VA Health Care Benefits

VA health care connects American veterans with a full range of medical and health related services. Veterans health insurance provides enrollees and their families with as much agency and control over their own care as possible.

Veterans can access care at designated Veterans Affairs (VA) facilities, from providers in their home communities or through in-home care programs, depending on their needs and geographic locations. The VA also makes informed, best-practice care available for women, LBGT, sexual abuse survivors and other veteran populations with unique or special health needs.

Benefits from the VA can stand alone or may be layered with other forms of public and private health insurance. Veterans holding VA health insurance for family members and themselves satisfy all Affordable Care Act mandates. However, where applicable, veterans are encouraged to pursue dual enrollment in VA insurance and Medicaid, private insurance or other programs as this can expand their options and minimize costs.

VA Health Care Benefits

Veterans’ access VA medical benefits can be influenced by their disability statuses, service and discharge histories, annual incomes and places of residence. For example, the Veterans Choice Program offers qualifying veterans the opportunity to seek care from health providers in their home communities instead of at VA facilities. Veterans are only eligible for the program if:

• They cannot be seen by the closest VA facility within 30 days.
• They live 40 or more miles from the closest VA facility that can meet their needs.
• Geography or other circumstances exist that constitute an excessive travel burden.
• There are no VA facilities in the veterans’ states of residence.

Regardless of where veterans receive care, however, VA health care benefits cover:

• Primary and preventative care.
• Emergency and specialty care.
• Diagnostic and laboratory work.
• Inpatient and outpatient services.
• Surgical care.
• Habilitative and rehabilitative care.
• Readjustment Counseling Services (including group, marriage and family counseling).
• Case management services.
• Mental health care.
• Crisis intervention services.
• Caregiver programs and services.

Some veterans will also qualify to receive VA health care dental services. Most enrollees who are not eligible to receive dental care directly from the VA may purchase independent, reduced-cost dental insurance through the VA Dental Insurance Program (VADIP). Veterans and their family members can also look in to Medicaid dental benefits or research ways to save on dental costs.

VA Health Care Eligibility

VA health care eligibility is based on several factors. Veterans health care benefits are available to individuals who:

• Began Active Duty service in any U.S. military branch prior to October 16, 1981.
• Began Active Duty after October 16, 1981 and served at least 24 contiguous months of duty or their full contract term.
• Began Active Duty after October 16, 1981 and served less than 24 months but were discharged for qualifying causes including disability or hardship.
• Members of the Reserves or National Guard who served Active Duty time by federal order.

Former servicemembers who separated from the military dishonorably are not eligible for benefits.

Members of the Guard or Reserves who served no Active Duty time, or who served Active Duty time for training purposes only do not qualify for VA medical benefits.

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Enrollment preference and priority may be given to veterans health insurance applicants who:

• Were Prisoners of War (POWs).
• Received Purple Heart Medals or Medals of Honor.
• Served in specific theaters during set periods of time (e.g. the Persian Gulf between August 1990 and November 1998).
• Have service-related disabilities or are Catastrophically Disabled.
• Are receiving VA pensions.
• Were discharged from service because of hardship.
• Meet VA low-income thresholds.

Applicants who elect to disenroll from VA health care may reenroll at any time.

Applying for Veterans Health Insurance

Applicants can apply for VA health insurance in person, online, by phone or by mail.

• Phone applications are accepted from 8 a.m. and 8 p.m. EST each weekday at 1-877-222-VETS (8387). Applicants who are hearing impaired may alternatively call 1-800-829-4833.
• Mail-in applications (VA Form 10-10EZ) can be downloaded from the VA, completed and mailed to the Health Eligibility Center ATTN: Enrollment Eligibility Division 2957 Clairmont Road Suite 200 Atlanta, GA 30329-1647.
• In-person applications can be submitted to any veterans health care facility or VA regional office.
• Online applications are available on the VA’s website and will be electronically verified upon receipt.

Veterans are strongly encouraged to apply for VA health care benefits if they:

• Have a service-related disability assessed as 50 percent or more.
• Have a service-related disability that has not yet been rated and were discharged less than 12 months ago.
• Are seeking assistance solely related to service-connected disabilities.
• Need registry examinations (e.g. ionizing radiation, Agent Orange, depleted uranium, airborne hazards).

Assistance is available for applicants who need help navigating the veterans health benefits application and enrollment processes.

VA Health Insurance for Families

Veterans families may be eligible for VA health care under a variety of programs. Benefits and eligibility vary by program. Examples of VA health benefit programs for families include, but are not limited to:

• Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) provides coverage to the spouses, widow(er)s and dependents of servicemembers who were disabled or killed in the line of duty.
• Spina Bifida (SB) extends benefits to the biological children of Vietnam and Korean War veterans who have spina bifida.
• Children of Women Vietnam Veterans (CWVV) provides VA health benefits payments for medical care related to qualifying birth defects in children whose biological mothers were Vietnam Veterans and who served during the program-specified time period.
• Camp Lejeune Family Member Program (CLFMP) offers VA-funded health care to the families of veterans stationed at Camp Lejeune between August 1953 and December 1987 who have been diagnosed with one or more of 15 specific conditions, including cancer and infertility.
• Caregiver Programs enable qualifying veteran caregivers to receive stipends and healthcare, along with counseling, training and travel expenses.

Families with questions about eligibility for these and other programs should contact the VA online or using the toll-free application phone numbers listed above.

As of June 2015, the Department of Veterans Affairs recognizes the legal legitimacy of same-sex marriages and any children of those marriages. This applies regardless of veterans’ states of residence or the marriage laws on record in those states. Veterans in same-sex marriages are encouraged to apply for benefits for which they and their spouses qualify, even if they have been denied such benefits prior to the change in law.

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