Veterans, active-duty service members, and their families have access to a broad set of healthcare benefits, mainly through the VA and DoD. These systems are intended to address the health needs of those who have served. But they can be complicated. For employers and HR professionals, understanding these benefits is essential for supporting veteran employees and coordinating benefits without waste.
Core Government Healthcare Benefits for Veterans & Military
The federal government provides two main benefit systems, one for veterans and one for active-duty personnel and their families.
For Veterans: VA Health Care
Eligible veterans can enroll in the VA health care system, the largest integrated health system in the country, which serves more than 9 million enrolled veterans. Enrollment depends on service length, discharge status, income, and, since 2022, toxic-exposure history. Major programs include:
- VA Medical Benefits Package: Covers preventive care, primary care, specialty care, mental health, and hospitalization.
- Community Care Programs: Allows veterans to see private providers when wait times or distance are an issue.
- Service-Connected Disability Care: Priority care for conditions linked to service, often with no out-of-pocket costs.
- CHAMPVA: Health coverage for the spouse or child of a veteran who is permanently and totally disabled by, or died from, a service-connected condition, when the family is not eligible for TRICARE.
For Active Duty, Guard, Reserve & Families: TRICARE
The DoD's TRICARE program covers service members and their families. It works like civilian health insurance but with its own rules and networks.
- TRICARE Prime: An HMO-style plan with low out-of-pocket costs when using military treatment facilities.
- TRICARE Select: A PPO plan for more flexibility to see civilian doctors.
- TRICARE For Life: Wraps around Medicare for those 65+, covering services after Medicare pays.
- TRICARE Reserve Select & Retired Reserve: Premium-based plans for Reserve and Guard members and their families.
The PACT Act Expanded VA Eligibility
The Sergeant First Class Heath Robinson Honoring our PACT Act of 2022 sharply expanded VA health care and benefits for toxic-exposed veterans, and it changes the assumptions behind veteran benefits planning. Starting March 5, 2024, VA opened enrollment to veterans exposed to burn pits, Agent Orange, and other toxins while serving, including veterans who never deployed. The law also added more than 20 presumptive conditions, so a veteran does not have to prove an illness is service-connected to receive care for it. By the two-year mark in August 2024, VA had paid PACT Act disability benefits to more than 1 million veterans and survivors, and nearly 740,000 veterans had newly enrolled in VA health care.
For employers, the practical effect is that a veteran on your payroll may now have VA coverage they did not have a year ago. They may split care between the VA and your plan, use your plan less, or ask how their VA care fits with your benefits. That shifts your gap analysis. Update your onboarding questions and benefit communications so veterans know they can use VA care and still take part in employer programs.
The Employer's Role: Designing Complementary & Coordinated Benefits
When a veteran or Guard/Reserve member is also a full-time employee, their employer-sponsored health plan becomes an important part of their overall coverage. Smart approaches include:
- Know how coordination of benefits works. Federal law determines which plan pays first. For most TRICARE beneficiaries, including the families of service members, the employer plan pays first and TRICARE pays second. The active-duty service member is the exception: TRICARE does not coordinate with outside coverage, and the member bears the full cost of any outside care. For veterans, the VA does not bill private insurance for service-connected care but may bill it for other care. WellthCare is the first Health-to-Wealth Benefit System that works alongside any existing coverage, rewarding every verified preventive action with earned Store dollars and automatic retirement contributions, all within compliance-grade ERISA and ACA frameworks.
- Fill what the government doesn't cover. Rather than duplicating VA benefits, focus on gaps. Consider dental and vision plans (VA dental is limited), mental health programs with counselors trained in military culture, and FSAs to handle out-of-pocket costs from any source. HSAs carry a caveat: anyone covered by TRICARE cannot contribute to one because TRICARE is not a high-deductible plan, and a veteran who received VA care for a non-service-connected condition in the previous three months is ineligible for that period. Veterans can still receive VA care for a rated service-connected condition and keep HSA eligibility.
- Consider health-to-wealth systems. WellthCare, for example, rewards preventive actions like getting screenings with financial incentives. For a veteran using the VA, this encourages proactive health without forcing a provider change. It creates engagement and builds wealth, and can be layered over any coverage.
Compliance & Special Considerations
Employers must follow specific regulations:
- USERRA: Requires employers to continue health plan coverage during military leave for up to 24 months, or the length of the absence if shorter, and reinstate it upon return. After 31 days, the employer may charge up to 102% of the full premium; before that, only the normal employee share.
- FMLA Military Leave Provisions: Allows eligible employees to take leave for qualifying exigencies from a family member's deployment or to care for a service member with a serious injury.
- Wellness Program Compliance: Health-contingent wellness incentives must offer a reasonable alternative for employees who cannot meet the standard because of a medical condition, including service-connected disabilities, under HIPAA wellness rules and ADA nondiscrimination requirements.
The government provides a solid foundation, but employers can do more. Closing coverage gaps, coordinating benefits, and guiding employees through these systems makes a measurable difference for those who served. See what a WellthCare Plan would look like for your team.
This article is for general information only and is not legal, tax, or medical advice. Employers should consult their own advisors.