Health insurance is a topic most military members don’t have to think much about while they are serving. Their health care needs are taken care of them and their families so they can concentrate on their duties. But things change quickly once you remove your uniform for the last time.
In this article and podcast we cover the various health care options for military veterans and their family members after they leave the military. The options available to you may vary depending on when and where you served, how long you served, your type of discharge (and whether or not it was involuntary or at the conclusion of your contract), whether you served on active duty or in the Guard or Reserves, and other factors. We also cover health care through the Department of Veterans Affairs, buying health insurance through the Affordable Care Act, and health care options for people with low income.
We have done our best to cover most scenarios, but it’s always possible there is something we missed. Please feel free to leave a question or comment here on the article and we’ll try to point you in the right direction.
Don’t Skip Health Insurance!
One quick note before we begin – it’s very easy to gloss over health insurance when you are separating from the military – there are hundreds of other major things you need to consider, such as finding a job and a new place to live, and making ends meet so you don’t fall behind on bills. But health insurance is something you don’t want to be without. Medical bills are one of the leading causes of bankruptcy, and health insurance can often help you avoid major out of pocket expenses. If possible, try to maintain your health coverage.
TRICARE Eligibility After Separating from The Military
Unfortunately, as we said before, you can’t always take your military health care benefits with you when you leave the military. There are a few exceptions to this, including military retirees, those who qualify for Transitional Assistance Management Program (TAMP), and some veterans with service connected disabilities. In the first two examples, your family will also continue to be covered by the military health care system (TRICARE). Those who qualify for medical coverage due to a disability may be eligible for TRICARE or VA medical care, depending on their specific condition and how their separation was coded . This is something that will be determined when you separate (Here is the TRICARE page that discusses injuries on active duty). In some instances, the coverage will include the veteran and family members, and in other cases, it may only cover the veteran. We will include more specific information for each program in the following paragraphs.
Veterans not eligible for military medical coverage: If you don’t meet the the above eligibility qualifications for taking your TRICARE benefits with you, then you will be required to find your own health care. This will apply to the vast majority of veterans who didn’t remain in the military long enough to reach retirement. We will cover a few other options for finding affordable health care coverage in this article. These tips can help you find the best places to get medical benefits to make sure your family is covered.
Military Retiree Health Care Options
Military retirees are eligible for health care benefits through TRICARE. However, the plans available to you, and their related costs, are determined by whether you retired from active duty or the Reserve Corps, and in some cases by where you live, if certain options aren’t available in your location.
Active Duty Retirees: If you are an active duty retiree, you should continue to be eligible for TRICARE benefits. These benefits differ slightly from active duty benefits, as you will have to enroll and pay a small annual fee for family members. But the plans are close enough to the active duty plans that the transition should be relatively painless compared to seeking out your own insurance.
Prior to age 65 you will be eligible for TRICARE Prime or TRICARE Standard. You will need to look closely into these options to see which is the best for you. Also note that some retirees may only be eligible for TRICARE Standard if they don’t live in an area where TRICARE Prime is available. Once retirees reach age 65, they are eligible for TRICARE for Life, which can be used in conjunction with Medicare.
Here is a podcast and lengthy article on Active Duty Retirement Benefits, including health care benefits and many other benefits.
Guard / Reserve Retirees: Members of the Reserve Corps who retire are eligible to receive the same retirement benefits as their active duty counterparts once they reach age 60. Prior to that, they are not eligible to receive TRICARE Prime or Standard. However, they are eligible for TRICARE Retired Reserve, which is very similar to TRICARE Reserve Select, except the veteran is required to pay the entire cost of the premiums; there are no subsidies from the government. This can be fairly expensive compared to what they may be used to, but it is comparable to many non-subsidized health care plans.
Many retired members of the Guard or Reserves under age 60 also work a civilian job. This may give the veteran access to an affordable employer-sponsored health care plan. Beyond that, veterans may be eligible for health care from the Department of Veterans Affairs, they may purchase their own health insurance through the Affordable Care Act exchanges or through a private health insurance plan, or they may be eligible for health insurance through Medicaid, which is a state-run program that offers health care coverage for low-income individuals. We cover all of these options later in this guide.
Here is a full Guard and Reserve Retirement Benefits Guide which explains several of these options, and many more benefits, in more detail.
