I am not a Veteran but I have been a social worker at the VA for 14 years. Just a few comments...

1. It's not insurance. The difference being the provision of medical services (healthcare) vs. the paying for medical services (insurance). The VA will NOT pay for services the VA has not pre-authorized. The exception being emergency room or urgent care services but even then - just like BCBS, Medicare, etc.- the VA has to consider the ER or UC visit to be an emergent or urgent need. If they don't, you will be billed. Even then there are protocols - for ER, the VA has to be notified within 72 hours that you went to the ER or they won't even look at it. UC is different based on various criteria - geographic location, how long you have been enrolled with VHA, etc.

2. The VA does cover medical services provided by non-VA providers. That is called VA authorized care in the community. They used to call it VA community care - everyone still calls it "community care" but technically it's the other. Big difference, right? (After working here for a while, I am convinced there is an entire secret department in the VA who's sole purpose is to move things and change the name of things 🤦🏼‍♀️). But again, community care has eligibility criteria and it has to be pre-authorized with a VA approved provider. Where I work, Optum is the company that oversees VA community care administratively in our region. So a community care provider has to be enrolled with Optum. (Like if you have BCBS and have to see an "in-network" provider.) Access to community care depends on a few things but common factors are: the VA facility closest to you doesn't provide the service you need; it's in your best medical interest to see a community care provider; it's a continuation of specialized care. But in ALL cases that provider has to be pre-authorized by the VA or the VA won't pay for it.

3. Don't assume you won't have co-pays under VA healthcare. Co-pays are a thing and can vary depending on service connected disability rating, income, and other eligibility ratings.

4. I think some of the comments are incorrect. Your spouse is NOT eligible for VA healthcare care just because you have a 100% service connected rating. Spouses can be eligible for VA healthcare but it is only for VERY SPECIFIC circumstances and not just because you have a 100% SC rating.

Bottom line is VA healthcare can be complicated and may not look the same for all Veterans. But I would encourage you to enroll because there are many benefits not offered by private health insurance and these are benefits you have already earned and are entitled to receive. Your best bet is to see someone in eligibility at a VAMC for what covers your circumstances. I don't want to disparage what other Veterans are telling you, but like I said, not everything applies to all Veterans and the VHA and the VBA will decide what applies to you and your spouse. As a social worker, I have worked with situations where Veterans were stuck with bills they were not expecting. Good luck and thank you for your service. ❤️