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Negotiating Healthcare for New Veterans

By University Alliance
Negotiating Healthcare for New Veterans

There are many things that a new veteran needs to consider when they become part of the private sector.  One of the most critical is how to deal with healthcare needs for themselves and for their families.  While in the military, healthcare is a fully subsidized benefit of service, and in the private sector there are a myriad of options.  New veterans may feel that they need to go through negotiation training just to decipher which option is best. 

The reality is that there are a variety of healthcare decisions that need to be made, and knowing how to evaluate those can make the decision making easier.  Here are some common healthcare options  and decision points that may be faced during a transition out of the military:

  • Signing up for Transition Healthcare. When veterans first leave the military, they can apply for the Transitional Assistance Management Program (TAMP), which will provide them with healthcare coverage for up to six months after leaving the service.  Operated by the TRICARE service, this gap healthcare will give a veteran and their family health care insurance protection while new private sector insurance is being processed.  For additional coverage time after that period has expired, the Continued Health Care Benefit Program (CHCBP) can offer veterans healthcare insurance for an extended amount of time, though a premium is required.  A veteran may also negotiate the waiting period upon starting a civilian position, and that may alleviate the need for any extended benefits.
  • Different Types of Healthcare Plans. There are several different basic types of healthcare plans that are available to private sector employees.  An HMO (Health Maintenance Organization) is similar to TRICARE Prime and offers a specific group of doctors that must be used.  Specialists are recommended in concert with the primary care physician.  A PPO (Preferred Provider Organization), like TRICARE Extra, allows workers to use both in-network and out-of-network doctors, but the cost to use out-of-network providers or services may be higher.  
  • You May Have to Contribute.  Co-insurance and co-pays are common in the private sector.  Co-insurance is the amount that the individual is expected to pay versus the insurer.  Typically, these programs feature 80/20 coverage.  Co-pays are the amount due at the time of the visit, anywhere from $15 to $100 for a visit.
  • Negotiate Premiums.  Premiums can be negotiated with an employer to better suit the situation.  Generally speaking, the higher the premiums, the more coverage that is provided.  Lower premiums may only provide select services, such as catastrophic care.
  • Select A Primary Care Physician.  One key consideration is finding a primary care physician that is easy to work with and is covered by the insurance plan that is chosen.  Finding a physician that is easy to relate to and can be reached after work hours can be helpful in making sure that there is adequate access to care for both the veteran and their family.
  • Save Money With an FSA.  Flexible Spending Accounts (FSAs) are a way to put pre-tax dollars into an account for healthcare needs.  Employers typically offer these to assist their employees with out-of-pocket healthcare costs such as co-pays and co-insurance.

There is a lot of information to digest for new veterans looking for health insurance, understanding these options will make the decision making that much easier.  By researching their available options and using eligibility for transitional healthcare benefits, new veterans will have an adequate amount of time to make decisions that make sense for them and for their families. 

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Category: Negotiations