Frequently Asked Questions

Does VA care only cover service-connected conditions?

No. Veterans can receive care for any injury or condition. Non-service-connected conditions may require a copay depending on income and eligibility factors.

What is military retirement?

Active duty members may retire after 20 years of service. Reservists must reach age 60 and accrue 20 years of service in order to retire. Medical retirement is also available if an active duty member becomes disabled as a result of an injury or condition connected to his or her service.

Are veterans with military coverage eligible to purchase a Marketplace plan?

Yes, veterans with VA care or TRICARE can buy a Marketplace plan. However, military coverage is considered to meet the health care law’s standard for minimum essential coverage, so veterans are ineligible to receive subsidies for a lower-cost plan.

Can veterans who are enrolled in the VA health care program purchase a lower-cost Marketplace plan for their families?

Yes. VA-enrolled veterans themselves do not have access to Marketplace subsidies, but their dependents do, based on family income.

Can veterans terminate their VA coverage in order to purchase a subsidized Marketplace plan?

Yes. However, a word of caution: one must be completely uninsured in order to qualify for a lower-cost Marketplace plan. There will be a gap in coverage between terminating VA benefits and enrolling in a Marketplace plan. Additionally, should a veteran wish to return to VA benefits in the future, factors of eligibility may change.

How do Medicare and Medicaid work with veterans’ benefits?

Veterans may enroll in Medicare or Medicaid while also receiving VA or TRICARE, but cooperation between the programs varies.

  • Medicare and TRICARE work together – there is a branch of TRICARE called “TRICARE for Life” that becomes available when you enroll in Medicare parts A and B. Medicare becomes your primary insurance, and TRICARE pays for the coinsurance and deductible.
  • Medicare and VA benefits, however, do not work together. Medicare does not pay for any care received at VA facilities.
  • Medicaid and TRICARE work together. Medicaid acts as the secondary payer for those enrolled in both.
  • Medicaid and VA benefits do not work together. Medicaid does not pay for any care at VA facilities.

What are the eligibility factors for free VA care?

Veterans who have the following eligibility factors are exempt from all inpatient and outpatient copays:

  • Former Prisoner of War status
  • 50% or more compensable military service-connected disabilities
  • Catastrophic Disability status

The following services are exempt from inpatient and outpatient copays, although still may be subject to extended care copays:

  • Care for a service-connected condition
  • Care for cancer of head or neck caused by nose or throat radium treatments received while in the military
  • Specialty registry examinations offered by VA to evaluate possible health risks associated with military service
  • Counseling and care for military sexual trauma
  • Compensation and Pension examinations
  • Care that is part of a VA research project
  • Health risk examinations
  • Smoking cessation and weight reduction services
  • Readjustment counseling
  • Individual or Group Smoking Cessation or Weight Reduction services
  • Publicly announced VA public health initiatives, for example, health fairs
  • Laboratory and electrocardiograms
  • Hospice care
  • Care potentially related to combat service for Veterans that served in a theater of combat operations after November 11, 1998