What is Long-Term Health Insurance?

Before we get into the solutions for health insurance for Veterans, we need to fully understand the difference between short and long term health insurance. If you’re new to shopping for insurance because you’ve always had the military cover it, read this blog to catch up.  Long-Term Health insurance is going to last at least 18 months and go up to typically 5 years. Whereas, Short-term health insurance lasts up to 18 months and can get covered for as little as a month.

Why Would You Need Long-Term Health Insurance?

For many Veterans, we tend to avoid getting health insurance because we have the Veterans Administration cover our needs. If you haven’t already found out, the VA will cover Veterans, but they do not cover your family members, such as wife/husband or daughter.son. For this reason, most of us need to find a way to cover our families in case our new employers don’t offer a coverage plan. Before we get into the companies and plan I would recommend the most, do you know if you’re covered at the VA?

How Do I Know If I’m Covered by the VA?

One big misconception a lot of Veterans make is thinking no matter what, they’re covered by the VA for all medical bills. This can be a costly and devastating mistake if you don’t understand what qualifies you for coverage. The table below will shed some more light on who is and who isn’t covered by the VA. Any Veteran can be seen for any issues they have at any VA in the country, but if your rating is lower than 50%, you will have a copay for those issues that didn’t occur while in the military. One thing to consider is your copay will be no more than $100 in most cases, which is still substantially less than any other civilian health insurance.

% Covered by the VA
50% disabled100% of any issue, regardless of service connection or not
100% Disabled100%
Less than 50%100% for all service-connected ailments. Anything not service-connected will require a copay

Why Should I Get Health Insurance if I don’t have a family?

I don’t have enough time or space to answer all the issues regarding the VA, but I can tell you that, in most cases, civilian insurance is much better. I know many Veterans that have nothing but great things to say about the care they’ve received from the VA, but I also know just as many that have horror stories about the treatment they’ve received. My one personal example is the Air Force diagnosed me with a sprained ankle during my 2nd tour, and once I got out, the VA confirmed that diagnosis. The unfortunate thing was my ankle was not sprained; it was broken, and eventually, the bone crumbled, and I couldn’t walk with crutches for about 1 year. Finally, after I called my Senator, the VA paid for the surgery to repair my broken ankle. To make things worse, the damage has been done, and I am in line for an ankle replacement surgery. I strongly believe this would have never happened with civilian doctors in charge who had the time and concern to get me help.

 

How Do I Apply For VA Healthcare Benefits?

Luckily, this is an easy part of your healthcare process with the VA. The VA Form 10-10EZ is the form you need to fill out to apply for benefits with the VA. Just click the link above, and you can fill this application out online, but if you would like a more personal approach, just go to your nearest VA, and they will help you fill out in person.

What are the Best Health Insurance Companies for Veterans?

As far as health insurance goes, I have found that most companies are similar in the types of plans they offer their customers. I want to focus specifically on what separates these companies, which is flexibility.  The 3 companies that have set themselves apart from the competition are Anthem Blue Cross, Transamerica, and Mutual of Omaha.

Note: Every state will be different, and premiums will be different based on your income in a lot of states, as well.

Anthem Blue Cross

Anthem Blue Cross offers health insurance in their Bronze, Silver, and Gold plans, but we will keep our focus on the Bronze. If you want to learn more about their Silver and Gold plans, click and follow this link. The Anthem HealthKeepers Bronze series is distinguished by their deductible cost. The most significant difference between these plans is the Bronze X 5700 Online Plus offers lower deductibles. The overall cost to benefit ratio is best with the Bronze X5700 Online Plus Plan.

Anthem HealthKeepers Bronze X 7500 – (4B9C)

Anthem HealthKeepers Bronze X 5250 – (4B98)

Anthem HealthKeepers Bronze X 5700 Online Plus – (4B9S)

Total Monthly Cost$189$204$215
Deductible$7,500$5,250$5,700
Max Out-of-Pocket Cost$8,150 (including the deductible)$8,150 (including the deductible)$8,150 (including the deductible)
Specialist cost40% after deductible35% after the  deductible30% after deductible
Out-patient surgery40% after deductible35% after the deductible30% after deductible
Mental health40% after the deductible35% after the deductible30 after deductible
Most Generic DrugsRetail and Mail Order: You pay 40% after deductibleRetail and Mail Order: You pay 35% after deductibleRetail and Mail Order: You pay 20% after deductible
Out of area costUrgent/Emergency Coverage Only BlueCard®Urgent/Emergency Coverage Only BlueCard®Urgent/Emergency Coverage Only BlueCard®

Best: Anthem HealthKeepers Bronze X 5700 Online Plus

The Bronze X 7500 Plan offers a $26 lower deductible than the 4B9S, but it has a 10% higher deductible than the 4B9S Plan. That 10% could cost you thousands more over the year, depending on your family’s health. Most families have someone get the flu, break a leg in sport, or get into a car accident during their lives. Your chances increase if you have a bigger family, meaning that 10% can save you from financial hardship if something does happen to your family.

