Is this an insurance policy or an HMO?

It is neither. VA health benefits are established by Federal law and regulations and funded through appropriations. They are not the same as an insurance contract. Also, veterans do not pay monthly premiums to receive VA health care. In addition, you are not required to use VA as your exclusive health care provider. If you have health insurance, or eligibility for other programs such as Medicare, Medicaid, or Department of Defense, you may continue to use services under those programs. We recommend that, if you have other insurance or HMO coverage, you should keep that coverage to provide you with options and flexibility in the future.