Guard and Reserve Health Care Options
I don’t want to tell anyone to rejoin the military simply to get health care coverage, but members of the National Guard and Reserves are eligible for TRICARE Reserve Select, which is a very affordable health insurance plan, coming in at just over $50 per month for an individual, and $200 per month for a family. The co-pays and out of pocket expenses are also very affordable. Again, one shouldn’t join the military for health care coverage, but if they miss the military environment and are seeking the other pay and benefits that come with serving, then this may be a good option.
We discuss TRICARE Reserve Select and other benefits in the article and podcast discussing joining the Guard or Reserves.
Transitioning from Active Duty to the Civilian World
There are several plans available to military members when the transition out of the military. Which health care plan you may be eligible for depends on your individual circumstances. We will cover three major plans in this next section. After that, we will show you some of the plans that are open to everyone.
- Transitional Assistance Management Program (TAMP) – available to military members making an unexpected transition from the military. Also available for family members.
- Continued Health Care Benefit Program (CHCBP) – Similar to a civilian COBRA program; available to all military members when they leave the service. Also available for family members.
- VA Health Care – Available to certain veterans, depending on individual circumstances. We will show you how to know if you qualify. Veteran only.
Transitional Assistance Management Program (TAMP)
The Transitional Assistance Management Program (TAMP) is a short term health care program which will give you and your family an additional 180 days of health care coverage after you separate from the military. The benefits are the same as active duty health care, and if you qualify, you and your family will receive DoD issued ID cards for access to health care on base.
TAMP is designed for military members and their families who are required to make a quick, and sometimes unexpected, exit from military service. Eligibility for TAMP depends on 2 factors: the reason you are separating form the military, and you must have an honorable discharge. Some qualifying reasons for separation include involuntary separation, stop-loss in support of a contingency operation, voluntary agreement to stay on active duty for less than one year in support of a contingency operation, receiving a sole survivorship discharge, and a few other select circumstances.
Involuntary Separation Guide – This article and podcast is an in-depth guide covering many of the struggles facing servicemembers facing an involuntary separation. Highly recommended if you need additional information about what to expect and how to cope with this transition.
If you are eligible for TAMP, it should show up in your DEERS profile, and it is recommended you apply for these benefits before you separate from the military. This will give you 6 additional months of active duty health care coverage, which will hopefully be enough time to find a civilian health care plan, or transition to the Continued Health Care Benefit Program (CHCBP), which is covered below.
If you do not qualify for TAMP, you and your family members may still be eligible for Continued Health Care Benefit Program (CHCBP) or some of the other health care options listed in this article.
Continued Health Care Benefit Program (CHCBP)
In the civilian world, companies offer their employees COBRA Health Insurance Coverage, which allows their employees to take their group health insurance with them when they leave their company. The only catch is the former employee is required to pay for the entire cost of the plan (i.e. it is no longer subsidized by their former employer). COBRA benefits are usually good for 18 months.
The military doesn’t have an exact COBRA program, but they offer something very similar with the Continued Health Care Benefit Program (CHCBP). Participants who are leaving the military health care system (TRICARE) are able to buy into the CHCBP.
Program eligibility: This program offers 18-36 months of benefits and is open to anyone who is leaving TRICARE, including military members and their families, children who lose age eligibility for TRICARE, divorced spouses, etc. This program is open to a wide variety of people, but there is a cost involved: the premiums for FY 2012 is $1,065 per quarter for individuals and $2,390 per quarter for families.
Here is more information about the Continued Health Care Benefit Program (CHCBP).
VA Health Care
There are many misconceptions about VA health care benefits, including who is eligible, and under which circumstances. You do not need to have a service-connected disability, you don’t need to have been wounded or injured during your service, and you don’t need to have served in a war zone to be eligible. In fact eligibility can be as simple as when and where you served.
There are several ways to be eligible for VA health care benefits. Here are just a few (check with the VA for a personalized benefits counseling session to determine your eligibility):
- Returning Servicemembers
- Members with a Service-Connected Disability
- Eligibility Based on Other Circumstances
- Low-Income Veterans
Returning Servicemembers (OEF/OIF/OND) – The VA has a program that offers VA health care for veterans for up to 5 years after they separate from the military if the veteran deployed for a contingency operation after Nov. 11, 1998. Here is a quote from the VA website: “Veterans who served in a theater of combat operations after November 11, 1998 are eligible for an extended period of eligibility for health care for 5 years post discharge.” (Source).
