Medicare Blog

a retired veteran with va compensation applying for medicare what kind of info is needed to apply

by Karley McClure Published 2 years ago Updated 1 year ago

To apply for either VA disability compensation or a VA pension, use VA Form 21-526, Veteran’s Application for Compensation and/or Pension. If available, attach copies of dependency records (marriage and children’s birth certificates), as well as proof of military service and discharge characterization.

Full Answer

How do VA benefits work with Medicare?

To use VA benefits, veterans must receive care from a VA-authorized or pre-authorized non-VA facility. Some veterans may qualify for additional benefits such as dental and vision coverage. Medicare eligibility requirements apply to veterans the same way they do other enrollees.

What should veterans of the Armed Forces know about Medicare?

But there are a few things that veterans of the armed forces should know about Medicare. 1. Medicare and VA coverage do not coordinate benefits Medicare and VA (Veterans Affairs) insurance do not coordinate coverage.

Do I qualify for Medicare or VA benefits?

For Medicare, you need to be a U.S. resident or citizen who has lived in the country for at least five years, along with being 65 years of age or older, or having specific health conditions. You can qualify for VA but not Medicare, or you might qualify for both. As we’ve mentioned, VA benefits are only applicable to VA medical centers.

Can veterans receive both VA health care and Medicare?

Veterans can receive both Veteran Affairs (VA) health care benefits and Medicare when they become eligible. It's recommended for veterans to enroll in Medicare so they have more coverage options when seeking care from non-VA health care facilities.

Do I need a Medicare supplement if I have VA benefits?

If you have VA benefits, you do not have to enroll in Medicare in order to keep your VA benefits. That being said, the Veterans Administration actually recommends veterans enroll in Medicare when they become eligible.

How does VA disability affect Medicare?

Having VA benefits does not affect Medicare costs. You can qualify for premium-free Medicare Part A coverage, but you'll likely have to pay premiums or a monthly fee for your other Medicare coverage depending on your plan.

Can you get Medicare with VA disability?

You can have both VA Benefits and Medicare. However, you will need to choose which benefits you use when you receive health care services or get health care items. To use VA benefits, you'll have to see a VA doctor or get care at a VA medical center or other VA location.

Do you lose your VA benefits when you turn 65?

Even after veterans reach full retirement age, VA's disability payments continue at the same level. By contrast, the income that people receive after they retire (from Social Security or private pensions) usually is less than their earnings from wages and salary before retirement.

How does the VA work with Medicare?

You can have both Medicare and Veterans Affairs (VA) benefits, but Medicare and VA benefits do not work together. Medicare does not pay for any care that you receive at a VA facility. In order for your VA coverage to cover your care, you must generally receive health care services at a VA facility.

Do veterans need Medicare Part B?

Therefore, it is beneficial to enroll in the hospital insurance you earned through Medicare. However, like other beneficiaries, veterans with VA benefits will need to pay a standard Medicare Part B premium for Medicare's outpatient coverage. You will want to enroll in Medicare Part B as soon as you are eligible.

Does VA follow Medicare guidelines?

If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits along with these plans. Learn more about how VA works with other health insurance.

Can you have a Medicare Advantage plan and VA benefits?

You can have both. Coverage through a Medicare Advantage Plan does not conflict with VA health care services and would increase your flexibility and options in terms of how and where you receive health care.

Do veterans get free healthcare for life?

You can get free VA health care for any illness or injury that we determine is related to your military service (called “service connected”). We also provide certain other services for free.

What is the VA 10 year rule?

The VA disability 10-year rule states that the U.S. Department of Veterans Affairs (VA) cannot eliminate a disability rating that has been in place for at least 10 years unless there is evidence of fraud. This 10-year period is calculated from the effective date of VA's original grant for service connection.

How much extra Social Security Do veterans get?

For those who served between 1957 and 1977, credits equal $300 for each quarter of active-duty pay. Those serving between 1978 and 2001 receive credits equal to an additional $100 in earnings for each $300 they receive in active-duty pay (total credits may not exceed $1,200 a year).

Is VA or Medicare better insurance?

VA coverage for prescriptions is typically less expensive than Medicare Part D drug plans, and you won't be hit with late penalties if you lose VA coverage in the future, provided that you sign up with a Part D plan within two months of that coverage ending.

Should I opt out of my other insurance plans (such as Tricare for Life or Medicare) if I’m accepted ...

Consider your budget, coverage preferences, and potential risk of losing your VA health coverage in the future when deciding to opt out. If your cu...

Should I get Medicare Part B if I have VA benefits?

The Department of Veterans Affairs recommends that you get Medicare Part B if you have VA benefits because you may incur a late penalty if you don’...

Do I have to pay for Medicare if I have VA benefits?

Having VA benefits does not affect Medicare costs. You can qualify for premium-free Medicare Part A coverage, but you’ll likely have to pay premium...

Is Medicare or the Department of Veterans Affairs the primary payer?

If you have both VA benefits and Medicare, the primary payer depends on which benefits you choose to use when you receive health care services. Gen...

Does the VA bill Medicare for services?

