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Enrolled with VA? What You Should Know
Your Enrollment Means You Don’t Need to Take Additional Steps
If you are enrolled in any of VA’s programs listed below, you don’t need to do anything more. You meet the requirements to have health care under the health care law:
- VA health care program
- Civilian Health and Medical program (CHAMPVA)
- Spina bifida health care program
The health care law does not change your VA health care benefits or out-of-pocket costs. You can continue to enjoy VA health care, which means you have:
- Medical care rated among the best in the U.S.
- Immediate benefits of health care coverage. Veterans may apply for VA health care enrollment at any time.
- No enrollment fee, monthly premiums, or deductibles. Most Veterans have no out-of-pocket costs. Some Veterans may have to pay small copayments for health care or prescription drugs.
- More than 1,500 places available to get your care. This means your coverage can go with you if you travel or move.
- Health care coverage that meets the minimum essential coverage standard under the law
The goal of the VA health care system is to achieve excellence in patient care and customer satisfaction. VA’s medical mission is singular — to serve Veterans by providing the highest quality health care available anywhere in the world. America’s Veterans deserve nothing less.
For more information about your health benefits, visit www.va.gov/healthbenefits anytime or call 1-877-222-VETS (8387) Monday through Friday from 8 a.m. until 8 p.m. Eastern.
You, VA and the Internal Revenue Service
The Affordable Care Act requires most U.S. taxpayers to declare they have minimum essential health coverage on their annual federal income tax return. In December, VA will begin sending out letters notifying all enrollees and beneficiaries of their VA health care coverage for the 2016 year. Enclosed with this letter will be IRS Form 1095-B “Health Coverage,” which includes details about your VA health care coverage for the 2016 calendar year. You will need this form to complete and report your coverage on your 2016 income tax return. Please keep IRS Form 1095-B for your records. The VA will also provide IRS Form 1095-B to the Internal Revenue Service for every Veteran who received health care coverage through VA in calendar year 2016, as required by law. If you or your dependents had a gap in coverage that lasted 3 consecutive months or more, then you may have to pay what is called the “individual shared responsibility payment” or penalty. Your 1095-B will reflect which months you did not have health insurance, if applicable. Please visit https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-individual-shared-responsibility-provision for more information on the IRS website for Questions and Answers on the Individual Shared Responsibility Provision. Expect to receive your 1095-B form by mail on or before March 02, 2017.
VA and Other Health Insurance
If you have other forms of health care coverage, such as a private insurance plan, Medicare, Medicaid or TRICARE, you can continue to use VA along with these plans. Remember: it is always a good idea to inform your VA doctor that you are receiving care outside of VA. This helps your provider to support coordinated health care that is safe, appropriate, and effective.
Health Insurance Marketplace
The Marketplace is a way to shop for and purchase private health insurance (for example, health coverage other than VA health care programs) that fits your budget and meets your needs. People who purchase insurance through the Marketplace may be able to lower the costs of health insurance coverage by paying lower monthly premiums. The 2017 Health Insurance Marketplace open enrollment period is November 1, 2016 through January 31, 2017. For more information, visit https://www.healthcare.gov/get-coverage/.
Family Members and the Marketplace
Even though you are covered by your VA health care enrollment, your family members who are not enrolled in a VA health care program and who do not meet the health care law coverage standards should use the Marketplace to get coverage. They may get lower costs on monthly premiums or out-of-pocket costs. They could be eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). They can submit an application for health care coverage through the Marketplace, and learn the amount of assistance for which they are eligible. The 2016 Health Insurance Marketplace open enrollment period is November 1, 2015, through January 31, 2016. For more information, visit www.healthcare.gov.
Canceling Your Enrollment…A Word of Caution
If you choose to cancel your VA health care enrollment, you may reapply for enrollment at any time; however, acceptance for future VA health care enrollment will be based on eligibility factors at the time of application, which may result in a denial of enrollment.