This program includes veterans from active duty, Guard, and Reserve and is for the veteran only. It does not offer health care benefits for family members.
Members with a Service-Connected Disability: Those with a Service-Connected Disability should be eligible for VA health care. However, their eligibility may only extend to the condition for which they have a disability rating. Other coverage may require out of pocket expenses, or may be submitted to another insurance plan for payment. Be sure to check with the VA to determine the scope of your eligibility.
Other VA Health Care Eligibility: VA health care eligibility is based on many issues, including active duty military service, type of military discharge, service-connected disabilities, medical conditions incurred while in the service, location of service, and more. You can be eligible based on your service dates, deployments you served on, or other criteria. Here is the the VA health care eligibility questionnaire.
Low Income Veterans: The VA offers health care for low income veterans. A recent change in the law (2015) removed net worth limitations. The VA will now only consider a Veteran’s gross household income and deductible expenses from the previous year. The VA automatically determines the veteran’s income and deductible expenses by matching records with the Internal Revenue Service and Social Security Administration. This reduces the burden on the veteran to file an annual income eligibility form each year.
Civilian Health Care Options
The following health insurance options are usually available to the general public, but are worth exploring when you are making the transition from the military, or any time you need to renew your plan or look for a new health insurance provider.
Here are some health care options available to the general public:
- Group and Individual Health Insurance – This includes employer sponsored plans and plans that can be found through the Affordable Care Act.
- Student Health Insurance Plans – generally available to students at some community colleges and universities. Often very affordable.
- Medicaid and Low-Income Options – Income based eligibility.
Group and Individual Health Insurance
Health insurance in the US is usually broken down into two categories: group health care coverage and individual health care coverage. A group health care plan is a health plan that is shared by a large group of people. These plans are often offered by employers as part of your benefits. TRICARE is an example of a group health care plan. An individual health care plan is just what they sound like – a health care plan that is for an individual or an individual family, and is not part of a larger group benefits plan. Many of these plans are part of the Affordable Care Act, and can be found on Healthcare.gov, or a private website such as eHealthInsurance.com (which I personally found easier to use than the government website).
How to get a group health care plan: A general rule of thumb is that you will be able to get a group health insurance plan through an employer, trade group, or another large group. Some companies also offer health care benefits to part time employees. It’s always a good idea to find out if there is a waiting period before you are eligible for benefits.
Individual health care plans: Individual health care plans vary by state and region, and there is no way I can list or cover them all on this site. The most important thing to know is which type of insurance you need, then compare plans to find the best cost/benefit ratio for your family. The best place I have found to compare individual health care plans online is eHealthInsurance.com, which offers a variety of health plans in each state. It doesn’t cost you anything extra to use a third party site, so feel free to shop around to find a site that you like.
There are pros and cons to both of these types of health care plans, and you can learn more about them here: Individual Health Insurance vs. Group Health Insurance.
Attending School? Look Into Educational Health Insurance
Most colleges and universities require students carry health care coverage while attending school, and many of them also offer affordable health care plans to enrolled students and their families. Keep in mind that you need to be enrolled in courses to be eligible for these health care plans, so plan accordingly if you are separating from the military and won’t be starting classes for a few months.
Veterans with Low-Income
Low-income veterans may also be eligible for health care through Medicaid, depending on their income. This is a program sponsored by the state and federal governments. However, each state has different rules or requirements, so it is recommended that you visit your state website or an office where you can learn more about the options available to you, specific costs (if any), and other features. You should also be aware of the options available to you through the VA.
Health Care Options for Dependents
Some of the health care options above are available to the veteran and his or her dependents, while some of the options are only available for the veteran. You may need to mix and match your coverage to ensure all family members receive health care insurance.
For example, spouses and dependents are eligible under the Transitional Management Assistance Program (TAMP), and the Continued Health Care Benefit Program (CHCBP) – both mentioned above. Divorced members may also be eligible for certain programs. Dependents may also be eligible for TRICARE up until age 26, depending on certain circumstances.
Be sure to ask questions and shop around to find the best deal for you and your entire family – even if it means the veteran receives health care from one place, and his or her dependents receive health care insurance from another provider.
Make sure you are covered
Health insurance is one of the most important types of insurance you can ever purchase – it doesn’t take much to run up a large hospital bill, and having insurance can protect you from major bills which may otherwise break you.