Veterans Service Division 4002 Fenton Avenue Harrisburg, PA

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1 Honor the Dead by Helping the Living" Department of Pennsylvania Veterans of Foreign Wars of the United States Veterans Service Division 4002 Fenton Avenue Harrisburg, PA Commander Gary R. Smith Department Service Committee Chairman John Foster, Editor John B. Getz, Jr. Secretary John A. Brenner, Member Russell R. Canevari, Member Robert C. Eiler, Member Franklin E. Lopes, Member Albert S. Thomas, Jr., Member Larry M. Wade, Member Service Bulletin January, February, March 2015 WHAT IS THE AFFORDABLE CARE ACT? The Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to all Americans, lower costs, and improve quality and care coordination. Under the health care law, people will: have health coverage that meets a minimum standard (called minimum essential coverage ); qualify for an exemption; or pay a fee when filing their taxes if they have affordable options but remain uninsured. 1

2 The Health Insurance Marketplace helps individuals find health coverage. On the Marketplace, some people may be eligible for lower costs on health premiums and out-of-pocket costs based on their income. What happens if I do not have health coverage? You do not have to pay a fee if you have coverage that meets a minimum standard (called minimum essential coverage ). VA is required by law to notify the IRS of Veterans enrollment status in the VA health care system in Veterans who are not enrolled in the VA health care system and who do not have qualifying medical insurance, unless given an exemption, will be charged a fee beginning on their 2014 federal income tax return, which most people will file in the spring of The fee is prorated based on the amount of time in the calendar year the Veteran does not have medical insurance that meets minimal essential coverage standards. VA is committed to ensuring Veterans are aware of the opportunities to meet the health care reform law s minimum essential standards for coverage either through enrollment with VA or through the purchase of insurance offered by the Health Insurance Marketplace. The feel either will be a flat fee or a percentage of your taxable household income, depending on which amount is higher. The fee will be phased in according to the schedule below: $95 or 1% of your taxable income in 2014 $325 or 2% of your taxable income in 2015 $695 or 2.5% of your taxable income in 2016 Exemptions from the fee will be granted under certain circumstances. For more information on these exemptions, visit Will VA notify the IRS of health care coverage provided to each Veteran and eligible beneficiary? Yes. Beginning in 2015, VA will send Veterans and eligible beneficiaries a letter and IRS form 1095B which will provide the details of the health care coverage provided by VA for the previous year. As required by law, VA also will notify the IRS. If I m enrolled in a VA health care program, do I meet the requirement for health care coverage? Yes. If you are enrolled in any of VA s programs below, you have coverage under the standards of the health care law: Veteran s health care program Civilian Health and Medical program (CHAMPVA) Spina bifida health care program WHAT ARE THE BENEFITS OF ENROLLMENT IN VA HEALTH CARE? Enrollment in VA health care means you have: Medical care rated among the best in the U.S. Immediate benefits of health care coverage. Veterans may apply for VA health care enrollment at any time. No enrollment fee, monthly premiums, or deductibles. Most Veterans have no out-of-pocket costs. Some Veterans may have to pay small copayments for health care or prescription drugs. More than 1,700 places available to get your care. This means your coverage can go with you if you travel or move. Met the new requirement to have health care coverage that meets the minimum standard. HOW DO I ENROLL FOR VA HEALTH CARE COVERAGE? 2

3 You may apply in one of three convenient ways: visit call VETS (8387) or visit your local VA health care facility. Can I continue to use VA health care with other programs, like private insurance or federal health care programs? Yes. You can continue to use VA for all your health care needs, or complement your VA care with private health insurance or coverage by other federal health care programs, including Medicare, Medicaid, and TRICARE. WHAT S THE HEALTH INSURANCE MARKETPLACE? 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. People who purchase insurance through the Marketplace may be able to lower the costs of health insurance coverage by paying lower monthly premiums. I am enrolled in a VA health care program. Would I be eligible for assistance to pay health insurance premiums on the Marketplace if I choose to purchase health care outside of VA? Since VA care meets the standard for health care coverage, you wouldn t be eligible for assistance to lower your cost of health insurance premiums if you chose to purchase additional health care coverage outside of VA. However, you may still purchase private health insurance on or off the Marketplace to complement your VA health care coverage. How will I know if I m eligible for assistance to purchase health insurance outside of VA? VA can t make this determination. If you use the Marketplace, you will find out if you can get lower costs on your monthly premiums for private health insurance plans. Remember, if you are enrolled in a VA health care program, you don t need to take additional steps to meet the health coverage requirements under the health care law. Are my family members (who aren t eligible for VA or other federal health care programs) eligible for assistance to purchase health insurance? Your family members who are not enrolled in a VA health care program 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). For more information, visit WHAT IS THE HEALTH INSURANCE MARKETPLACE OPEN ENROLLMENT PERIOD FOR COVERAGE STARTING IN 2015? The proposed open enrollment period is November 15, 2014, through February 15, Can I still enroll through the Health Insurance Marketplace even when we re not in an open enrollment period? Individuals with a qualifying life event can enroll in health coverage or change their coverage outside of the open enrollment period and have it be effective for that coverage year. Qualifying life events include having a baby or getting married. Visit to learn more about these qualifying life events and other circumstances for special enrollment. Can I cancel my VA health care coverage? 3

