While many Veterans qualify for free health care services based on a VA compensable service-connected condition or other qualifying factor, most Veterans are asked to complete an annual financial assessment, to determine if they qualify for free services. Veterans whose income exceed the established VA Income Thresholds as well as those who choose not to complete the financial assessment must agree to pay required copays to become eligible for VA health care services.
Private health insurance coverage through a Veteran or Veteran's spouse is insurance provided by employer, Veteran or other non-federal source.
VA is required to bill private health insurance providers for medical care, supplies and prescriptions provided for treatment of Veterans' nonservice-connected conditions. Generally, VA cannot bill Medicare, but can bill Medicare supplemental health insurance for covered services.
All Veterans applying for VA medical care are required to provide information on their health insurance coverage, including coverage provided under policies of their spouses. Veterans are not responsible for paying any remaining balance of VA's insurance claim not paid or covered by their health insurance, and any payment received by VA may be used to offset "dollar for dollar" a Veteran's VA copay responsibility.
Your insurance coverage or lack of insurance coverage does not determine your eligibility for treatment at a VA health care facility.
What should you do with your private health insurance if you are accepted into VA health care? You could save of money if you dropped the insurance, but there are some things you should consider.
VA does not normally provide care for family members of Veterans enrolled in VA's health care program. If you drop your private health insurance, they may have no health care coverage.
There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.
VA does not require a Veteran to have Medicare Part A or B to be enrolled in VA health care. However, a Veteran may want to consider their total health care needs before changing any insurance coverage.
If you cancel your Medicare Part B Coverage, you need to know that you cannot be reinstated until January of the following year, and you may be penalized for reinstatement.
For these reasons, VA encourages you to keep your private health insurance.