Did you know that if you are a veteran, you can benefit by having both Medicare and VA benefits?
Veterans can can sign up for a zero premium Medicare Advantage Plan and use it when they want to see doctors or receive medical services outside the VA system. The only time you would have to pay a co-pay is if you use it. Prescription costs vary between plans, with tier 1 and 2 drugs costing less using Medicare plans, while the higher tier and more expensive drugs can cost less with the VA.
A note should be made that although you can have both Medicare and VA benefits, you cannot use one on the other (e.g. You cannot use Medicare to pay for any care that you receive at a VA facility).
Generally speaking, in order for VA coverage to cover your care, you must receive health care services at a VA facility.
Similarly, in order for your Medicare plan to cover your care, you must receive care at a Medicare-certified facility that works with your particular Medicare coverage.
VA benefits will also not pay for Medicare cost-sharing such as deductibles, copayments, and coinsurances.
The only circumstance where you may be able to use both, is if the VA authorizes services in a non-VA hospital, but does not pay for all the services you get during your hospital stay. In that case, Medicare may pay for Medicare-covered services the VA does not pay for, but it depends on the particulars.
To get a Medicare plan you will need to sign up for Medicare Part B, which you can do with SeniorQuote. Typically, Part B has an average premium of $134/mo. Some choose to enroll in Medicare Part A because it’s premium-free but turn down Part B because of the additional monthly premium; we recommend speaking to one of our licensed agents to help you know all of your options. If you choose not to enroll in Medicare, you will not have health insurance for facilities outside the VA health system, and if you change your mind and want to enroll in Medicare in the future, you may face penalties and would likely have to wait to enroll during the AEP or Open Enrollment.
If you decide to enroll in Part B, you should do so during your Initial Enrollment Period (IEP), if for no other reason than to avoid late fees. Not only that, but enrolling in Part B would provide you with the flexibility of getting health care outside the VA system, so you are not entirely dependent on it. It may also help to know that you can keep your VA health benefits to get coverage for health care services and items not usually covered by Medicare, such as over-the-counter medications, annual physical exams, and hearing aids.
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Article Originally Published in EJL Medicare Advisors eNewsletter October – 2018 Edition
Original Wording Edited for Reposting Purposes