4 Yes. However, acceptance for future VA health care coverage will be based on eligibility factors at the time of application, which may result in a denial of health care coverage. WHERE CAN I GET MORE INFORMATION? For information on VA health care and the Affordable Care Act, visit VA s website at or call VETS (8387), Monday through Friday from 8 a.m. until 8 p.m. eastern. For information on the Marketplace, visit or call RESERVE AND NATIONAL GUARD FEDERAL BENEFITS FOR VETERANS, DEPENDENTS AND SURVIVORS ELIGIBILITY FOR VA BENEFITS Generally, all Reserve and National Guard members discharged or released under conditions that are not dishonorable are eligible for some VA benefits. The length of your service, service commitment and/or your duty status may determine your eligibility for specific benefits. Eligibility requirements for several VA benefits include a certain length of active service. Active service in the National Guard or Reserve includes: Active duty (Title 10) - full-time duty in the Armed Forces, such as unit deployment during war, including travel to and from such duty, except active duty for training, OR Full-time National Guard duty (Title 32) duty performed for which you are entitled to receive pay from the federal government, such as responding to a national emergency or performing duties as an Active Guard Reserve (AGR) member. Note: A state or territory s governor may activate National Guard members for State Active Duty, such as in response to a natural or man-made disaster. State Active Duty is based on state law and does not qualify as active service for VA benefits. Unlike full-time National Guard duty, National Guard members on State Active Duty are paid with state funds as opposed to federal funds. QUALIFYING FOR VA HEALTH CARE Under the Combat Veteran authority, Combat Veterans who were discharged or released from active service on or after Jan. 28, 2003, are eligible for enrollment in Priority Group 6, unless eligible for enrollment in a higher priority group. This authority provides a 5-year enrollment period, which begins on the discharge or separation date. These Combat Veterans are eligible for health care services and community living care for conditions possibly related to their military service, and are not required to disclose their income information unless they would like to be considered for a higher priority status, beneficiary travel benefits, or exemption of co-pays for care unrelated to their military service. Activated Reservists and members of the National Guard are eligible if they served on active duty in a theater of combat operations after Nov. 11, 1998, and were discharged under other than dishonorable conditions. Veterans who enroll with VA under this authority will continue to be enrolled even after their enhanced eligibility period ends. At the end of their enhanced eligibility period, Veterans enrolled in Priority Group 6 may be shifted to a lower priority group depending on their income level. For additional information, call VETS (8387). OEF/OIF/OND Veterans may be eligible for a one-time dental evaluation and treatment following separation from service, if they did not have a dental exam prior to separation. Veterans must request a dental appointment within the first 180 days post separation from active duty. 4

