Example of how vets are excluded from VA healthcare

Imagine the frustration a young self-employed veteran might feel when deciding to enroll in the relatively simple VA health care program, a benefit earned, rather than in an expensive complicated Obamacare marketplace place. He finds the VA’s Benefit Explorer tool (buggy IMO), enters some basic information, and then reads:

“Based on the information you provided, it appears we cannot enroll you in VA Health Care at this time due to your income exceeding the established income thresholds for enrollment. Although you might not be eligible for enrollment at this time, VA strongly encourages you to apply now. This will allow VA to automatically reassess your application information if there is a change to the Public Law or other qualifying criteria is met.”

“Other qualifying criteria?” “Public Law” changes?  The door to confusing VA-Land is shut when he comes knocking.


Image: PD Pixabay

In this post, I decided to see what a vet might have to pay for private insurance as a painter (Dept. of Labor occupation SOC #47-2141) across several states, if excluded from Priority 7 or 8.  Here are the characteristics I used.  Gender: male; Age 35; Non-smoker; Single; did not serve in any combat zone; takes no medications. He recently injured a knee hiking and it didn’t heal correctly. Now painful, it is interfering with his work.  He anticipates minor outpatient surgery and determines that he needs a GOLD plan.

A  top-notch painter, he earns in the 90th percentile in his state.  I picked these states because they all allow interstate insurance sales. These are my best guess estimates using government data and may not be accurate.


Fair? In this example, Congress excludes four out of five veterans from VA health care for working hard as a self-employed painting contractor.  If this vet hurts himself on the job, there is no workman’s compensation to back him up.  So the choice is go without and pay the penalty or pay for insurance.  The other choice is not to work so hard or be so honest.  


In Lexington, Kentucky, our hypothetical vet could see one of eight orthopedic surgeons for his knee treatment.   He gets to decide, go VHA or private, because he isn’t allowed to have both.  The Maine and Wyoming veterans will pay high premiums. Neither system makes much sense but the veterans should at least be able to access VA care if he/she chooses–especially for preventative services.   This is why young people are balking at paying these high premiums to for-profit companies; they realize that bronze plans are a bad deal altogether.


Image: Pixabay

About Laura

NW Vermont.
This entry was posted in All about Veterans, Food for thought, General Messages, Guest authors, non-va care, Uncategorized, VA Health Care and tagged . Bookmark the permalink.

4 Responses to Example of how vets are excluded from VA healthcare

  1. Ron says:

    It has always been a curiosity to me as to how a man that served in combat, faced insurmountable odds and overwhelming resistance from a smaller less equipped army, like the NVA for example, would be so passive when it comes to dealing with the non-hackers at the VA.
    While I am not criticizing them, where is the attitude that we displayed after returning from Nam of “IT is mine by God and I am going to have it.”

    There is also something to be said about congress and their passing ludicrous laws regarding veterans. Today we have a vast majority of men and women in the house and senate that never had the backbone and gonadal tissue to serve in the military, let alone a combat zone. There was a study done in the nineties of the over five hundred members of congress and the study proved that they are a majority of sociopaths that are interested in themselves only. This proves to be true especially when it comes to veterans. That is why the rules are stacked against us. Also that is why the current administration hates veterans.

    • Kiedove says:

      A lot to consider in your comments. I think George Bush senior was the last president to have served in the military. We now have unneeded military bases all over the world. Why? Money talks.

  2. john king says:

    I am 100% vet and VA attempts to bill my private insurance every time I use the VA. I told my insurance not to pay and now they sent the VA a bill for service refunds. The VA health care system needs to be pulled down and something else put in its place that actually serves vets and not the buck passer’s that run the joint now. Every vet should have access regardless of income. If I were not SC I would not be able to use the VA just based on my income from some investments I made over 30 years. I took all the risks and pay the tax and I would get nothing. By the way the VA cut off my pain meds after 10 years because pills got lost in the UPS system.

    • Kiedove says:

      re: pain meds. If my private doc ordered pee drug tests routinely, every visit, I would leave. But I guess the VA does this because, as they found at Tomah (VA) poor vets were selling some of them because otherwise they would have been markers in the urine. And some vets abuse meds or confused, take the wrong dose. But what a waste of time and money to screen everyone. Insulting too in many cases. Lost meds–now they use tracking and send a shipment notice via email which we like.
      A postal worker may have stolen yours. They’ve been caught stealing gift cards, packages, etc..

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