Veterans May Choose Veterans Affairs (VA) Benefits and Medicare
As a Medicare-eligible Veteran or a Disabled Veteran, you have options when it comes to healthcare. You will find information that all Veterans should know when they become Medicare eligible.
Call 888-354-3129 today to schedule a time to discuss Medicare Supplement Insurance Plan options for:
- Medicare Supplement Insurance Plan,
- Medicare Advantage Plans and
- Medicare Part D Plan Prescription Drug Plans.
Choose from the top Medicare Carriers. See your plan options from Aetna, Humana, AARP and UnitedHealthCare.
Veteran’s Affair (VA) Benefits and Medicare
Although the VA Veteran’s Affair (VA) and Medicare are both Government Health Programs and if you are eligible for both, it is important to know your options.
You can have both Medicare and VA benefits. However, Medicare and VA benefits do not work together. Medicare does not pay for any care that you receive at a VA facility.
- VA plans only cover care at VA facilities,
- Medicare only covers care at Medicare assigned facilities.
- The VA and Medicare plans do not overlap.
Enroll in Medicare Part A If You Have VA Benefits
Both Medicare and the VA suggest you should enroll in Medicare Part A and Part B. You can have both Medicare and VA benefits at the same time and this is recommended. It is strongly recommended that all Veteran seniors enroll in Medicare Part A (Hospital Coverage) and usually there is no additional cost. This will allow you receive hospital coverage should you go to a non-VA facility. According to the VA’s website “[We] encourage you to keep your private [Medicare] health insurance.”
Medicare Part B If You Have VA Benefits
Although it’s not absolutely necessary, it is strongly recommended that any Medicare eligible Veterans and Disabled Veterans enroll in Medicare Part B (Medical Coverage, Dr’s, other outpatient services, etc).
There is usually a monthly fee for Part B but it is worth it. If your VA Benefits are dropped at some point or, and this is important, if your local VA facility does not cover all health services, you could pay 100% out of pocket for a serious illness. The VA highly recommends that you enroll in Part B as well.
Many veterans use their VA health benefits to get coverage for health care services and items not covered by Medicare, such as over-the-counter medications and annual physical exams.
However, you may want to consider enrolling into Medicare Part B (medical insurance), even if you have VA coverage. Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. In addition, if you do not enroll into Part B when you are first eligible to do so, you will most likely incur a Part B premium penalty for each 12-month period you were without Medicare Part B coverage. In addition, you may also experience gaps in coverage.
Some say Veterans will not need a Medicare Supplement Insurance Plan (Medigap plan) if they qualify for VA benefits. It is important to consider the option of Medicare with a Medigap plan will fill in the gaps such as deductibles, copays, and coinsurance, as well as other benefits when seeking care outside of the VA, or outside of the U.S. and its territories.
Here are just a few reasons why Veterans may consider enrolling in a private Medicare Supplement Insurance Plan:
- You do not live near a VA facility
- You are enrolled in one of the VA lower priority groups, and could potentially lose your benefits*
- Option to use local Doctors and Hospitals
*“There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.” Source: VA.gov website.
Buy a Medigap policy or Medicare Advantage Plan (part C) when you’re first eligible
The best time to buy a Medigap policy or Medicare Advantage Plan Part C is during your 7-month Medicare open enrollment period. During that time you can buy any Medigap policy or Medicare Advantage Plan Part C in your state, even if you have health problems. This period automatically starts the month you’re 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you’re able to buy one, it may cost more.
IT’S SO EASY TO GET A FREE MEDICARE QUOTEGET A FREE MEDICARE QUOTE
During Initial Enrollment Period (IEP)
Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, even if you have health problems, during your Medigap open enrollment period you can buy any policy the company sells for the same price as people with good health.