5 DISABILITY BENEFITS VA pays monthly compensation benefits for disabilities incurred or aggravated during active duty, or active duty for training for disabilities as a result of injury or disease, or inactive duty training for disabilities due to injury, heart attack, or stroke. Additionally, the discharge must be under other than dishonorable conditions. For additional information see Chapter 2, Service-connected Disabilities. POST-9/11 GI BILL The Post-9/11 GI Bill is an education benefit program for Servicemembers and Veterans who served on active duty after Sept. 10, Benefits are payable for training pursued on or after Aug. 1, No payments can be made under this program for training pursued before that date. To be eligible, the Servicemember or Veteran must serve at least 90 aggregate days on active duty after Sept. 10, 2001, and remain on active duty or be honorably discharged. Active duty includes active service performed by National Guard members under title 32 U.S.C. for the purposes of organizing, administering, recruiting, instructing, or training the National Guard; or under section 502(f) for the purpose of responding to a national emergency. Eligibility for benefits expires 15 years from the last period of active duty of at least 90 consecutive days. If released for a service- connected disability after at least 30 days of continuous service, eligibility ends 15 years from when the member is released for the service-connected disability. If, on August1, 2009, the Servicemember or Veteran is eligible for the Montgomery GI Bill; the Montgomery GI Bill Selected Reserve; or the Reserve Educational Assistance Program, and qualifies for the Post-9/11 GI Bill, an irrevocable election must be made to receive benefits under the Post-9/11 GI Bill. MONTGOMERY GI BILL SELECTED RESERVE Members of reserve elements of the Army, Navy, Air Force, Marine Corps and Coast Guard, and members of the Army National Guard and the Air National Guard, may be entitled to up to 36 months of educational benefits under the Montgomery GI Bill (MGIB) Selected Reserve. To be eligible, the participant must: 1. Have a six-year obligation in the Selected Reserve or National Guard signed after June 30, 1985, or, if an officer, agree to serve six years in addition to the original obligation. 2. Complete initial active duty for training (IADT). 3. Meet the requirement to receive a high school diploma or equivalency certificate before completing IADT. 4. Remain in good standing in a Selected Reserve or National Guard unit. Reserve components determine eligibility for benefits. VA does not make decisions about eligibility and cannot make payments until the Reserve component has determined eligibility and notified VA. PERIOD OF ELIGIBILITY Benefits generally end the day a reservist or National Guard member separates from the military. Additionally, if in the Selected Reserve and called to active duty, VA can generally extend the eligibility period by the length of time on active duty plus four months for each period of active duty. Once this extension is granted, it will not be taken away after leaving the Selected Reserve. Eligible members separated because of unit deactivation, a disability that was not caused by misconduct, or otherwise involuntarily separated during Oct. 1, 1991, through Dec. 31, 2001, have 14 years after their eligibility date to use benefits. Similarly, members involuntarily separated from the Selected Reserve due 5

6 to a deactivation of their unit between Oct.1, 2007, and Sept. 30, 2014, may receive a 14-year period of eligibility. PAYMENTS The rate for full-time training effective Oct.1, 2013, is $ a month for 36 months. Part-time benefits are reduced proportionately. For complete current rates, visit DoD may make additional contributions. TRAINING Participants may pursue training at a college or university, or take technical training at any approved facility. Training includes undergraduate, graduate, or post-graduate courses; state licensure and certification; courses for a certificate or diploma from business, technical or vocational schools; cooperative training; apprenticeship or on-the-job training; correspondence courses; independent study programs; flight training; entrepreneurship training; remedial, deficiency or refresher courses needed to complete a program of study; or preparatory courses for tests required or used for admission to an institution of higher learning or graduate school. Accelerated payments for certain high-cost programs are authorized effective Jan.28, EDUCATION AND CAREER COUNSELING Refer to Chapter 11, Transition Assistance, for detailed information on available services. Reserve Educational Assistance Program (REAP). This program provides educational assistance to members of National Guard and Reserve components who are called or ordered to active duty service in response to a war or national emergency as declared by the President or Congress. Visit gibill/ for more information. ELIGIBILITY Eligibility is determined by DoD or the Department of Homeland Security. Generally, a Servicemember who serves on active duty on or after Sept.11, 2001, for at least 90 consecutive days, or accumulates a total of three or more of years of service is eligible. PAYMENTS Reserve or National Guard members whose eligibility is based upon continuous service receive a payment rate based upon their number of continuous days on active duty. Members who qualify after the accumulation of three or more years of aggregate active duty service receive the full payment allowable. ACTIVE DUTY SERVICE MONTHLY PAYMENT RATE FOR FULL-TIME STUDENTS 90 days but less than one year $ One year but less than two years $ Two or more continuous years $1, TRAINING Participants may pursue training at a college or university, or take technical training at any approved facility. Training includes undergraduate, graduate, or post-graduate courses; state licensure and 6

