Orlando Harmon
Veterans who are eligible for VA health care benefits can use them alongside other forms of health care coverage, such as private insurance plans, Medicare, Medicaid, or TRICARE. While VA benefits are typically reserved for veterans with service-connected disabilities, Medicaid is available to all Americans who meet the eligibility requirements, including veterans. The type of care required is usually the deciding factor between choosing Medicaid or a VA pension. For those needing home care or assisted living, VA benefits are often more suitable, while those needing nursing home care may prefer Medicaid, as it typically covers the full cost.
| Characteristics | Values |
|---|---|
| Can you have veterans insurance and Medicaid at the same time? | Yes, you can have both at the same time. |
| Veterans Insurance Provider | Department of Veterans Affairs (VA) |
| VA health care eligibility | Veterans who meet basic service and discharge requirements and were exposed to toxins and other hazards while serving are eligible for VA health care. |
| Medicaid eligibility | All Americans are eligible for Medicaid if they meet the eligibility requirements. |
| VA health care benefits | VA health care benefits can be used with other insurance plans. |
| Medicaid benefits | Medicaid provides health coverage for people with lower incomes. |
| Cost | If eligible for both, the VA benefit will be reduced to around $75 monthly, while the Medicaid benefit will cover long-term care costs. |
| Dependents | Dependents of veterans who are not eligible for a VA health care program can get coverage through the Health Insurance Marketplace. They may also be eligible for free or low-cost coverage through Medicaid. |
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What You'll Learn
Eligibility for VA health care
If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits alongside these plans. The VA works with other health insurance providers to ensure that veterans receive the care they need.
Whether or not you have health insurance coverage does not affect the VA health care benefits you can get. However, it is important to note that VA health care benefits are prioritized based on certain criteria, and your priority group may affect how soon you are signed up for health care benefits and how much you will have to pay toward the cost of your care.
To be eligible for VA health care, veterans must meet basic service and discharge requirements. This includes serving in the active military, naval, or air service and not receiving a dishonorable discharge. Additionally, veterans must have served 24 continuous months or the full period for which they were called to active duty, unless they were discharged due to a disability or hardship.
Veterans who served in specific conflicts, such as the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11, are also eligible for VA health care. Those who were exposed to toxins and other hazards while serving, including chemicals, pesticides, lead, asbestos, and nuclear weapons, are also eligible.
It is important to note that VA health care benefits are separate from TRICARE, and veterans may be eligible for both depending on their circumstances. Additionally, veterans who are enrolled in VA health care can still use other insurance for non-service-related conditions, and the VA will bill the insurance provider for those services.
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VA health care and other insurance
If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits alongside these plans. When you apply for VA health care, you'll be assigned one of eight priority groups. This system helps ensure that veterans who need immediate care can be signed up quickly. Your priority group may affect how soon you're signed up for health care benefits and how much you'll pay toward the cost of your care.
The VA is required by law to bill your health insurance (including your spouse's insurance if you're covered under their policy). The money collected goes back to VA medical centers to support health care costs for all veterans. You can submit a restriction request asking the VA not to disclose your health information for billing purposes, but they're not required to grant your request.
The VA doesn't normally provide care for veterans' family members, so if you drop your private insurance plan, your family may not have health coverage. Additionally, the VA doesn't know if Congress will provide enough funding in future years to care for all veterans who are signed up for VA health care. If you're in one of the lower priority groups, you could lose your VA health care benefits in the future.
It's always a good idea to let your VA doctor know if you're receiving care outside the VA. This helps your provider coordinate your care to ensure you're getting care that's proven to work and meets your specific needs. The VA may also bill and accept reimbursement from High Deductible Health Plans (HDHPs) for medical care and services to treat non-service-connected conditions. If you have an HDHP linked to an HSA, you can use your HSA to pay your VA copayments for non-service-connected care.
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Medicaid and VA pensions
Veterans and their spouses should consider the eligibility requirements for both Medicaid and VA pensions when planning for care. It is uncommon to receive concurrent benefits from both programs, but dual eligibility is possible. The type of care required is usually the deciding factor between choosing VA pension benefits or Medicaid. Income and asset amounts may also be limiting factors.
VA pensions are better suited for home care or assisted living, while Medicaid is better for nursing home care. Married couples may want to receive benefits from both programs, with one spouse receiving Medicaid assistance and the other using VA pension benefits. Generally, VA pensions are advantageous for home care or assisted living, while Medicaid covers nursing home care and may also cover home care and assisted living in many states. However, it will not cover the room and board costs of assisted living.
VA pension benefits are available to veterans who meet the basic service and discharge requirements and were exposed to toxins and other hazards while serving. To qualify for a VA pension, the monthly income limit is $1,229, while those eligible for Aid and Attendance benefits have a monthly income limit of $2,051. Medical expenses can be deducted from income to qualify. To be eligible for Medicaid, the average monthly income limit is $1,500 for a single person, and assets cannot be over a certain limit—the national average asset limit is around $2,000.
