What are some considerations when deciding between using VA healthcare versus a private plan?

I have Cigna and VA health care I use the VA healthcare due the no copay for my testing and imaging and meds the ONLY reason I have Cigna is o also have Medicare PT a,b and d just to satisfy the affordable care act .
For some reason VA healthcare is not approved to satisfy the ACA and Medicare requirements

I have both VA and private coverage through my former employer. I have to buy the private coverage to get my wife covered and pay for both of us as there is no option for spouse only. In my case I prefer to use the VA system as I have had very good experience, and no premiums, Rx cost, optical or co-pay as I have a 70% disability rating, I find it faster to get VA appointments compared to my private insurance.

When I retired 1983 I used civilian. Now at 89 I need different care and need VA support Finding it very difficult to coordinate all past years info with VA. If I could start over, I would use civilian but be sure everything was submitted to the VA for their records. In 1983 my disability was 50% but 2023 100%. If the records had been integrated the increase would most likely have occurred much earlier to my benefit.

I’ve been using VA healthcare since August 2005 and I can say it’s improved by leaps and bounds! In 2005, with the exception of my PCP in my local CBOC, the VA was run by headless chickens! I switched to another VA in Jan 2015 and that was the first time I felt like I was receiving high quality care. I have Tricare Select Retiree and I still only trust the VA for my care because they are the most sensitive to veterans needs. I’ve had a surgery, I’m on a dozen medications that would cost me $2K a month outside of the VA since I’m 100% PT. So far I’ve used Tricare for the first time in December because a psych drug I need is currently not in VA formulary. My VA psych has to call Expresscripts for refills.
I’m also from Southern California and there’s no such thing as a bad VA here.
In summary:
2005-2014 VA Greater Los Angeles is a B-.
2015 - 2016 VA Long Beach is an A-.
2016 - current VA Loma Linda is A+!
I will only trust VA care because they have all of my active duty records from October 1999 until now Jan 2025. Get with DAV/VFW/PVA to advocate your requests and they will hold the President and Congress feet to the fire for our benefits!

DAV/VFW/AFA Life Member since 2014.

The problem I got I have been using the VA pain clinic for many years, All procedures are done by fellow doctors who don't have much experience at all, out of seven procedures I had done The only one that worked was the one I refuse to let a fellow doctor do it and told them I wanted a real doctor

After being in the VA health care system for 14 years, the first thing to consider is the quality of care. So if your issues are not complicated then free care and pay to and from your appointment is a strong reason to do it. As long as you qualify that is. If on the other hand you have complicated issues then the VA may not be the best. Unfortunately mine are complicated and the VA try’s to address one issue without treating any of the others. Some they have just ignored completely. My ankles are an example. They are not aligned properly and I only found out last year I needed inserts. This has been one of the reasons my knees are hurting me.
Next is distance to and from the clinic. Makes little since to do a two hour drive even with reimbursement of travel.
Next is medication. If you are taking daily medications then the fact they are free and after the initial in person pick up, they can be mailed to you saving you a trip.
So if you can and it works then yes if you can. If you would get the same level of care then yes again. However if your provider gives better care then stick with it. Keep in mind you still have to do yearly physicals

Any wait for an appointment/procedure 60 days or longer makes the veteran eligible for the VA's Community Care Program where a referral will be made to a local provider (there is another part of CC using travel distance the criteria). Participation in the Million Veteran project helps medical researchers access real-life large population of medical diagnostic, treatments, and outcomes where all PI & PII are scrubbed so HIPPA compliant. All my records and prescriptions (minus dental) are in one electronic system accessible wherever there is a VA facility (as well as from your personal MyHealtheVet account so you can make copies available to a non-VA provider).
Two drawbacks 1) A co-pay/deductible for some of the Priority Groups 2) I have only had one bad experience with an assigned care giver/VA employee - but it is little different from your luck of the draw either from a DoD or non-VA civilian provider.

Tricare for life and Medicare. I get prescriptions at base when I can but I'm a little far away so primarily use Express Scripts. I use private physicians. Convenience and my feeling of quality of care.

1st, I have bcbs thru retirement from my former employer. My wife uses it with champva, for her it's great....still costs me $500 per month. I use the VA and have since 2017 and have very few complaints. I get great care. The VA will send bills to your medical insurance

There is really no reason not to carry both. 1 is free and the other does cost. I have Medicare as well as Tricare. But you really need both. I had a procedure covered by Medicare but I was billed $10K. Luckly Tricare covered the balance