7 certification courses; courses for a certificate or diploma from business, technical or vocational schools; cooperative training; apprenticeship or on-the-job training; correspondence courses; independent study programs; flight training; entrepreneurship training; remedial, deficiency, or refresher courses needed to complete a program of study; or preparatory courses for tests required or used for admission to an institution of higher learning or graduate school. Accelerated payments for certain high-cost programs are authorized. PERIOD OF ELIGIBILITY Prior to Jan. 28, 2008, members of the Selected Reserve called to active duty were eligible as long as they continued to serve in the Selected Reserve. They lost eligibility if they went into the Inactive Ready Reserve (IRR). Members of the IRR called to active duty were eligible as long as they stayed in the IRR or Selected Reserve. Effective Jan. 28, 2008, members who are called up from the Selected Reserve, complete their REAPqualifying period of active duty service, and then return to the Selected Reserve for the remainder of their service contract, have 10 years to use their benefits after separation. In addition, members who are called up from the IRR or Inactive National Guard (ING), complete their REAP-qualifying period of active duty service, and then enter the Selected Reserve to complete their service contract, have 10 years to use their benefits after separation. EDUCATION AND CAREER COUNSELING Refer to Chapter 101, Transition Assistance, for detailed information on available services. Home Loan Guaranty National Guard members and reservists are eligible for a VA home loan if they have completed at least six years of honorable service, are mobilized for active duty service for a period of at least 90 days, or are discharged because of a service-connected disability. Reservists who do not qualify for VA housing loan benefits may be eligible for loans on favorable terms insured by the federal Housing Administration (FHA), which is a part of HUD. Additional information can be found in Chapter 6. LIFE INSURANCE National Guard members and reservists are eligible to receive SGLI, VGLI, and FSGLI. They may also be eligible for SGLI Traumatic Injury Protection if severely injured and suffering a qualifying loss, Service-Disabled Veterans Insurance if they receive a service-connected disability rating from VA, and Veterans Mortgage Life Insurance if approved for a Specially Adapted Housing Grant. Complete details can be found in Chapter 7 VA Life Insurance. BURIAL AND MEMORIAL BENEFITS VA provides a burial flag to memorialize members or former members of the Selected Reserve who served their initial obligation, or were discharged for a disability incurred or aggravated in the line of duty, or died while a member of the Selected Reserve. Reservists and National Guard members may be eligible for additional burial benefits if their death was due to an injury or disease that developed during, or was aggravated during, active duty, active duty for training, or inactive duty for training. Burial benefits may include burial in a national cemetery; an inscribed headstone, marker, or medallion; a Presidential Memorial Certificate; and an allowance to partially reimburse burial and funeral costs. Additional information about burial benefits that may be available can be found in Chapter7 8 "Burial and Memorial Benefits". 7

8 RE-EMPLOYMENT RIGHTS A person who left a civilian job to enter active duty in the armed forces is entitled to return to the job after discharge or release from active duty if they: 1. Gave advance notice of military service to the employer. 2. Did not exceed five years cumulative absence from the civilian job (with some exceptions). 3. Submitted a timely application for re-employment. 4. Did not receive a dishonorable or other punitive discharge. The law calls for a returning Veteran to be placed in the job as if he/she had never left, including benefits based on seniority such as pensions, pay increases and promotions. The law also prohibits discrimination in hiring, promotion, or other advantages of employment on the basis of military service. Veterans seeking re-employment should apply, verbally or in writing, to the company s hiring official and keep a record of their application. If problems arise, contact the Department of Labor s Veterans Employment and Training Service (VETS) in the state of the employer. Federal employees not properly re-employed may appeal directly to the Merit Systems Protection Board. Non-federal employees may file complaints in U.S. District Court. For information, visit TRANSITION ASSISTANCE ADVISOR PROGRAM The Transition Assistance Advisor (TAA) program is a partnership between the National Guard and VA to assist Veterans. The TAA Program, housed within the National Guard (NG) Office of Warrior Support, places an NG/VA trained expert at the NG Headquarters in each of the 50states as well as PR, GU, VI, and the District of Columbia. The advisor serves as an advocate for Guard members and their families, as well as other geographically dispersed military members and families. In collaboration with state and local coalition partners, the TAA Program provides VA benefit enrollment assistance, referrals, and assists in facilitating access for Veterans through the overwhelming maze of programs, with the compassion of someone who knows what it is like to transition from the Guard to active duty and then back to civilian status. Advisors receive annual training from VA experts in VA health care and benefits to assist Guard members and their families with access to VA health care facilities and TRICARE facilities within their network. To find a local Transition Assistance Advisor call or go to Outreach for OEF/OIF/OND Veterans VA s OEF/OIF/OND Outreach Teams focus on improving outreach to members of the National Guard and Reserve by engaging them throughout the deployment cycle with targeted messages and face- to-face encounters with VA staff. These outreach teams are located at VAMCs to help ease the transition from military to civilian life. To learn more, visit Veterans can also call the toll-free OEF/OIF/OND Help Line at for answers to questions about VA benefits, health care, and enrollment procedures. Air Reserve Personnel Center. The Air Reserve Personnel Center (ARPC) is available to assist with various personnel issues, including requests for personnel records, copies of DD Form 214, or other military documents. Many Veterans file an Air Force Board Correction of Military Records (AFBCMR) or write their Congressman to get these basic issues resolved which requires that the request be routed through appropriate authorities, sometimes taking up to 180 days. Alternately, the ARPC routinely handles these actions on a much quicker basis. Members should call the ARPC for assistance at or logon to gum-crm.csd.disa.mil. 8

