Military benefits are varied and depend on your needs and active duty status. Below is a summary of how each military benefit works:
TRICARE is a regionally-managed healthcare program provided by the Department of Defense for active duty and retired service members. Family members and survivors of beneficiaries may also enroll. TRICARE is a part of the Military Health System (MHS) and extends coverage for enrollees from solely military facilities to civilian facilities. For those currently serving in the Army, Navy, Air Force, Marines, and Coast Guard. MHS healthcare is delivered not only in facilities in the US but also in combat, on ships, and on overseas military bases.
Plans within TRICARE are region-dependent and priced on a scale. TRICARE Prime plans are similar to HMOs and TRICARE Select plans are similar to PPOs — you can compare plans on TRICARE’s website. Most TRICARE health plans meet the requirements for minimum essential coverage, so take care to view your individual plan to ensure it meets your health needs. While TRICARE enrollees typically find care at Military Health Systems, TRICARE may also be used with civilian doctors and facilities.
Application: Similar to Marketplace’s Open Enrollment Period, TRICARE also has an annual Open Season where you can enroll or switch your plan. It is usually in the fall — in 2021, Open Season was from November 8 to December 13. A qualifying life event also provides a period to alter your plan and lasts 90 days. You can apply online, mail your application, or call your region’s phone number. Find forms for your individual plan here.
Note: Military retirement is separate from being a veteran. TRICARE eligibility for non-active service members is dependent on active duty retirement (those who have 20 or more years of active service) or reserve retirement (those who have 20 or more years of qualifying service).
Veterans Affairs (VA) Healthcare, provided by the US Department of VA is available for those who served in active military service and were separated under any condition other than dishonorable discharge. Enrollees can access care at VA medical centers but can also get care from a non-VA facility with prior authorization. However, you will be responsible for a copay for non-service-related conditions regardless of where you go. Additionally, your priority group, which is based on a number of factors including disability rating and income level, will determine how soon you’ll be signed up for healthcare and your copay. Check out the most updated priority-dependent copay rates here.
You can apply by phone at 877-222-8387, by mail, in person at your nearest VA medical center, or online. You can also request application help from a trained professional. Read more about all the options and apply here.
The VA healthcare program meets the ACA’s minimum essential coverage requirements. While VA healthcare may be combined with other insurances, veterans who are enrolled in a VA health plan will not be eligible for premium assistance or cost-sharing reductions for ACA plans. It’s also important to note that VA benefits do NOT coordinate with Medicare; those two programs are completely separate. For this reason, individuals eligible for VA healthcare and Medicare will also elect to enroll in the latter so that they have access to non-VA healthcare as well.
This health program is for spouses or dependents of veterans who are permanently and totally disabled or who die of a service-connected disability. Veterans and family members may use doctors and hospitals outside of VA hospitals for care. To be eligible for CHAMPVA, applicants cannot be eligible for TRICARE.
Application: Forms can be found online and submitted by mail or fax.
Combining Healthcare Options:
You can combine several healthcare options above if you’re eligible. For instance, you can combine VA healthcare with TRICARE as well as Medicare and Medicaid. For those who are eligible for Medicare and a military-related health program, you may find that your healthcare options are broadened since you will have more non-military options to choose from when you are on Medicare.
For those who are dual-enrolled in VA Healthcare and Medicare, be aware that Medicare does not cover your care at a VA facility and the VA does not cover your care at community facilities without prior approval. Having both options only means you have expanded healthcare options at Medicare-certified facilities.
For those who are dual-enrolled in TRICARE and Medicare, you’ll find that your two coverage options will coordinate care, meaning they will each share the costs of your healthcare expenses. Additionally, TRICARE may pay for your Medicare cost-sharing. Learn more about how TRICARE works with Medicare here.
Important Note about Military Coverage and the ACA: If you have VA coverage, TRICARE, CHAMPVA, or are a recipient of the Spina Bifida Healthcare Benefits Program, your coverage meets ACA’s health coverage requirements.
Learn More:
Medicare Plans Resource for Veterans | Medicare Plans
Last Revised May 20th, 2022