If a veteran is eligible for both Medicaid and VA pension benefits, their VA benefit will be reduced to around $75 monthly, while the Medicaid benefit will cover long-term care costs. Additionally, if a married individual with Aid and Attendance benefits is receiving Medicaid-covered nursing care, their pension will remain unchanged. However, single veterans or surviving spouses without dependents receiving Medicaid-covered nursing care will have their pension benefits reduced to $90 a month.
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VA health care benefits and costs
Veterans Affairs (VA) health care benefits are available to all veterans who meet the basic service and discharge requirements and were exposed to toxins and other hazards while serving. This includes veterans who served in the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11. To be eligible, veterans must have served 24 continuous months or the full period for which they were called to active duty. However, this minimum duty requirement may not apply if they were discharged due to a disability caused or worsened by their active-duty service.
When applying for VA health care, veterans are assigned to one of eight priority groups, which determine how soon they are signed up for health care benefits and how much they will have to pay toward their care. Veterans with a lower income may be eligible for free or reduced-cost care. Additionally, VA is committed to providing free health care for conditions related to military service and for veterans with catastrophic disabilities and disability ratings of at least 50%.
VA health care covers regular check-ups, appointments with specialists, home health care, geriatric care, women's health care, mental health care, and prescriptions. It also includes urgent and emergency care services, as well as specialized care such as organ transplants and intensive care for mental and physical conditions. Each veteran's medical benefits package is unique and may include added benefits like dental care.
VA health care benefits can be used alongside other forms of health care coverage, such as private insurance plans, Medicare, Medicaid, or TRICARE. VA is required by law to bill the veteran's health insurance for non-service-connected care, but veterans will not have to pay any balance not covered by their insurance provider. It is important for veterans to inform their VA doctor if they are receiving care outside of VA to ensure coordinated and effective care.
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Applying for VA health care
To apply for VA health care, you must first determine whether you are eligible. All veterans who meet basic service and discharge requirements and were exposed to toxins and other hazards while serving their country (at home or abroad) are eligible for VA health care. This includes veterans who served in the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11.
To be eligible for VA health care benefits, you must have served in the active military, naval, or air service and not have received a dishonorable discharge. You must have served 24 continuous months or the full period for which you were called to active duty. However, this minimum duty requirement may not apply if:
- You were discharged for a disability caused or made worse by your active-duty service.
- You were discharged for a hardship or "early out".
If you are an OEF/OIF/OND combat veteran who has recently returned from service, you can receive free medical care for any condition related to your service in Iraq or Afghanistan for 10 years after discharge.
Additionally, if you are a combat veteran discharged or released on or after September 11, 2001, you may be eligible for VA health care. Other eligibility criteria include receiving a VA pension, being a former prisoner of war (POW), receiving a Purple Heart or Medal of Honor, receiving Medicaid benefits, or being exposed to toxins or hazards such as chemicals, pesticides, lead, asbestos, certain paints, nuclear weapons, or X-rays.
Once you have determined your eligibility, you can gather the necessary information to fill out the Application for Health Benefits (VA Form 10-10EZ). This includes:
- Social Security numbers for you, your spouse, and your qualified dependents.
- Your military discharge papers (DD214 or other separation documents) and military service history information.
- Details about exposure to any toxins or other hazards.
- Insurance card information for all insurance companies that cover you, including any coverage provided through a spouse or significant other (Medicare, private insurance, or insurance from your employer).
- Gross household income from the previous calendar year for you, your spouse, and your dependents, including income from jobs and other sources.
- Your deductible expenses for the past year, including certain healthcare and education costs.
You can apply for VA health care benefits online, by phone, fax, or mail. If needed, you can work with an accredited attorney, claims agent, or Veterans Service Organization (VSO) representative to help you with your application. After submitting your application, you may need to provide additional information, such as your income and expenses, if you are not eligible based on other factors.
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Frequently asked questions
Yes, veterans can have insurance and Medicaid. If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits alongside these plans.
To be eligible for VA health care, you must meet the basic service and discharge requirements and have been exposed to toxins and other hazards while serving. This includes veterans who served in the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11. You must have served 24 continuous months or the full period for which you were called to active duty.
To apply for Medicaid, you must first determine your eligibility. If you are eligible, you can then submit an application. If you are married, do not meet the strict eligibility limits, or are uncertain about your eligibility, consult with a Medicaid Planner or Veterans Benefits Planner before applying.
When you apply for VA health care, you are assigned to one of eight priority groups based on factors such as income, service-connected disabilities, and discharge status. Your priority group determines your coverage and out-of-pocket costs within the VA system, with higher priority groups receiving more benefits and lower out-of-pocket costs.