9 ABOUT VETERANS HEALTH ADMINISTRATION USEFUL TERMS Healthcare System: In many areas of the country, several medical centers and clinics may work together to offer services to area Veterans as a Healthcare System (HCS) in an effort to provide more efficient care. By sharing services between medical centers, Healthcare Systems allow VHA to provide Veterans easier access to advanced medical care closer to their homes. Examples of Healthcare Systems include the VA Pittsburgh Healthcare System which serves the Pittsburgh area of Pennsylvania, and the VA Puget Sound Healthcare System which serves the Seattle and Tacoma areas of Washington State. Community-Based Outpatient Clinic: To make access to health care easier, VHA utilizes more than 800 Community-Based Outpatient Clinics (CBOC) across the country. These clinics provide the most common outpatient services, including health and wellness visits, without the hassle of visiting a larger medical center. VHA continues to expand the network of CBOCs to include more rural locations, putting access to care closer to home. Community Living Center: Community Living Centers (CLC) are skilled nursing facilities, often referred to as nursing homes. Veterans with chronic stable conditions such as dementia, those requiring rehabilitation or those who need comfort and care at the end of life are served within one of our 135 Community Living Centers*. Domiciliary: Forty-eight VHA Domiciliaries* provide a variety of care to Veterans who suffer from a wide range of medical, psychiatric, vocational, educational, or social problems and illnesses in a safe, secure homelike environment. Vet Center: Vet Centers provide readjustment counseling and outreach services to all Veterans who served in any combat zone. Services are also available for family members dealing with military related issues. VHA operates 278 community based Vet Centers* in all fifty states, the District of Columbia, Guam, Puerto Rico, and the US Virgin Islands. Veterans Integrated Services Network: The U.S. is divided into 21 Veterans Integrated Service Networks, or VISNs regional systems of care working together to better meet local health care needs and provides greater access to care. The Veterans Health Administration is home to the United States largest integrated health care system consisting of 150 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliaries. Together these health care facilities and the more than 53,000 independent licensed health care practitioners who work within them provide comprehensive care to more than 8.3 million* Veterans each year. WHERE IS THE NEAREST MEDICAL CENTER OR OTHER HEALTH CARE FACILITY? Use the Facility Locator to find the VA medical facility that will best meet your health care needs using a variety of search methods including using your ZIP code. OUR DOCTORS Once you find the VA medical facility that can best meet your health care needs, explore that facility s Our Doctors tool. The Our Doctors online directory lists all independent health care licensed practitioners at the local medical center and within that health care system. This includes any individual 9

10 permitted by law and by the organization to provide care and services, within the scope of the individual's license and consistent with individually granted clinical privileges. While called Our Doctors the tool lists more than just physicians, with the directory including nurse practitioners, dentists, radiologists, psychologists and other staff who are directly involved in your care. Anyone can search and sort information for these providers based on your preferences and needs. The directory lists this staff in alphabetic order with their name, education, license, specialty and gender. With regular updates and additions to the directory, the resource is part of VA s ongoing effort to provide the highest quality information and care. COMMON MEDICAL CENTER SERVICES VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of our medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. Some medical centers also offer advanced services such as organ transplants and plastic surgery. PATIENT ADVOCATES Available at every medical center, Patient Advocates are highly trained professionals who can help resolve your concerns about any aspect of your health care experience, particularly those concerns that cannot be resolved at the point of care. Patient Advocates listen to any questions, problems, or special needs you have and refer your concerns to the appropriate Medical Center staff for resolution. 10