The Biggest difference between the Bronze X 5250 and the Bronze X 5700 Online Plus is the money you could save if you get medication shipped to your house. If you or your family needs meds shipped to your home, you will end up saving anywhere between $50-200 on each shipment. Once you add the 5% savings from each deductible category, $11 extra month seems like a great buy.

 

Runner-UP: UnitedHealthCare Doctor’s Plan

The UnitedHealthcare Doctor’s Plan looks to be the most affordable and flexible, but we do not know the deductibles for each category. The reason this plan was not the winner is due to the issue of getting a price range without calling into their company and starting a profile. So for someone who is researching each company, this makes it difficult to get a complete review. However, paying anything between $200-300 per month for a family would be a great deal. I love the flexibility of being able to call a doctor anytime you need one to get professional advice and recommendation for any medical issue you have. This plan is built around flexibility and would be perfect for any active family.

UnitedHealthcare Doctor’s Plan
Copay for primary care provider (PCP)?$0
Copay for urgent care visits$0
Copay for virtual visits$0
Copay for convenience care visits$0
24-hour virtual doctor visitsCall a doctor anytime you need one at no extra cost
24-hour access to a nurse phone lineCall a nurse 24/7 to get help with medical concerns
Health-Screenings100% covered by in-network doctors
Emergency Room VisitsA copay, plus deductible and coinsurance for emergency room visits
Preventive care – including immunizations, preventive exams100% covered for in-network doctors
Choice of own PCP100% your choice on what doctor you want to see

Student Health Plans for Veterans: Aetna Health Insurance

Aetna offers a student health plan for students in college who may not have a lot of money because they’re training to earn that money. I went to West Virginia University (WVU), and Aetna provided the coverage that I used during my last 2 years at WVU. I thought the care I received from the University medical staff was better than what I was receiving at the VA. If you’re a Veteran studying at a college or university covered by Aetna, I recommend you taking advantage of the supplemental insurance. Although this is more a short-term solution, you could use this insurance for the length of your college career. Whether that’s 4 or 8 years, you’ll pay the same rates that are given to all students in each student category (B.A, M.A, and Doctorate candidates).

What are the Qualifications?
  • Degree-seeking undergraduate students enrolled in six or more credit hours and graduate students enrolled in one
    graduate credit hour or more are eligible.
  •  Non-degree seeking Continuing Education students, Study Abroad (including Semester at Sea) students, Evening
    MBA students and students taking University-specific courses enrolled in six or more credit hours and
    paying the base student and health fees.
  •  Students approved for the Leave of Absence Program associated with their school.
What is the Coverage?
Aetna Health Insurance
Fall Semester Fee$1,874
Spring Semester Fee$1,874
Deductible per Semester$500
Max Out-Of-Pocket Costs$5,000
Routine Physical Exam100% covered for in-network care

What is the Referral Program?

If you need to see outside network care, it’s a requirement that you seek a referral from your PCP at your college or University. If you do not get a written referral from your PCP, Aetna will not pay for costs associated with your outside visit. There are, however, some exceptions that Aetna makes that are considered acceptable reasons to not wait for a referral.

Exceptions

  • Treatment for an emergency medical condition
  • Obstetric and gynecological care
  • Pediatric care
  • The school health services are closed
  • If the care you receive is more than 15 miles away from the health center
  • Routine/Preventive services not available at CU Boulder Medical Services;
  • Dermatology Expenses;
  • Home Health Care Expenses;
  • Pediatric Vision care services provided by an optometrist or an ophthalmologist
  •  TMJ
  • Removal of Impacted Wisdom Teeth
  • Outpatient Mental Health & Substance Abuse Office Visits

Conclusion

Health Insurance is the barrier that keeps us safe in the roughest times of our lives (family tragedy) and some of the best of times (children). Getting long-term health insurance for your family is a big commitment, but it’s also the easiest money you’ll ever spend.  These companies will give you the peace of mind needed to get a good night’s sleep, knowing your family is financially protected from the realities of life.