VA benefits and Medicare are separate plans that don’t overlap in coverage. Enrolling in Medicare does not affect VA benefits and vice versa. Every time you receive care, you need to decide which benefits to use. You would use your Veteran Health Identification Card when accessing care at VA facilities and your Medicare card at other facilities.
Do you need Medicare if you have VA benefits?
You might think that you don’t need Medicare if you qualify for VA medical benefits. However, Medicare can pick up the slack when the VA won’t cover the bill for certain services or at specific facilities. For instance, maybe you live around the block from a VA hospital, but you get sick or injured while traveling. You’ll enjoy more flexibility if you have both Medicare and VA benefits.
How veterans can make sense of Medicare and VA benefits?
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) 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.
Do veterans with VA benefits need Medicare?
You can use your Veterans Affairs (VA) health care benefits along with Medicare. Enrolling in Medicare will not affect your VA benefits. If you have VA benefits, you are not required to enroll in Medicare when you turn 65, but the VA recommends Medicare enrollment to cover non-VA medical expenses.
Is VA considered creditable coverage for Medicare?
That's because enrollment in the VA health care system is not considered creditable coverage. Creditable coverage for Medicare Part B (meaning health insurance that can take the place of Part B) can only be provided by certain employer group health plans.
Do I need a Medicare supplement if I 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.
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.
Do veterans have to pay Medicare premiums?
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.
Can you have Medicare and VA Advantage?
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.
Do veterans get free healthcare for life?
If you are a 50% or greater disabled veteran or a former POW, all your medical care from the VA is free. There are other groups that may get some, or all VA medical care for free, see our VA Copay page for details.
At what age does VA disability stop?
age 67When veterans reach age 67, all VA disability payments would revert to the amount associated with the rated disability level; veterans age 67 or older who are already receiving IU payments would no longer receive them after the effective date of the option.
How can you lose your VA benefits?
VA disability compensation payments are reduced if a Veteran is convicted of a felony and imprisoned for more than 60 days. Veterans rated 20 percent or more are limited to the 10 percent disability rate. For a Veteran whose disability rating is 10 percent, the payment is reduced by one-half.
Is VA insurance primary over Medicare?
The VA pays for VA-authorized services or items . For active-duty military enrolled in Medicare, TRICARE pays first for Medicare- covered services or items, and Medicare pays second . For inactive-duty military enrolled in Medicare, Medicare pays first and TRICARE may pay second .
Does VA disability count as income for Medicare?
VA Aid and Attendance Benefits do not count as income for Medicaid purposes, so he/she may meet income eligibility criteria for Medicaid. Once approved for Medicaid, though, the VA benefit is reduced to $90/month for most recipients.
Will I lose my VA disability if I go to a nursing home?
The VA may pay all or part of the nursing home costs for disabled and elderly veterans. The Department of Veterans Affairs (VA) provides both short-term and long-term care in nursing homes to veterans who aren't sick enough to be in the hospital but are too disabled or elderly to take care of themselves.
Why do military retirees have to pay for Medicare?
By law, TRICARE Prime and TRICARE Select end at age 65. This requires service retirees to enroll in Medicare at age 65 to maintain a major health care plan and our TRICARE benefits. TRICARE For Life (TFL) acts as our Medicare supplement, and TFL allows us to continue using the TRICARE pharmacy.
What are the income limits for VA health care 2020?
In 2020, the VA National Income Thresholds were as follows: $34,171 or less if you have no dependents. $41,005 or less if you have one dependent. $43,356 or less if you have two dependents.
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 ...
What happens if you don't have Part B insurance?
If you are not already signed up for Part B (and don't have insurance through an employer or other source), you'll likely have to wait a while for coverage, and you could be liable for late penalties that are permanently added to your Part B premiums.
Can Medicare cover non VA?
With Medicare, you're covered if you need to go to a non-VA provider. This is an especially important point to consider if you live some distance from the nearest VA facility. You may be subject to penalties in the future.
Is VA coverage less expensive than Medicare?
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.
Is Medicare and VA separate?
The Medicare and VA systems are entirely separate, with no coordination of benefits between them. You would use your VA identity card at VA facilities and your Medicare card anywhere else. You'll find more information at the VA website on how VA care works with other insurance . Return to Medicare Q&A Tool main page >>.
Is VA health coverage the same for everyone?
VA health coverage isn’t set in stone and isn’t the same for everyone. The VA assigns enrollees to different priority levels according to various factors, such as income and whether they have any medical condition that derives from their military service.
Does Medicare cover VA?
