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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

VA vs Employer Coverage?

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Question: I have had no medical insurance for 2014 except for how I am covered at the VA. The job I have for 2015 now offers insurance. Will I be penalized for using the VA and not acquiring CC insurance for 2014?

Answer: VA health coverage is recognized by the ACA aa meeting the "minimum acceptable coverage" requirement, so you are not subject to penalty if you opt out of your employer-based coverage. If you take the employer's coverage and keep the VA coverage, your benefits will be coordinated with the employer coverage used first and the VA covering the gaps.

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VA coverage does not cover “gaps” unless care is provided in a VA facility, in which case it would be primary to employer-sponsored coverage. The only possible exception to this that I am aware of would be a “gap” in emergency room coverage, if any. The employer-sponsored plan would be primary in any non-government (federal) hospital emergency room, with the VA possibly covering expenses not paid by the employer-sponsored plan.

Because VA benefits are limited, in most cases, to VA facilities and clinics, most employees are best advised to accept their employer-sponsored plan unless the cost is unreasonable.

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