ACA Frequently Asked Questions – VA, Affordable Care Act and You

Health Insurance Marketplace Open Enrollment Period for 2022 Coverage

The Health Insurance Marketplace open enrollment period for coverage beginning in 2022 is from November 1, 2021, to December 15, 2021.

What is the Affordable Care Act?

The Affordable Care Act, also known as the Health Care Act, was established to provide more Americans with access to affordable health insurance, enhance the quality of health care and health insurance, and reduce healthcare spending in the United States. The health insurance marketplace helps individuals find health coverage. In the marketplace, some individuals may qualify for reduced health premiums and out-of-pocket costs based on their income.

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What if I don’t have health coverage?

The VA is dedicated to ensuring that veterans are aware of opportunities to meet the minimum essential standards of coverage set by the Health Care Reform Act. This can be achieved through enrollment in the VA or by purchasing insurance offered by the health insurance market.

Will you notify the IRS about the health care coverage provided to each veteran and eligible beneficiary?

Yes, the VA will send eligible veterans and beneficiaries a letter and IRS Form 1095b that provides details of VA-provided health care coverage for the previous year. The VA will also notify the IRS, as required by law.

VA Health Care Programs and Eligibility

If you are enrolled in any of the VA programs listed below, you are covered under the standards of the health care law:

• Veterans Health Care Program
• Medical and Civil Health Program (CHAMPVA)
• Spina Bifida Health Care Program

Benefits of Enrolling in VA Health Care

Enrolling in VA health care offers several advantages:

• Access to medical care ranked among the best in the US
• Immediate benefits of health care coverage with no enrollment fee, monthly premiums, or deductibles
• Over 1,500 locations available to receive care, allowing coverage to travel with you
• Meets the minimum standard for health care coverage

How to Sign Up for VA Health Care Coverage

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To sign up for VA health care coverage, follow these steps:

1. Determine your eligibility.
2. Complete and submit the VA Form 10-10EZ, Application for Health Benefits.
3. Await notification of your enrollment status.

Combining VA Health Care with Other Programs

Yes, you can continue to use VA for all your health care needs while supplementing your care with private health insurance or coverage from other federal health care programs like Medicare, Medicaid, and Tricare.

Understanding the Health Insurance Marketplace

The health insurance marketplace provides a platform to find and purchase private health insurance plans that fit your budget and meet your needs. By buying insurance through the marketplace, you can lower the costs of health insurance coverage by paying reduced monthly premiums.

VA Health Care and Assistance with Health Insurance Premiums

If you are enrolled in a VA health care program, assistance in lowering the cost of health insurance premiums outside of the VA is not available. However, you can still purchase private health insurance in or out of the marketplace to supplement your VA health care coverage.

Eligibility for Help Buying Health Insurance Outside of VA

VA cannot determine eligibility for help buying health insurance outside of Virginia. By using the marketplace, you can find out if you qualify for lower costs on monthly premiums for private health insurance plans. Remember, if you are enrolled in a VA health care program, you do not need to take any additional steps to meet the health coverage requirements under the health care law.

Family Members and Health Insurance

Family members who are not enrolled in a VA health care program must use the marketplace to obtain coverage. They may be eligible for lower monthly premiums or out-of-pocket costs. Additionally, they may qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). Visit www.healthcare.gov for more information.

Special Enrollment Period and Qualifying Life Events

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Individuals with qualifying life events, such as having a baby or getting married, can enroll in or change their health coverage outside of the open enrollment period. This enrollment is effective for the coverage year. For more information on qualifying life events and special enrollment circumstances, visit www.healthcare.gov/coverage-outside-open-enrollment.

Canceling VA Medical Coverage

Yes, you can cancel your VA medical coverage. However, acceptance of future VA health care coverage will be based on eligibility factors at the time of application, which may result in denial of health care coverage.

Reporting Health Care Coverage to the IRS

It is necessary to report whether you had health care coverage in 2020 on various IRS income tax forms, such as line 61 on Form 1040 and line 38 on Form 1040A.

Health Care Enrollment and IRS Requirement

Your health care enrollment with the VA satisfies the IRS requirement to have health insurance.

Where to Get More Information

For information about VA health care and the Affordable Care Act, visit the VA website at www.va.gov/health-care/about-affordable-care-act/ or call 1-877-222-VETS (8387) from Monday to Friday, between 8 a.m. and 8 p.m., Oriental Time. For marketplace information, visit www.healthcare.gov or call 1-800-318-2596.

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