the VA can be reimbursed. The veteran will not be liable for any unpaid difference, but the law is clear that VA must get the insurance payments due for the services it provided.

Programs to Support Veterans’ Families

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Family members can get health benefits, and the eligibility depends on specific conditions. These programs can reduce health care costs for families and provide particular types of health services. These can include doctor’s office visits, medicines, prescription assistance, and medical supplies.

CHAMPVA is the Civilian Health and Medical Program at the VA. It is a comprehensive health services program. Those enrolled in CHASMPVA meet the requirements of the individual mandate for qualified health coverage. The following items name other major VA programs for families:

  • Spina Bifida (SB)
  • Children of Women Vietnam Veterans (CWVV)
  • Foreign Medical Program (FMP)
  • Caregiver

VA Health is Important to Everyone

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The VA is a vital source of health benefits for veterans and their families. VA Health is qualified coverage; it avoids the tax penalty of the ACA. It is comprehensive and tuned at the particular situation of veterans and their families.

Comparison shopping can help veterans and veteran’s family members that need to meet the individual mandate to find coverage in the Obamacare marketplace. It’s also a great way to find the best value and consistency with individual or family medical care needs.

Compare the costs of veteran health insurance today by entering your zip code in our free search tool.

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