Navigate your post-service health care with this health insurance guide for veterans, so you can find the right coverage for you and your family.
Article: 10 minutes
Updated: October 25, 2023 Published: November 20, 2023
When figuring out whether to retire from the service or separate prior to reaching 20 years, health care needs to be part of that decision. Approximately 200,000 service members separate each year from military service, and approximately 20,000 of them retire.
Like any major career change, the overall financial decision can be difficult. Often the big choice is one of many that happen at the same time, like figuring out what you'll do for work or where you plan to live.
Military members have special considerations with their health insurance planning. Whether you separate or retire from service will determine which path of options you have. This guide will serve as a high-level resource to help navigate your health insurance in the near term as well as into your future.
For most, TRICARE ends after military separation. Several programs are designed to help service members and their family to receive transitional and temporary health coverage. But these programs aren't intended to be long-term replacements for your health insurance needs.
If you've entered the civilian workforce and your employer offers health care benefits, you may be able to enroll in a health insurance plan. Typically, employers offer an enrollment opportunity to new employees at the start of their new job. But benefits may have a waiting period before they can be used.
Your new employer could have multiple options with different costs and benefits. It's important to know the different plan types and key terms when making your health insurance plan decisions. Get a head start by reading our Health Insurance 101 guide.
If your job doesn't provide benefits or perhaps, you're a small business owner and looking for options to get your own health insurance coverage in place, the federal health care exchange may be an option. See note 1
The health care exchange, or marketplace, has a variety of plans available in your location. Each plan will be classified in tiers from bronze up to platinum. You can use the tiering for a basic comparison.
But your decision should be determined by your unique financial situation. You may not need to buy a platinum plan when a silver plan could meet your needs when it comes to deductibles, premium cost and network.
Dental and vision care can come in a few varieties. Some plans operate like traditional insurance with copays and deductibles, while other plans may provide a fixed or limit of benefits. Dental and vision care can be vital to your health and well-being, so it's important to have a plan in place for your care needs.
The TRICARE Dental Program is a voluntary dental insurance program for eligible family members of active-duty service members, National Guard and Reserve members, and their families. At military separation, enrollees will need to acquire dental coverage from another provider.
Regular dental and vision care can be helpful as part of your physical wellness, but this care can also detect related ailments that you may not expect. For example, poor dental hygiene can be connected to increased risk of cardiovascular disease, pneumonia and diabetes.
For many Americans, their ability to earn income is their most valuable asset. If you become disabled after your military service or due to a non-service-connected reason, you could be financially at risk. Disability insurance can help replace your income while you're recovering or rehabilitating. Some plans can also offer benefits if you're permanently disabled and can't work.
Dental, vision and disability insurance can typically be purchased directly through a provider or a broker. Learn more about dental and vision options from USAA.
According to the Veterans Affairs, veterans are covered for checkups with a primary care doctor and care from specialists. VA care can also provide home health equipment, prosthetics, prescriptions and elder care needs.
In most cases, veterans with at least an honorable discharge can receive medical care from a VA facility. But care is prioritized based on VA priority groups. See note 1
Priority groups will be based on your military service history, your disability rating, income level and other benefits you could be receiving. Veterans who acquired a disability in the line of duty are assigned the highest priority.
If you have a service-connected disability, it makes the most sense to receive care from the VA versus going to a different care provider. This will also help you with any ongoing reviews of your disability rating. You shouldn't have any out-of-pocket costs for treatment related to your disability.
If you don't have a service-connected disability and earn above VA income limits, you'll likely be assigned a lower priority group tier. Groups 7 and 8 could be responsible for copays for care received. Copays can vary based on the medical service or treatment, read more about the different copay rates. See note 1
Consider your proximity to a VA facility, wait time for care and potential copays when deciding if you should use VA health care benefits versus other health care providers. If you have private health insurance, you can compare copays and other out-of-pocket costs for care that you may receive with your insurance plan network versus the VA.
TRICARE can transition with you into retirement, although it takes on a slightly different shape. Depending on your region and what you want from your health insurance plan, you have several choices within the TRICARE system. Some of the most common options include:
If you have access to TRICARE Prime or TRICARE Select in addition to plan options through your work, you should compare the plan costs, coverage networks and potential out-of-pocket expenses.
