These rules come from the VA's own website. Your benefits depend on your service history, your disability rating and your income, so your situation may differ. If you are unsure, call us first and we will help you sort it out.
Care at non-VA hospitals
VA health care is mainly for care at VA facilities, or from community doctors the VA approves ahead of time. A trip to a non-VA hospital is not always covered.
The VA can pay for emergency care at a non-VA hospital in some cases, but the rules are strict:
- The VA must be told within 72 hours of when your emergency care starts. The hospital should do this, but you or a family member can too.
- You generally need to be enrolled in VA health care.
- For a condition that is not service connected, you usually must have had VA care in the 24 months before the emergency.
- The emergency has to be one where waiting could have put your life or health in danger.
- If you have other insurance, VA payment may be limited, and the VA will not pay copays your other insurance charges.
Medicare covers emergency care at hospitals across the U.S. that take Medicare. That is one reason many veterans keep Part B as a backup.
Coverage for your spouse
VA health care covers the veteran, not the family. Some spouses can get CHAMPVA, which is mainly for families of veterans rated permanently and totally disabled from a service-connected condition. Others have TRICARE through military retirement. Many spouses rely on Medicare and a plan of their own. When a veteran turns 65, it is a good time to check the spouse's plan too.
Routine dental care
Most veterans do not get routine dental care from the VA. Dental care depends on your eligibility class. Some examples from the VA:
- A service-connected dental condition with disability pay can mean any needed dental care.
- Former prisoners of war can get any needed dental care.
- A permanent 100% disability rating, or being paid at the 100% rate for unemployability, can mean any needed dental care.
- Other classes cover one-time or limited care in certain cases.
If you are enrolled in VA health care or CHAMPVA, you may be able to buy dental insurance through the VA Dental Insurance Program (VADIP). Original Medicare does not cover routine dental either. See your dental, vision and hearing options.
Long-term care
The VA does offer nursing home care, but there are limits. You must be enrolled, the VA must decide you need it, and there must be space near you. Whether the VA helps pay depends on your income and your service-connected disability. You may owe a copay.
Assisted living facilities are not run or paid for by the VA. The VA may help with some extra services, but you may need Medicaid or private coverage for the rest. Medicare also does not pay for long-term custodial care, so this is a gap worth planning for early.
Travel to your appointments
Not every veteran gets travel pay. To be paid back for mileage, you must be traveling for VA care or VA-approved care, and meet at least one other rule. Examples include a disability rating of 30% or higher, traveling for a service-connected condition, receiving a VA pension, or having income below the VA pension limit.
Life insurance and burial benefits
VGLI. Veterans' Group Life Insurance lets you keep term life coverage after you leave the military, as long as you pay the premiums. You can get coverage up to the amount you had with SGLI while serving. You generally must apply within 1 year and 120 days of leaving. If you apply within 240 days, there are no health questions. The cost depends on your age, so it goes up as you get older.
Other life insurance. If you missed the VGLI window, or the price has climbed, a private policy may be worth comparing. Some veterans choose a small whole life or final expense policy so family has cash for bills. Learn about final expense coverage.
Burial benefits. For eligible veterans, the VA can help pay some burial and funeral costs, a burial plot, and the cost of moving remains. The VA is clear these benefits help with some of the costs, not all. Many families do not want to leave the rest as a burden, so they plan for it ahead of time.
Not sure where your gaps are? Call (816) 307-6165 or book a free review. We will go over what the VA covers for you and what the plans we offer can add. Our help is free.
Questions people ask us
Will the VA pay if I go to a non-VA emergency room?
Sometimes. The VA has strict rules, including telling the VA within 72 hours, and for many veterans, having VA care in the past 24 months. Medicare can help cover a non-VA emergency visit, which is one reason many veterans keep Part B.
Does VA health care cover my wife or husband?
No. VA health care covers the veteran. Some spouses can get CHAMPVA or TRICARE, but many spouses rely on Medicare and a Medicare plan of their own.
Does the VA cover dental care?
Only for some veterans. The VA uses eligibility classes, such as a service-connected dental condition or a permanent 100% disability rating. Many veterans do not qualify for routine dental care.
Is VGLI the same as my old SGLI?
VGLI is the life insurance you can keep after you leave the service, up to the amount you had with SGLI. You generally must apply within 1 year and 120 days of leaving, and the cost goes up as you get older.
Will VA burial benefits pay for the whole funeral?
No. VA burial benefits help with some burial, funeral and plot costs for eligible veterans, but they are not meant to cover the full cost. Many families plan for the rest with savings or a final expense policy.