if have va healthcare why medicare

Having coverage through both the VA health program and Medicare gives you wider coverage and more choices of where you can be treated. 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.

Full Answer

Who is eligible for VA healthcare?

Under the bill, about 1.5 million additional veterans would become eligible for VA health care, and 2 million veterans would qualify for disability compensation. The Senate bill, which focuses solely on health care, comes with a price tag of about $1 billion, Tester said. The two chambers are in negotiations on the issue.

Can I have VA medical benefits and Medicare?

VA health care benefits typically only cover services received at a VA facility, and for Medicare to cover your care, you must visit a non-VA facility that accepts your Medicare coverage. Having coverage through both the VA health program and Medicare gives you wider coverage and more choices of where you can be treated.

Does the VA offer health insurance?

VA health care coverage is available for family members of certain Veterans who are permanently and totally disabled or died serving our country and in some cases, Veterans with children who have Spina Bifida.

What healthcare services does the VA provide?

VA provides supportive medical services to help chronically ill or disabled eligible Veterans of any age remain in their home. These services are referred to as home health care and are considered extended care services prescribed by and under the direction of a VA physician. VA provides several types of home health care including:

Do you need 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.

Can you have Medicare and VA benefits at the same time?

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.

Is VA benefits primary or Medicare?

VA health benefits always provide primary coverage in VA facilities. If you have VA benefits and become eligible for Medicare, you should consider the benefits of both types of insurance and whether you should enroll in Medicare now or delay enrollment—and the potential consequences of delayed enrollment.

Is VA health care the same as Medicare?

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.

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.

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.

When would the VA pay primary to Medicare?

Who pays first, Medicare or Veterans benefits? The only case in which both the VA and Medicare pay is if the VA partially authorizes care you receive from a non-VA hospital. So, if the balance of services is Medicare-eligible, Medicare will pay for what the VA doesn't.

What happens to my VA disability when I 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.

What insurance does the VA use?

TRICARE For Life (TFL) is a program that provides health coverage to all military retirees, their spouses, survivors and other qualified dependents.

Will the VA pay for outside prescriptions?

Answer: The VA Medical Center will only fill non-VA prescriptions for veterans who are enrolled in the VA healthcare system and are in receipt of Aid and Attendance (A&A) or housebound benefits or have been authorized by VA to receive care in the community.

Will the VA pay for outside treatment?

VA will also help resolve billing issues with the community provider. VA can pay for emergency medical care outside the United States if the emergency is related to your service-connected condition. More information can be found through the Foreign Medical Program (FMP) resources listed below.

Do all veterans get VA benefits?

All veterans, regardless of priority group, are generally entitled to the same medical services after enrollment. Visit the VA website for a comprehensive description of the medical benefits provided, including doctors' visits, mental health care, emergency care, in-patient hospital services, and more.

What does Medicare mean?

Having Medicare means you’re covered if you need to go to a non-VA hospital or doctor—so you have more options to choose from.

What happens if you delay Medicare Part B?

If you delay signing up for Medicare Part B (coverage for doctors and outpatient services) and then need to sign up later because you lose your VA health care benefits or need more choice in care options, you’ll pay a penalty. This penalty gets bigger each year you delay signing up—and you’ll pay it every year for the rest of your life.

Can HRAs reimburse you for non service connected conditions?

We may also accept reimbursement from HRAs for care we provide to treat your non-service-connected conditions.

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).

Do you have to bill your spouse's health insurance?

We’re required by law to bill your health insurance (including your spouse’s insurance if you’re covered under the policy). The money collected goes back to VA medical centers to support health care costs provided to all Veterans.

Can you request a restriction on VA health information?

You can submit a restriction request asking us not to disclose your health information for billing purposes, but we’re not required to grant your request. To submit a restriction request, please contact your nearest VA health facility and ask to talk with the privacy officer. You can also ask to talk with the billing office for more information.

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.”.

How to file a VA claim?

The process varies depending on the provider’s preferences: 1 The provider can file the claim with the VA, and you only pay any applicable deductibles. You can also choose to use your Medicare benefits. 2 You pay for the fees relating to the services you received, then submit your own claim to the VA. This option takes longer, but it might prove necessary if you can’t get to a VA hospital. 3 Use your Medicare benefits instead of your VA medical benefits. You might prefer this option if you don’t have the money to pay up front for services rendered as described in the second option.

How to avoid paying penalties for VA?