Find your situation below:
I Am 65 Years Or Older
Your Medigap open enrollment period begins when you enroll in Part B and can’t be changed or repeated. In most cases, it makes sense to enroll in Part B when you’re first eligible, because you might otherwise
I Am Turning 65
The best time to buy a Medigap policy or Medicare Advantage plan is during the Initial Enrollment Period (IEP)
The Initial Enrollment Period (IEP) refers to the first time an eligible person can enroll in the Federal Medicare program. It’s a period that starts three months before the month of your 65th birthday, continues through your birth month, and lasts for three months after it. Signing up for Medicare during your IEP is one way for you to avoid any late-enrollment penalties.
Example your birth date is in June (total 7 months):
- March (3 months before your 65th Birthday)
- June (total 7 months)
- September (3 months after your 65th Birthday)
Most people are enrolled automatically ahead of their 65th birthday, but the IEP is the first-time people can enroll manually if they have to. You also have the option of enrolling in a stand-alone Medicare Prescription Drug Plan at this time, as long as you are entitled to Medicare Part A or enrolled in Part B.
I Am 65
Federal law doesn’t require insurance companies to sell Medigap policies to people under 65. If you’re under 65, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65. However, some states require Medigap insurance companies to sell you a Medigap policy, even if you’re under 65. If you’re able to buy one, it may cost you more.
I have group health coverage through an employer or union
If you have group health coverage through an employer or union because either you or your spouse is currently working, you may want to wait to enroll in Part B. Employer plans often provide coverage similar to Medigap, so you don’t need a Medigap policy.
When your employer coverage ends, you’ll get a chance to enroll in Part B without a late enrollment penalty. That means your Medigap open enrollment period will start when you’re ready to take advantage of it. If you enrolled in Part B while you still had the employer coverage, your Medigap open enrollment period would start. Unless you bought a Medigap policy before you needed it, you’d miss your open enrollment period entirely
VA Benefits and Medicare Part D
As a Veteran, the choice of whether to enroll in Part D is up to you. You don’t need a Medicare Prescription Drug Plan, aka Medicare Part D, your VA plan may offer more coverage than Medicare’s Rx coverage. Remember that any prescription prescribed by a non-VA doctor needs to be approved by your VA doctor for the VA to approve it. This may take extra time and your VA doctor can say that prescription is unnecessary. If you choose not to enroll in Part D when you are first eligible you can still enroll in Part D without paying a penalty later. VA drug coverage is considered creditable coverage.
Some veterans only use their VA drug coverage to get their medications, since VA drug coverage may offer more generous prescription drug coverage than Medicare Part D, the Medicare prescription drug benefit. Since VA drug coverage is considered creditable, meaning it is as good as or better than the Medicare prescription drug benefit, you can delay enrolling into Medicare Part D without penalty. If you do lose VA drug coverage, make sure you enroll into a Part D Prescription Drug plan within 63 days of losing your VA benefits.
Note that although you can have both Medicare Part D and VA drug coverage, the two do not work together. VA benefits only cover the drugs you get from VA pharmacies and Part D plans usually only cover drugs you get from pharmacies that are within the plan’s network.
You may want to join a Part D Prescription Drug Plan in certain situations. You may want to enroll in a plan if you move into a nursing home outside of the VA health system and need coverage for medications from the nursing home pharmacy. You may also want to enroll in a Part D Prescription Drug Plan if you qualify for Extra Help, the federal assistance program that helps people with Medicare afford their Part D drug costs.
If you have questions about VA benefits and coverage, contact the VA Health Administration Center at 1-800-733-8387 or 1-877-222-VETS
Medicare and related issues. If you have questions about your VA coverage, please contact Veterans Affairs directly 877-222-8387
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Call 888-354-3129 today to schedule a time to discuss Medicare plan options for:
- Medicare Supplement Insurance Plan,
- Medicare Advantage Plan and
- Medicare Part D Prescription Drug Plan.
Choose from the top Medicare Insurance Carriers. See your plan options from Aetna, Humana, AARP and UnitedHealthCare.