VA health care eligibility myths

One valuable veteran benefit is access to the VA health care system. Unfortunately, there are many rumors and misconceptions circulating that may prevent some veterans from applying for the benefits to which they are entitled.

It can be confusing to determine whether you qualify because eligibility for VA health care depends on a variety of factors and circumstances. The following are some common misconceptions about VA health care eligibility:

Myth 1: “I didn’t serve overseas or in combat, so I’m not eligible.” If you served in the active duty military, even during peacetime, and were honorably discharged, you likely meet the minimum requirements to qualify for VA health care. However, meeting the service requirement doesn’t automatically qualify or disqualify you because there are other factors the VA considers to decide eligibility. Some of these include: being a former prisoner of war; receiving the Purple Heart Medal or Medal of Honor; receiving a VA pension; being discharged from the military because of a disability (not pre-existing), early out or hardship; or having a household income below certain VA income thresholds.
Myth 2: “I wasn’t injured in the service, so I’m not eligible for VA health care, or I can only receive care for service-connected injuries.” These are common misconceptions, but the truth is you don’t have to have a service-connected disability (injury/illness) to use VA health care. The VA is uniquely equipped and trained to treat combat wounds, yes, but they also treat everything — including mental health and AODA treatment. You can receive VA hospital and outpatient care for any ailment, service-connected or not, if you are enrolled in the VA health care system.
Myth 3: “I make too much money to qualify for VA health care.” This may or may not be true. Income does affect eligibility in many cases. If you do not have a service-connected disability, or do not qualify due to other factors, income may be a limiting factor for your enrollment. See a local veteran service officer if you have questions about how income affects enrollment.
Myth 4: “VA health care is health insurance.” Enrolling in the VA health care system does not mean you have health insurance. VA health care is coverage for care received at VA facilities only (with some limited exceptions that need preapproval). In fact, you should have other private health insurance or Medicare/Medicaid to cover care outside the VA. It is especially important to have other insurance to avoid incurring large bills due to emergency room visits, which are not covered by the VA unless the visit is at a VA hospital emergency room or it is a life-threatening emergency, like a heart attack or stroke.
Myth 5: “I can’t use VA health care if I have private health insurance.” You may receive care at the VA and still choose to use your private health insurance to receive treatment from private doctors as well. The VA will work with other doctors to meet your health care needs and coordinate effective treatment.
Myth 6: “I can only apply once.” This is not true. You may apply whenever there is a change in your circumstances, such as change in income, being granted a service-connected disability or a change in the VA eligibility standards.

Bottom line: Because there are so many factors, the best way to determine if you are eligible is to apply and get an official decision from the VA. You can do this by going to: https://www.va.gov/HEALTHBENEFITS/apply/. You can also apply in person at any VA clinic or with help at your county’s Veteran Service Office. Call to make an appointment in Shawano County at 715-526-9183. Nick Benzinger, Shawano County’s veteran service officer, is available to answer questions.