Last Friday, March 14, in collaboration with HHS and our community partners, VA hosted a Google+ Hangout to provide uninsured Veterans, their family members, caregivers and advocates with the information they need about healthcare options and the Affordable Care Act. If you missed the event, you can still watch it here:
We received some very insightful questions during the event, and while we were unable to get to all of those questions during the hangout, we followed up with our subject matter experts for a response.
Here is what they told us:
“What are the options for family members reaching 26 years age who will need health care? When would they be able to enroll?”
They can enroll in the Healthcare Marketplace. For example, if someone is on their parents’ plan until age 26 and they turn 26 after March 31 – the deadline for open enrollment – that would trigger what’s known as a special enrollment period. In the marketplace, a person generally qualifies for a special enrollment period of 60 days following certain life events, such as a loss of other health coverage. This means a person can enroll in coverage outside the open enrollment period.
Also note that, depending on the family member’s state and income, he/she may also be eligible for Medicaid, which provides health coverage to those with limited incomes. People can enroll in Medicaid in their state at any time-there is no limited enrollment period for these programs.
“I don’t have private insurance. If I have an emergency and the ambulance takes me to a non-VA hospital, will the VA cover the emergency hospital bills until I can be transferred to a VA hospital? Thanks.”
VA does allow payment for emergency care services in certain situations. Pre-authorization is one way, but in an emergency, pre-authorization is not always possible. If a Veteran believes his life or health is in danger, it is always important to call 911 or go to the nearest emergency room right away. VA has programs that don’t require pre-authorization for emergency care outside of a VA medical center. One is for emergency care required for a Veteran’s service-connected condition. In this situation, payment may be limited to the point when the Veteran’s condition is stable enough for him/her to travel to a VA facility. The other is for emergency care required for treatment of a Veteran’s non-service-connected condition. In this case, for VA to authorize the non-VA emergency care, the Veteran cannot have other health care coverage and must have received VA health care within the prior 24 months.
You, your family, friends or hospital staff should contact the nearest VA Medical Center as soon as possible, preferably within 72 hours of your emergency care, so you are better aware of what services VA may or may not cover.
“So what is the difference in Obamacare for Vets? Is this the same healthcare or is there something extra or cheaper for Vets.”
If you are enrolled with VA, you do not need to take any additional steps to meet the health care laws requirements. Enrollment means you are covered. If you are not enrolled with VA you can apply at any time. Before you apply, you may want to visit www.va.gov/aca and use VA’s Health Benefits Explorer to learn about the VA health benefits you may receive.
Some of the benefits of enrolling with VA include medical care that is rated among the best in the U.S., personalized, proactive, patient-driven and high quality health care that Veterans have earned and deserve. Also, all enrolled Veterans receive VA’s comprehensive medical benefits package which includes preventive, primary and specialty care, diagnostic, inpatient and outpatient care services. Veterans may receive additional benefits, such as medically related travel benefits and dental care depending on their unique qualifications
You’ll also find there are usually no, or only low out-of-pocket costs to using VA health care. There are no enrollment fees, monthly premiums or deductibles. Most Veterans have no out-of- pocket costs. Some higher-income Veterans may have to pay modest copayments for health care or prescription drugs. The average out-of-pocket cost for 2013 was only $322.
VA offers convenience. There are more than 1,700 places available to get care. This means coverage can go with you if you travel or move.
Freedom to use other plans, including non-VA care using your Medicare, Medicaid, TRICARE or private insurance coverage along with your VA health care. Your VA care team will coordinate your health care with other VA and non-VA providers alike.
Getting more information and applying for VA health care is easy. Veterans may apply for VA health care enrollment at any time.
For more information and to apply online visit www.va.gov/aca. Check out the Health Benefits Explorer on that site to see all of the health benefits that come with Enrollment. You can also visit a local VA health care facility or call 877-222-VETS (8387). We’ll even take your application by phone.
We would like to thank everyone who participated in our Hangout, and we hope to see you all again in future events.