Probably the best deal the VA has to offer veterans is the cost of the healthcare the veterans will receive. When a person considers the cost of insurance and/or the cost of healthcare without insurance, the VA’s medical benefits package is outstanding!
Copayments are determined by a few factors: service connection, income, other insurance, pension, etc. Each VA Medical Center has a department whose purpose is to determine eligibility. The name of that department is “Eligibility.” The VA doesn’t have to be creative with names. Eligibility will determine the Priority Treatment Group of the applicant. Once the veteran’s Priority Treatment Group has been determined, the appropriate copayment, or no copayment, can be determined.
When a veteran has a service-connected condition, the veteran will be assigned Priority Treatment Group 1. These veterans have no copayments for any of their medical care. That’s right. The cost is $0.00. Regardless of medical procedure, hospitalization, medication, prosthetic appliance, durable medical equipment and everything else associated with their medical care, there is no cost. And please keep in mind, to qualify for Priority Treatment Group 1, all the veteran needs is a compensable service-connected condition. Take for example a veteran who injured a finger on active duty. That finger could have a 10% service-connected rating. If that is the case, there is No Cost For Medical Care. The veteran will even receive 41.5 cents per mile (after a small deductible) to travel to and from their medical care. I can’t think of any health insurance policy that compares to this.
Something else important to understand is the veteran did not have to serve in combat in order to qualify for VA medical care. I can’t count the number of veterans I’ve spoken with felt they had to serve in a war, or in combat, to qualify for VA medical care. Serving in war, or combat, is not a requirement.
How much are the copayments if the veteran is required to pay? The costs are very minimal. A visit to a Primary Care Provider is only $15.00. That’s it. There is no deductible. It is just $15.00 to see a non-specialist. When the veteran is referred to a specialist, the cost is only $50.00. Again there is no deductible. Compare that to any insurance plan.
Last week I had a patient call who was upset about the cost of his VA health care. The veteran was nonservice-connected. He was required to make a copayment. He said that he can use any Medicare provider he likes and he doesn’t have any out-of-pocket expenses. I asked the veteran if he had a supplemental policy that provides additional coverage to the Medicare. The veteran confirmed he had an AARP policy. He then said that because of this, he doesn’t have to pay anything for his health care.
I hated bursting his bubble but I had to ask how much his monthly premiums are for both his Medicare and AARP policies. He said the two combined are about $400.00. I explained the reason he doesn’t have any out-of-pocket expenses is that he pays for his care in advance of his visits. Furthermore, he was paying close to $5,000.00 per year even if he didn’t see a doctor or have any prescriptions filled. If he had used the VA for all his care, it would have cost less than $100.00 for the entire year. He didn’t seem to understand he was paying far more than the VA requires. He was just upset he is billed $15.00 for his Primary Care Provider and pays $8.00 per month per medication.