Disability
Disability
Posted on Apr 9, 2024
What are some considerations when deciding between using VA healthcare versus a private plan?
Posted Anonymously
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I'm a veteran thinking about enrolling in VA healthcare but also have civilian health care with Blue Cross Blue Shield. What are some considerations that should go into this decision?
Veterans Affairs (VA)
Healthcare
Disability
Caregiver
Posted 20 d ago
Responses: 17
First, if you're eligible*, there is no reason you wouldn't enroll in VA healthcare. There are no premiums that you would pay.
One big caveat. While all veterans who have met the basic criteria (i.e., 24 continuous months of active duty, reservist ordered to active duty, etc.) can enroll in VA healthcare, if you are a "Priority Group 8"*, don't have a service-connected disability (or don't have a rating of 10%+) and don't meet income thresholds, then you aren't eligible for treatment (you'll be in the system, but currently won't be able to get treatment for non-service connected issues).
If you are the only person that you need to consider healthcare for, and you're eligible for VA healthcare, the other considerations about getting BCBS come down to really one main factor - flexibility.
VA healthcare means you will be treated at a VA medical center or though the community care program. You can't go to a non-VA doctor unless the VA refers you there. BCBS on the other hand can be used at any participating doctor.
If you're looking at it from a purely cost basis, VA healthcare will usually win out because there are no premiums and in most comparisons, the co-pay* rates will beat out BCBS rates (even if they don't, remember - no premiums).
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* VA health care eligibility - https://www.va.gov/health-care/eligibility/
* VA co-pay rates - https://www.va.gov/health-care/copay-rates/
* VA priority groups - https://www.va.gov/health-care/eligibility/priority-groups/
One big caveat. While all veterans who have met the basic criteria (i.e., 24 continuous months of active duty, reservist ordered to active duty, etc.) can enroll in VA healthcare, if you are a "Priority Group 8"*, don't have a service-connected disability (or don't have a rating of 10%+) and don't meet income thresholds, then you aren't eligible for treatment (you'll be in the system, but currently won't be able to get treatment for non-service connected issues).
If you are the only person that you need to consider healthcare for, and you're eligible for VA healthcare, the other considerations about getting BCBS come down to really one main factor - flexibility.
VA healthcare means you will be treated at a VA medical center or though the community care program. You can't go to a non-VA doctor unless the VA refers you there. BCBS on the other hand can be used at any participating doctor.
If you're looking at it from a purely cost basis, VA healthcare will usually win out because there are no premiums and in most comparisons, the co-pay* rates will beat out BCBS rates (even if they don't, remember - no premiums).
------------------------------------
* VA health care eligibility - https://www.va.gov/health-care/eligibility/
* VA co-pay rates - https://www.va.gov/health-care/copay-rates/
* VA priority groups - https://www.va.gov/health-care/eligibility/priority-groups/
Eligibility for VA health care | Veterans Affairs
Find out if you can get VA health care as a Veteran.
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I have Tricare for Life plus MEDICARE but I still use the VA whenever possible. I believe they are a little more in tune with the Veteran community.
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I love BCBS because everyone takes it.
It doesn't hurt to enroll in the VA but if you only use the VA you have to go to the VA so it depends how close you are to them. I have to drive past maybe 10 hospitals to get to my local VA where I can walk to a doctor that takes BCBS.
It doesn't hurt to enroll in the VA but if you only use the VA you have to go to the VA so it depends how close you are to them. I have to drive past maybe 10 hospitals to get to my local VA where I can walk to a doctor that takes BCBS.
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CPT Lawrence Cable
I have a Medicare Advantage Plan and use VA (priority group 1). I agree that it's nice to maintain the option to use whoever is available where you are at and I keep the Advantage plan for that reason (BCBS). However, I work in Lexington and live in the next county and there is a large VA presence here, so I use it for most stuff.
I did Community Care for Orthopedics, it's pretty clunky and bureaucratic.
As a note, your civilian doctor can do procedures and use medicines off label, any VA treatment has to be FDA approved.
I did Community Care for Orthopedics, it's pretty clunky and bureaucratic.
As a note, your civilian doctor can do procedures and use medicines off label, any VA treatment has to be FDA approved.
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