As far as I know, only the veteran gets care at a VA facility. Also, they have a rating system. It was several years ago that I went through the application process, so I don't recall the details, but it is a priority system based on disability level. Vets who don't have a disability rating can go to the VA, but will pay a fee for the services. It is very affordable compared to civilian medical services and there is a substantial discount for financial hardship determination (i.e. income below a certain level depending on where you live). However, as I understand it, if Congress ever decides to roll back on the VA budget, these are the folks who would no longer be eligible for VA services.
Those with a disability rating would not be affected (as I currently understand it) and don't pay for services at the VA except those with less than a certain disability level do pay a fee for medications. I pay very small fee for medication since I don't have a full 100% disability rating, but not for any services. To me, this seems a fair system. One thing I am really pleased with is that us Vietnam veterans are treated very well at the VA (at least that has been my experience) - very different from how civilians treated us when we came home all those years ago. The weird thing is that I always thought of the WWII vets as the old guys around the VA, but we are in that role now.
I have a younger brother with a 100% disability rating and I know his family is covered under a military insurance plan, but are not eligible for the VA services he gets. He retired from the Marines, so I don't really know how their insurances work. I was in the Army, and I don't know about family insurance since I was not a lifer.
Despite the fact that the VA is my primary care, I still had to sign up for Medicare. My supplement costs almost nothing since I really don't need it, but it is good to have something just in case. I also think this is fair, since we all need to support Medicare. Besides, it is nice to know that if I ever did end up in a civilian hospital due to an emergency situation, I have that coverage.
Tony