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Family Members
VA wants all Veterans and their families to receive health care that improves their health and wellbeing.
Family members are a key part of Veterans good health and support network. VA health care coverage is available for family members of certain Veterans who are permanently and totally disabled or died serving our country and in some cases, Veterans with children who have Spina Bifida.
Family Members and the Marketplace
The Affordable Care Act, also known as the health care law, was created to provide more Americans with access to affordable health insurance, improve the quality of health care and health insurance, and reduce health care spending in the U.S. Under the health care law, individuals:
- must have health insurance that meets the “minimum essential coverage” requirement, or
- must pay an “individual shared responsibility payment,” also known as a “penalty,” when filing their taxes if they can afford to buy health insurance, but choose not to buy health insurance, unless they meet certain requirements to qualify for an exemption from paying the penalty.
Visit https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-individual-shared-responsibility-provision for more information.
The Marketplace is a new way to shop for and purchase private health insurance (for example, health coverage other than VA health care programs) that fits your budget and meets your needs.
The 2018 Health Insurance Marketplace open enrollment period is November 1, 2017, through December 15, 2017. For details regarding enrollment dates, visit https://www.healthcare.gov/quick-guide/dates-and-deadlines.
Family members who are not enrolled in a VA health care program and who do not meet the health care law coverage standards should use the Marketplace to get coverage. They may get lower costs on monthly premiums or out-of-pocket costs. They could be eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). They can submit an application for health care coverage through the Marketplace, and learn the amount of assistance they are eligible for. For more information, visit www.healthcare.gov.
If your family members have access to affordable coverage but remain uninsured, you may have to make payment when filing your taxes. This payment will either be a flat fee or a percentage of your taxable household income, depending on which amount is higher. You do not have to pay a fee if your family members have coverage that meets a minimum standard (called “minimum essential coverage”).
Exemptions from the payment will be granted under certain circumstances. For more information on these exemptions, visit www.healthcare.gov.
CHAMPVA Beneficiary? What You Should Know
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), is a health care benefits program that provides coverage to the spouse or widow(er) and to the dependent children of a qualifying Veteran or Servicemember who:
- is rated permanently and totally disabled due to a service-connected disability, or
- was rated permanently and totally disabled due to a service-connected condition at the time of death, or
- died of a service-connected disability, or
- died on active duty, and
- has dependents who are not eligible for Department of Defense TRICARE benefits.
In addition, primary caregivers of OEF/OIF Veterans may be eligible to receive CHAMPVA coverage if they are not already entitled to care or services under a health plan contract, including Medicare, Medicaid or workers compensation.
Under CHAMPVA, VA shares the cost of covered health care services and supplies with eligible beneficiaries.
Coverage under VA’s CHAMPVA program means you already satisfy the requirement to have health care coverage under the Affordable Care Act, also known as ACA or health care reform. You don’t need to do anything more to avoid an individual fee from the IRS. Beneficiaries continue to enjoy health care coverage without having to pay enrollment fees, monthly premiums or deductibles.
For more information, visit our CHAMPVA website or call 1-800-733-VETS (8387) Monday through Friday from 8 a.m. until 8 p.m. Eastern.
Spina Bifida beneficiary? What You Should Know
The Spina Bifida Health Care Program is a health benefit program administered by VA for Vietnam and certain Korean Veterans' birth children who have been diagnosed with spina bifida (except spina bifida occulta). The program provides reimbursement for medical services and supplies.
Coverage under VA’s spina bifida program means the beneficiary has satisfied the requirement to have health care coverage under the Affordable Care Act also known as ACA or health care reform. Nothing more needs to be done to avoid an individual IRS fee. Beneficiaries continue to enjoy health care coverage without having to pay enrollment fees, monthly premiums or deductibles.
For more information, visit VA’s Spina Bifida website or call 1-888-820-1756.