There are several other TRICARE plans available for different service member groups like those living overseas or retired reserves. For more information about the other TRICARE plan types, visit TRICARE.mil. See note 1
Most military retirees will go onto a second career, often in a civilian job. If your new employer provides access to health insurance plans, it may make good sense to enroll in one.
Your new employer could have multiple options with different costs and benefits. It's important to know the different plan types and key terms when making your health insurance plan decisions. Get a head start by reading our Health Insurance 101 guide.
Compare your employer options and TRICARE plans you can access. You may find that your enrollment fees with TRICARE are less than your employer health insurance premiums, but you'll want to compare provider networks as well as out-of-pocket costs for medical services.
In circumstances where you may live in an area that doesn't have TRICARE authorized providers and no access to employer provided insurance options, you can get access to a variety of health insurance providers and plans in your area. Health insurance plans offered through the federal exchange can qualify for premium tax credits or subsidies based on your financial makeup.
USAA's health insurance shopping guide can give you tips on what to look for in your health insurance.
In 2018, the TRICARE Retiree Dental Program shut down. This change effected military retirees and their family members because they needed to find a new provider for their dental care needs. During the shutdown, TRDP enrollees were encouraged to look at the FEDVIP program, which offers supplementary health insurance to federal employee retirees, or look for coverage from a private provider like USAA.
Disability insurance will be an important protection to maintain during your employment. As you get closer to civilian retirement, your assets may offset your need for income replacement protection, and you may want to shift your focus to planning for long-term care needs, discussed more below.
Like health insurance shopping, you should compare the features, benefits and costs of all plan options and choose the one that best suits your needs. You have no requirements to pick one plan over another.
As you near or reach age 65, you'll be able to enroll in Medicare. Depending on your employment status and where you get your current health insurance from, you may need to enroll in Medicare. The Centers for Medicare and Medicaid Services created a helpful guide on when you should enroll in Medicare. See note 1
For military retirees, the conversation may be simpler than for civilians. Health insurance beyond your employed years is provided by Medicare and TRICARE For Life.
TRICARE for Life works as a Medicare supplement plan. But it's a free benefit to you as a military retiree. Although you won't have no enrollment fee or process, you must enroll in Medicare Parts A and B. You will pay for Medicare Part B premium that will be based on your income.
Medicare becomes your primary insurance and TRICARE for Life wraps around Original Medicare coverage. Coverage will begin automatically the first day Medicare Parts A and B are in effect. Claims are typically filed with Medicare directly by your provider, and then Medicare will file with TRICARE to coordinate coverage and payments.
Typically, services that both Medicare and TRICARE cover will be fully paid for, and you should have no out-of-pocket costs. But you may have some out-of-pocket expense if you receive services that aren't fully covered by Medicare and TRICARE.
For example, if you have a stay in the hospital for less than 60 days, Medicare will cover your costs at 100% after you've met a deductible of $1600 for 2023. The deductible is paid for by TRICARE, and you pay $0 for services received during that stay. There are some scenarios in which you may have cost-sharing expenses, but those are usually for extended stays beyond 150 days. For more information, review the TRICARE for Life Cost Matrix guide. See note 1
Bottom line is that if you have TRICARE for Life, you won't need a different Medicare Supplement plan or Medicare Advantage plan. TRICARE for Life should be considered the gold standard plan when it comes to both coverage and costs.
Depending on your financial position and family dynamic, you may want to evaluate other types of insurance planning in addition to your health insurance choices. Health insurance is meant to cover rehabilitative or recovery care. But when there is a change to your daily function of living, other factors may come into play.
Long-term service and support are needed by nearly 70% of Americans over 65 years old. Having a home health aide or the support of a full-time care facility may not be covered by your health insurance plan beyond a certain number of days. The costs can quickly erode your savings and potentially be burdensome to family members.
As part of your health insurance planning into your retirement years, plan for your long-term care needs. Although not everyone needs insurance, everyone needs to have a plan that addresses costs, care and impacts to their family.
As a federal retiree, you can potentially acquire long-term care insurance through the Federal Long Term Care Insurance Program (FLTCIP). You can also acquire traditional long-term care insurance or life insurance solutions that address long term care costs. Review each option carefully and work with a reputable advisor or specialist as needed. Visit USAA's Long-term care site for more information about options.
Whether you're separated or retired from military service, the USAA team is ready to help you. Learn more about options available through USAA and our partner organizations by visiting USAA.com/healthsolutions. You can also speak to a USAA health solutions specialist at 800-531-USAA (8722).