Veterans Corner: Qualifications & Benefits: Understanding VA Healthcare

by Jim Pedersen, VSO & Director of Moore County Veterans Service Office

Our office often fields questions about VA healthcare. While county Veterans Service Offices are not part of the VA, do not schedule medical appointments, bill health insurance or enroll veterans in VA healthcare, we often are asked for information and guidance from people who are seeking those services.

VA healthcare is available to any service member who was honorably discharged and who has been classified as a veteran by the Veterans Affairs department. Any veteran who enlisted after September 7, 1980 or who entered active duty after Oct. 16, 1981, must have served 24 continuous months or the full term of active duty for which they were called to be eligible. Members of the Reserves or National Guard must have been called to active duty and completed the full term for which they were activated in order to qualify for VA medical care. Those who only had active-duty status for training purposes do not qualify.

The VA may waive the minimum duty requirement if a veteran was discharged for a disability that was caused or aggravated by active-duty military service, was given a hardship discharge or who served prior to Sept. 7, 1980.

One of the most common misconceptions among veterans is that they need a service-connected disability in order to qualify for VA medical care. That is simply not true. Factors such as service dates, where the service member was deployed, income and other factors are used to determine eligibility.

Some veterans qualify for veteran’s health care benefits based on an enhanced eligibility status. POWs, veterans who received the Purple Heart or Medal of Honor and those who receive a VA pension qualify under the enhanced programs. Additionally, any veteran who received an early discharge due to hardship or disability, who served on active duty in a theater of combat operation or who served in a war zone for a full tour are also eligible.

Veterans do need to enroll in VA health care in order to receive benefits.

What does VA Healthcare cover?

VA medical care covers a wide variety of services from preventive to urgent. Health exams and preventive care, education, immunizations including flu shots, pharmacy services and outpatient diagnostics and treatments are among the many options available at VA medical facilities. The VA also offers inpatient hospital care, acute emergency services and specialized care including intensive care for physical and mental conditions, organ transplants and traumatic injuries. Some VA health facilities offer urgent care for injuries and illnesses that don’t require an emergency room visit.

Veterans may be eligible to receive care through non-VA medical providers in their own communities. The Veterans Choice Program, formerly known as the Community Care Program, provides services when the VA can’t provide the services the veteran needs or can’t provide an appointment time within 30 days of the date the veteran is scheduled to be seen for care. Veterans who live more than 40 miles from the nearest VA medical facility with a full-time primary care physician or those who must travel by air, boat or ferry and those who are physically unable to travel to the nearest VA facility may also take advantage of the Veterans Choice program.

Is VA healthcare free?

For some veterans, VA healthcare is available free of charge. This includes those who have a service-connected injury or illness rated at 50% or higher, those who need re-adjustment counseling and other mental health services and those suffering from military sexual trauma. Additionally, Purple Heart and Medal of Honor recipients have no co-pays for care, tests or medications.

For veterans who have non-VA health insurance, it is important to provide plan information with the VA. The VA can bill your private health insurance for any costs the VA does not pay. Veterans do not have to pay any unpaid balances not covered by your private health insurance.

How do veterans enroll?

Veterans can go to their nearest VA medical center to determine their eligibility and enroll in VA healthcare. They will need to complete a form 10-10EZ. In order to complete the form, veterans will need their DD-214, service records if they were a POW or medal of honor recipient and any military records that indicate participation in a war zone or hostile combat situation.

The Moore County Veterans Service Office, located at 707 Pinehurst Ave., Carthage, is one of nearly 100 similar offices throughout the state. The office is staffed by three accredited Veterans Service Officers who help Moore County veterans apply for disability, survivor and other benefits. The office is open from 8 a.m. to 5 p.m. Monday through Friday. Appointments are needed and may be made by calling 910-947-3257.

VSO Jim Pedersen, right, is the director of the Moore County Veterans Service Office. Experienced nationally-certified VSOs Kelly Greene, and Robert “Bob” Hall, a Vietnam-era veteran who retired from the Army after 30 years of service, assist Moore County veterans with their disability claims.