Veterans have dedicated their lives to serving their country and keeping their families safe. They are an important class of society, making up 6.4% of the population (16.5 million). It’s important for Veterans and their loved ones to know about the various benefits available to them and how they can attain them. Here, we explore the various types of coverage available for Veterans, and discuss ways to better care for Veterans in a home setting. 

What is Veteran Care?

The Veterans Administration (VA)  provides free healthcare to Veterans for any illness or injury that they determine is related to their military service. This healthcare is referred to as “service connected,” and was created by Congress to provide assistance, benefits and support for American Veterans in an effort to show gratitude for their service.

This service connected healthcare is called Veteran care, and can be defined as care provided to a Veteran for an illness or injury related to military services. This care is provided through The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), which is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. Services are provided directly from a VA facility or by a community provider on behalf of VA. 

Veterans who aren’t enrolled in VA or other Veterans health coverage can still receive coverage through the health insurance marketplace. Most Veterans have TRICARE. This is the Department of Defense’s (DOD) health care program for uniformed service members, retirees & their families. Eligibility and location determine which particular plans are available to them. However, Veterans can also receive Veteran care through a private insurance plan, community provider, Medicare, or Medicaid. 

Eligibility: Am I qualified?

In general, for a veteran to receive Veteran care, they must have been called to active duty by a federal order and completed the full period in which they were called or ordered to active duty. If they had or have active-duty status for training purposes only, they don’t qualify for VA health care. TRICARE eligibility is determined by military services. All Veterans receive coverage for most care and services, however each Veteran’s medical care package is unique, and only some will qualify for added benefits like dental care.

A Veteran’s eligibility depends on: 

• Their individual health care needs or circumstances
• The advice of the VA Primary Care Provider (PCP) ( doctor, nurse practitioner, or physician assistant)
• The medical standards for treating any condition the Veteran may have
• Household size
• Disability rating (based on the severity of their service-connected condition)
• Priority group (based on their military history, disability rating, and Medicaid qualification)
• Income

VA staff members generally make all eligibility determinations, and if the Veteran qualifies, they’ll receive coverage for the services they need to help get and stay healthy. Note that with any care Veterans choose to receive from a carrier, it must first be authorized by the VA to avoid being billed.

The types of care provided by and on behalf of VA include but are not limited to: 

• home health & hospice care 
• surgeries
• mental health services 

• health exams (including gender-specific exams)
• health education (including nutrition education)
• immunization against infectious diseases (like flu shots)

• acute care (short-term treatment for a severe illness or injury or after surgery)
• specialized care (including organ transplants, intensive care for mental and physical conditions, and care for traumatic injuries)

Costs and Insurance 

There are still co-pays with care provided by VA. Some Veterans don’t have to pay copays due to their type of disability, income level, or special eligibility factors. Whether or not they’ll need to pay copays—and how much they’ll pay—depends on their disability rating, income level, military service record, and which priority group they’re assigned to when they enroll in VA health care. All VA healthcare facilities participate as TRICARE network providers and can provide care on a space available basis. 

Veterans may be able to get lower costs on monthly premiums and out-of-pocket costs on private insurance depending on their circumstances. For example, if they have a service-connected condition that’s rated at 50% or more disability or that the VA has determined makes them unable to work, or if they’ve received a Medal of Honor, they’ll be assigned to priority group 1 and won’t pay copays for any types of care, tests, or medications. The disability rating is used to determine how much disability compensation they’ll receive each month, as well as their eligibility for other benefits.

If the Veteran has an illness or injury that was caused—or made worse—by their active-duty service they may be able to get disability compensation (monthly payments) from VA. If they need further assistance due to life situations like losing a job, having a sudden decrease in income, or having an increase in out-of-pocket family health care expenses, they can request financial hardship assistance. Of course, if they qualify, this will help manage current VA copay debt, and they can also request an exemption from future copays. 

Veterans in the home care setting: caring for those who have served

In addition to veteran care, the VA also provides assistance for Veterans in need of homecare. The VA Aid and Attendance or Housebound benefits program provides monthly payments added to the amount of a monthly VA pension for qualified Veterans and survivors. If Veterans are housebound or need help with daily activities, they can apply for this benefit. Eligibility is dependent upon the Veteran receiving a pension, and whether or not they are bed bound, blind, in a nursing home, or need another person to help them perform daily activities such as bathing, feeding, and dressing. Veterans can also access benefits through other veteran homecare companies by taking loans from the VA upon approval of the Aid and Attendance benefit. 

For Veterans with caregivers, it’s important to note the common conditions and injuries among Veterans and familiarize yourself with their unique needs. If you’re caring for a Veteran, here’s a list of tips and precautions  to help provide the best possible care for the Veteran:

• PTSD (Post traumatic stress disorder) is the most common condition suffered by many Veterans. Symptoms include disturbing thoughts, physical distress, difficulty sleeping and more. Some effective strategies for treatment include:
  • Education for the whole family about the effects of trauma on survivors
  • Support groups and individual therapy for both partners and Veterans
• Veterans often suffer from respiratory issues such as tuberculosis, lung cancer, and pneumonia from exposure to infectious agents or airborne environmental hazards. To help maintain and improve  their lung health, caregivers can assist Veterans with regular breathing exercises,  keeping the air purified, and conducting regular lung function tests.
• Military training and fighting in a war takes a toll on most Veteran’s bodies. 60% of recent Veterans were diagnosed with musculoskeletal alignments (muscle injuries), including joint and back disorders. When caring for a Vet with such disorders, it’s important to consistently rest the injured muscle, assist them with daily stretching and medication, and encourage them to avoid smoking which can increase inflammation.
• Blast exposure accounts for 68-78% of combat injuries amongst Veterans, the most common being Traumatic brain injury (TBI). This is caused by vehicle accidents, being struck by an object, assault, and other factors. When caring for a loved Veteran with TBI, note that it is difficult for them to multitask and try using lists, memory notebooks, and calendars to organize daily tasks. Be sensitive to the issue of fatigue; if they seem tired or overwhelmed, suggest they take a break.

The country is blessed to have Veterans that offer their services for the care and protection of the Nation. No matter where they served, or for how long, each Veteran deserves respect for the sacrifices they made for the country, and it’s important for Veterans to receive every benefit they are entitled to. More information on Veteran care and home assistance can be found on the VA and DOD websites as well as additional resources for all Veterans.

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