No, the VA generally can’t bill Medicare for services, but they can bill Medicare supplemental plans for covered services since they’re private pro...

What should veterans know about Medicare?

Here are seven things every veteran should know about Medicare. Medicare covers veterans in the same way as it covers most other Medicare beneficiaries. But there are a few things that veterans of the armed forces should know about Medicare. 1. Medicare and VA coverage do not coordinate benefits. Medicare and VA (Veterans Affairs) ...

How to enroll in Medicare Advantage?

There are a few instances in which enrolling in a Part D plan or a Medicare Advantage plan with prescription drug coverage may make sense: 1 VA coverage includes its own drug formulary (a list of drugs covered by the plan). If the VA does not cover a specific drug that you need to take, you might consider enrolling in a Medicare Part D plan that covers that drug. 2 A drug prescribed by a doctor at a non-VA facility may not be covered by VA benefits without authorization. 3 A non-VA pharmacy may be a more convenient way to obtain your drugs, especially if you reside in a nursing home or other long-term care facility. 4 If you qualify for Medicare Extra Help, your overall drug costs may be lower with a Part D plan than under VA coverage.

What if VA does not cover a specific drug?

If the VA does not cover a specific drug that you need to take, you might consider enrolling in a Medicare Part D plan that covers that drug. A drug prescribed by a doctor at a non-VA facility may not be covered by VA benefits without authorization.

What happens if you don't sign up for Medicare Part B?

If you do not sign up for Medicare Part B during your Initial Enrollment Period, you may be subject to late enrollment penalties if you decide to sign up later on.

Does Medicare Advantage have its own formulary?

There are a few instances in which enrolling in a Part D plan or a Medicare Advantage plan with prescription drug coverage may make sense: VA coverage includes its own drug formulary (a list of drugs covered by the plan).

Does Medicare cover non VA care?

Medicare will not provide coverage at a VA facility, and VA benefits will not provide coverage at a non-VA facility.

Does Medicare and VA insurance work together?

Medicare and VA coverage do not coordinate benefits. Medicare and VA (Veterans Affairs) insurance do not coordinate coverage. The only instance in which the two programs might team up to offer dual coverage is when the VA approves qualified care to be received at a non-VA facility. Medicare coverage for people with VA insurance typically works like ...

Why is it important to understand VA and Medicare?

Because each offers different benefits, having both at your disposal will broaden your health insurance coverage options. If you’re a veteran, it’s important to understand how VA benefits and Medicare work in tandem before you make the choice.

How long do you have to enroll in Medicare if you lose your VA benefits?

If you lose your VA benefits, you’ll have 63 days to enroll in a Part D plan before that penalty kicks in.

What is Medicare Supplement Insurance?

A veteran may choose to supplement their Medicare coverage with a privately administered Medigap Insurance plan (also called Medicare Supplement Insurance), which helps cover the out-of-pocket costs associated with Medicare, such as deductibles, copayments, coinsurance and other fees.

How much is the VA deductible for 2021?

In addition to the 2021 Medicare Part A deductible of $1,484 per benefit period, coinsurance for hospital stays lasting longer than 60 days starts at $371 per day in 2021. Moreover, after meeting your 2021 Part B deductible ...

What is the priority number for veterans?

All veterans who qualify for VA health benefits are assigned to a priority group numbered 1 through 8, with 1 being the highest and 8 being the lowest. Your priority number, which depends on factors such as your income level and if you have a service-connected disability, determines everything from copayments to out-of-pocket costs to ...

What happens if you don't enroll in Part B?

If you don’t enroll in Part B when you’re first eligible and later change your mind, you will likely have to pay an ongoing late-enrollment Part B premium penalty of 10% for every 12-month period that you didn’t have it.

How long do you have to serve in the military to get VA benefits?

The minimum duty requirements for VA benefits call for 24 months of continuous service, which also applies to members of the National Guard and the Reserves. But because there are many exceptions ...

Why is Medicare important for VA?

Therefore, Medicare coverage may be particularly important if, say, you don’t live near a VA facility or your local facility has long wait times.

How to contact Medicare.org?

For further information about finding a Medicare plan that works with your VA health benefits and individual needs, call (888) 815-3313 – TTY 711 to talk with an experienced Medicare.org licensed sales agent.

What happens if you wait to enroll in Medicare Part B?

If you wait to enroll in Part B when you are first eligible, you will likely experience gaps in coverage and incur a penalty for each 12-month period you were without Medicare Part B coverage. Learn more about Medicare Part B.

What is Medicare Advantage?

Medicare Part C (Medicare Advantage) and VA Benefits. If you need additional services or coverage not offered to you through your VA benefits, you may consider a Medicare Advantage plan. Most Medicare Advantage plans offer additional coverage, like vision, hearing, dental, prescription drug coverage, and/or health and wellness programs. ...

Do you have to pay a penalty for Medicare?

The VA encourages you to consider enrolling in Medicare as soon as you’re eligible because Medicare and VA benefits don’t work together – and you may have to pay a penalty if you end up enrolling in Medicare later.

Do veterans need Medicare?

