Veterans Face Choices with Health Reform Law

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With the Patient Protection and Affordable Care Act set to take effect next year, many veterans are struggling to get the information they need to make important decisions about medical care. Medicare expert Diane Omdahl warns that many veterans are at risk of being misinformed, which may cost them thousands of dollars in enrollment penalty fees.

According to the U.S. Department of Health and Human Services, nothing in the law will affect access to the care veterans may already receive through the VA medical system or Tricare. Veterans enrolled in VA health care do not need to obtain additional coverage. Veterans receiving VA health care will have the option to enroll in an additional insurance plan through the new health insurance exchanges, which open in 2014.

Veterans who are happy with their current coverage do not need to make any changes. If they’re not happy, they can explore their options, said Omdahl, who also is co-founder of 65 Incorporated, a health care information company (

Under the health reform law, current guaranteed Medicare-covered benefits won’t be reduced or taken away, nor will the ability of seniors to choose their own doctors. However, veterans need to be aware of how the new health care law affects veterans and Medicare, Omdahl said.

For veterans who are eligible for Medicare Part D prescription drug coverage, enrollment in the VA health care system is considered creditable coverage for Medicare
Part D purposes. This means that VA prescription drug coverage is at least as good as the Medicare Part D coverage. Since only veterans may enroll in the VA health care system, dependents and family members do not receive coverage under a veteran’s enrollment.

There is, however, one significant area where VA health care does not qualify as creditable coverage: Medicare Part B. Because VA health care is not a health insurance plan, it is not considered creditable coverage for Medicare Part B, which covers outpatient services, including doctors’ fees. So while veterans may avoid the late enrollment penalty for Medicare Part D by citing VA health care enrollment, they cannot do the same to avoid the late enrollment penalty for Part B.

For the 56 percent of veterans with private insurance coverage, new consumer protections prevent insurance companies from dropping them if they get sick or injured. And there are no longer any lifetime limits on how much insurance companies will cover.

Veterans who are not eligible for VA health care or other coverage may be eligible to receive tax credits for insurance bought in the exchanges. This may also apply to their families. Those exchanges will provide access to much-needed care for the 1.3 million veterans who are neither insured nor eligible for VA health care.

Uninsured veterans may also benefit from the Medicaid expansion. But, according to the Robert Wood Johnson Foundation, of the veterans who are potentially eligible for that coverage, fewer than half live in states committed to expanding Medicaid.