Abstract: The U.S. health insurance system is composed of a variety of insurance and care coverage types with different eligibility requirements, coverage rules, and costs. U.S. residents may be eligible for more than one form of insurance coverage or ways to access free or low-cost care. For example, U.S. military veterans may be enrolled in the Veterans Health Administration (VHA) and might also be covered by Medicare. Having multiple ways to get health care coverage and seek health care can lead to confusion on the part of patients, providers, and institutions providing care, and those paying for care (i.e., private or government-sponsored insurers) about which source pays for — or should pay for — specific services. Enrollment in multiple forms of health care coverage indicates potential inefficiencies and raises questions about whether different programs are making duplicative payments for the same care or providing duplicative coverage for the same patient (Meyers et al., 2024). Throughout the paper, coverage is used to describe any way in which veterans receive health care and includes both insurance coverage and care coverage (such as the direct services that VHA provides).