Department of Veterans Affairs (VA) who is eligible, or nearing eligibility for Medicare coverage? If you already have medical coverage through the VA health program, you may be wondering if you also need to enroll in Medicare. The answer is that you could probably benefit from having both VA ...

Does VA cover prescription drugs?

With VA health benefits, you typically get premium-free drug coverage. However, if the VA-approved pharmacy locations or the Consolidated Mail Outpatient Pharmacy Program (CMOP), doesn’ t work for you, then you may consider a Part D or a Part C plan with prescription drug coverage.

What is tricare reserve select?

Enrolled in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult or the US Family Health Plan. Another important note is that when you become Medicare eligible, the age of your spouse and covered family members, as well as the TRICARE plan you all were on, each play a role in your coverage options.

What is Medicare Made Clear?

Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.

How long do you have to change your tricare plan?

You have 90 days after you become eligible for Medicare to change your TRICARE health plan, and your plan options will depend on your specific situation including how you qualify for Medicare, you or a family member’s active duty status and which TRICARE plan you’re currently enrolled in.

Does Medicare cover VA care?

The VA will also cover care if it’s been pre-authorized for services in a non-VA hospital or other care location. If you go to a non-VA or also VA authorized care facility, Medicare may pay for the services you may need, or if the VA has only pre-authorized some services at the non-VA location, then Medicare may provide coverage for other services ...

Do you have to enroll in Medicare if you have VA?

If you have VA benefits, you do not have to enroll in Medicare in order to keep your VA benefits. That being said, the Veterans Administration actually recommends veterans enroll in Medicare when they become eligible. Enrolling offers veterans more coverage choices and options for medical and hospital care, as well as for prescription drug services ...

What is Medicare Advantage for veterans?

Many veterans are going to find Medicare Advantage a practical solution to coverage. Most plans boast a $0 premium and extra benefits beyond Medicare. Some plans may include prescription drug coverage. Depending on the service area, an Advantage plan could include telehealth, dental, vision, and a gym membership.

Who pays first, Medicare or Veterans Administration?

Who Pays First, Medicare, or the Veterans Administration? The simple answer to the question of who pays first is both. When you go to the Veterans facilities, the only coverage you have is Veterans Administration coverage. Then, when you go to civilian facilities, you only have Medicare coverage.

Does Medicare cover veterans?

As you know, Veteran benefits only apply to Veterans’ facilities and doctors. So, if you want to see a civilian doctor, Medicare can help with some of the costs. Having both Medicare and Veterans benefits gives you the opportunity to see a wide range of doctors and specialists. The Veterans Association recommends you enroll in Part A ...

Do disabled veterans have to have Medicare?

While it’s not mandatory, the Veterans Administration suggests all veterans, disabled or not, have Medicare. It’s especially beneficial to have Medicare when the need for civilian coverage arises. You might be thinking you’re fine without it, but delaying Part B will result in penalty charges when you do enroll.

Can you get a prescription for Part D?

Part D for Veterans. Even though you can get prescriptions through the Veterans Administration, sometimes it’s more convenient to have Part D. For example if a civilian doctor prescribes a medication, the Veterans Administration doctor needs to approve the medication for the Veterans Administration to cover. But, if you have Part D, you can go fill ...

Is Medicare creditable for veterans?

This is because the Veterans’ benefits are not considered creditable coverage under Medicare. Medicare will provide coverage outside a Veterans facility, this can come in handy in the case your Veteran benefits are dropped or if your local Veteran facility does not cover all your health services, you could pay up to 100% ...

How to apply for VA benefits?

Generally, Servicemembers, Veterans, and families can apply for VA benefits using one of the methods below. Apply online using eBenefits, OR. Work with an accredited representative or agent, OR. Go to a VA regional office and have a VA employee assist you.

What are the benefits of being an elderly veteran?

VA benefits include disability compensation, pension, education and training, health care, home loans, insurance, vocational rehabilitation and employment, and burial.

What is geriatric care?

Extended care – also known as long term care – is a program for Veterans of all ages who need the daily support and assistance of another individual. Elderly Veterans can receive geriatric and long term care programs at home, at VA medical centers, or in the community.

What is the vision limit for a nursing home patient?

You are bedridden. You are a patient in a nursing home. Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes; or concentric contraction of the visual field to 5 degrees or less.

How to apply for VA disability?

How do I prepare before starting my application? 1 Find out if you’re eligible for VA disability compensation 2 Gather any evidence (supporting documents) you’ll submit yourself when you file your VA disability claim. 3 Be sure your claim is filled out completely and you have all the supporting documents ready to send in along with your claim. This will help us process your claim quickly.#N#Learn about fully developed claims 4 Find out if you’ll need to turn in any additional forms with your claim

What are VA medical records?

VA medical records and hospital records that relate to your claimed illnesses or injuries or that show your rated disability has gotten worse. Private medical records and hospital reports that relate to your claimed illnesses or injuries or that show your disability has gotten worse.

How to submit intent to file?

You can submit your intent to file by phone or by written form. Note: If you file your claim online, you don't need to separately send an intent to file form. The online application already includes your intent to file.

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