Who Is Eligible for VA Healthcare Benefits?

VA LogoThis is a question of great importance to service members who may be retiring, simply leaving the service, or those who may have incurred a disability in combat. Obviously, it is also of great concern to spouses and their dependents. As is true in the form of any military benefits, each individual must meet certain criteria in order to be eligible for any form of benefit.

In the case of a spouse, widow or dependent children, in order to qualify, the veteran or service member needs to meet any of the following criteria:

  1. The soldier must be rated as a permanent and totally disabled veteran (100% disabled). This must be due to a service-connected disability incurred while on active duty. This includes a reservist/guard who was injured while on duty (includes drills, training, and activations).
  2. Must have been a war related disability at time of death.
  3. Die during active duty.
  4. If the dependents are not eligible for Department of Defense TRICARE benefits.

Tricare is a regionally managed healthcare program for active duty soldiers or retired members of the uniformed services, their families and survivors. It actually works quite simply. A VA facility bills Tricare for non-service-connected medical treatment. Visit the Tricare website at www.tricare.mil. This is the official website of the Defense Health Agency (DHA) which is part of the Military Health System.

CHAMPVA shares the cost of covered health care services. Coverage under CHAMPVA proves your eligibility for healthcare coverage under the Affordable Care Act (ACA) or Healthcare Reform. With this you will have no more deductibles, monthly fees or co-pays. It is also good to remember that your insurance coverage or lack of coverage does not determine your eligibility for treatment at a VA facility.

In addition, family members who are primary caregivers of OEF/OIF veterans may be eligible to receive ChampVA (formerly CHAMPUS) if they are not already entitled to care under a health plan or contract such as Medicare, Medicaid or workers compensation. For example, if a veteran’s sister, spouse, or child has legally been declared as their primary caregiver; legally responsible for them. A good link for additional information and instructions on applying is http://www.va.gov/HEALTHBENEFITS/apply/family_members.asp. It is of significant importance to understand that VAHC is not considered a health insurance plan. You can visit the CHAMPVA website or call 1-800-733-VETS (8387).

Teresa Agostino

Teresa Agostino

Originally from Canada, Terri moved to the US at 16 and joined the Army Reserves at 17. She went active Army in 1991, and spent almost 2 years in Iraq as a program analyst for the Army Corps of Engineers. She currently works for the VA as an Accounts Management Supervisor. Terri has her MBA in HR management.
Teresa Agostino

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