Having both Medicare and VA benefits greatly widens your coverage. VA coverage pays for medical services if you go to a VA hospital or doctor. If you need to go elsehwere, you'll probably end up having to pay the full cost yourself, even in emergencies. With Medicare, you're covered if you need to go to a non-VA provider.
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.
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. ...
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.
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.
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 Medicare Advantage?
A Medicare Advantage plan, for example, usually allows affordable and convenient access to a plan network of medical service providers that includes hospitals, doctors, and therapists. In some cases, MA plans also include Part D prescription coverage that helps control drug costs.
Do both Medicare and the VA pay for the same services?
Typically, both health plans will not pay for the same services. Additionally, Medicare.gov says that veterans are also free to join a Part D drug program, but the VA and Medicare typically will not pay for the same prescriptions. Retired veterans actually have more choices than most other Medicare beneficiaries.
Does the VFW have Medicare?
In fact, the VFW organization even recommends a Medicare Advantage plan on their website, but there is no one-size-fits-all senior health insurance option. Veterans are free to shop around for the best plan for their needs. Medicare supplements work differently, and they supplement Medicare Part A and B to fill in coverage gaps for things ...
Do Medicare Supplements work?
Medicare supplements work differently, and they supplement Medicare Part A and B to fill in coverage gaps for things that Part A and B do not cover. Understanding Medicare options. Most retired Americans do not have to pay a Part A premium and do have to pay a premium for Part B. MA plans may have little or no additional premium, ...
Does Medicare pay for copay?
You simply present your required health card, pay your copay (if any), and receive services. However, you might be interested in the way that Medicare.gov tells us that the VA and Medicare coordinate coverage: If you receive Medicare-covered services, Medicare pays. If you receive VA authorized services, the VA pays.
Do veterans get health insurance?
After serving our country in a branch of the US military, many veterans are entitled to health benefits through the VA. However, VA doctors and hospitals are not always convenient options.
Should veterans decline Medicare?
In fact, according to a press release from Blue Cross, veterans should not decline Medicare benefits just because they get VA health benefits. Their reasoning includes: The VA actually recommends that veterans enroll in both Part A and Part B of Medicare because they are entitled to these benefits and they may complement VA benefits.
When can veterans enroll in Medicare?
Like other Americans, veterans become eligible for Medicare at age 65. (Those with a qualifying disability may enroll earlier.) The best time to sign up is during your initial enrollment period. That begins 3 months before the first day of your birthday month and lasts for 7 months.
Do you have to enroll in Medicare if you have VA benefits?
You don’t. But without Medicare coverage, you’ll be uninsured for any treatment you get at non-VA facilities or care from providers not authorized in advance by the VA. You’ll be billed for the full cost of those services, at serious risk to your net worth. That’s why the VA recommends that veterans sign up for Medicare as soon as they can.
What are the benefits of combining Medicare and VA benefits?
Enrolling in Medicare could fill in gaps in the coverage you get through the VA benefits. That’s because you’ll be able to go either to VA facilities for treatment (covered under VA benefits) or to Medicare-approved doctors and facilities (covered by Medicare). Also, VA benefits are not guaranteed, so your coverage could change in the future.
Which areas of Medicare coverage and VA benefits can you combine?
Medicare and VA benefits do not work together. But they can sometimes complement each other. For example, if the VA pre-authorizes treatment at a non-VA hospital but not certain services you get during the hospital stay, Medicare may pay for those services. For specifics, contact your Medicare plan.
How does VA disability affect Medicare?
VA benefits — including disability payments — don’t affect Medicare. At age 65, you are eligible for Medicare regardless. Before that, you may receive Social Security Disability Insurance (SSDI) while you’re on VA disability. After 2 years of SSDI payments, you can enroll in Medicare. Your VA disability benefits remain in place.
What do you have to do to manage Medicare and VA benefits?
You will have to pay the premiums for Medicare Part B or Medicare Advantage as well as any cost-sharing copayments. For VA benefits, there typically aren’t enrollment fees, monthly premiums, or deductibles. But some veterans may have copayments for healthcare or prescription drugs.
Where can you get help coordinating Medicare and VA benefits?
Various government-supported offices have staffers to help you combine and manage your health plans:
Does VA health care meet the ACA?
If I’m signed up for the VA health care program, does that mean I meet the requirements to have health care under the Affordable Care Act (ACA)? Yes. Being signed up for VA health care meets your Affordable Care Act health coverage requirement of having “minimum essential health coverage.”.
Does VA pay deductible?
Your private insurer may apply your VA health care charges toward your annual deductible (the amount of money you pay toward your care each year before your insurance starts paying for care).
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 ...