To avoid paying penalties, make sure you enroll in a creditable drug plan by the due date. VA medical benefits offer a creditable drug plan that might prove more cost-effective than other options, such as Medicare or TRICARE. Sometimes, paperwork gets lost or buried.

Can I use Medicare and VA at the same time?

Just remember that you can’t use both benefits at the same time. If you use Medicare to help pay for an MRI scan, for instance, the VA won’t pick up the rest of the cost. When you get treatment, try to determine which benefits will allow you to pay the least money out of pocket.

Can you have both Medicare and VA?

You’ll enjoy more flexibility if you have both Medicare and VA benefits. Additionally, the VA benefits program is subject to government oversight. The government can suspend or lower funding at any time, and you don’t want to find yourself without viable medical coverage.

Can disabled veterans live near VA hospitals?

Some disabled veterans don’t live near VA hospitals. In this case, they may receive fee-based identification cards. They can present these for treatment at a health care facility or doctor’s office. Be sure to call ahead before accepting an appointment since not all providers accept these cards.

Does Medicare cover VA hospital?

If you get medical care at a VA hospital, your VA benefits will generally cover the costs. This is because the VA uses providers who are covered under the plan, so you won’t necessarily need the institution to submit any claims to Medicare. However, Medicare can also cover services included with your VA medical benefits.

Does the VA accept Medicare?

Many health-care providers accept Medicare. The VA itself encourages vets — whose VA coverage can differ from person to person depending on their health and military service history — to sign up as soon as they are eligible (doing so does not affect VA benefits). You get seven months to sign up: The enrollment period starts three months before the month of your 65th birthday and ends three months after it.

Can Medigap charge more?

After that window, you may have to go through medical underwriting. And depending on your health , that process could cause the Medigap insurer to charge you more or deny coverage altogether.

Do Advantage plans have yearly out of pocket limits?

They do, however, have their own cost structure — meaning that deductibles, copays or coinsurance can be different from plan to plan. However, unlike Parts A and B, Advantage Plans do come with a yearly out-of-pocket maximum.

Why do veterans want to sign up for Medicare?

Why Veterans May Want to Sign Up for Medicare. Funding for VA Health Care is not guaranteed. The Department of Veterans Affairs submits a budget to the federal government every year, but there is no guarantee that the requested dollar amount will be appropriated. A lower budget could mean reduced coverage or loss of coverage altogether ...

What are the benefits of VA?

Hearing and vision coverage is offered to veterans with the following: 2 1 Compensable service-related disability 2 Functional or cognitive impairment that decreases the ability to perform activities of daily living 3 Permanent homebound status 4 Prisoner of War 5 Purple Heart 6 Service-related hearing disability with a loss of communication ability 7 Title 38 United States Code (U.S.C.) 1151 benefits 8 Vision and/or hearing impairment related to a condition managed at the VA (e.g., cataracts, diabetes, stroke) 9 Vision and/or hearing impairment that interferes with the veteran’s medical treatment

How many veterans are in Medicare?

Why Sign Up for Medicare. Of the more than 19.5 million veterans alive today, 9.1 million are currently enrolled in VA Health Care. 1 The majority of those enrollees are also eligible for Medicare.

Why did the VA scandal break out?

A scandal broke out in 2014 due to long wait times at a number of VA sites. This led to the development of the Veterans Choice Program. When appointments were not available for 30 days or more at a local VA facility, veterans could seek care with a private non-VA physician.

Is Medicare Part D good?

Medicare Part D. VA prescription drug coverage is seen as creditable, i.e., as good as Medicare. For this reason, you would not face late penalties if you signed up for a Medicare Part D plan at a later time. Still, there could be benefits to enrolling in a Part D plan.

Does Medicare cover out of network VA?

Since the VA does not pay for care received out of network (unless it is part of the Veterans Community Care Program), Medicare could be a good option to cover you in an emergency or if you wanted to see certain non-VA physicians.

Does Medicare Advantage cover hearing and vision?

Some Medicare Advantage plans could offer coverage for these services as a supplemental benefit, but that could require higher monthly premiums. VA Health Care, however, does offer these services, but not to everyone. Hearing and vision coverage is offered to veterans with the following: 2.

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 ...

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 ...

Can veterans get Medicare?

How Veterans Can Make Sense of Medicare and VA Benefits. Veterans who receive health care benefits through the U.S. Department of Veterans Affairs (VA) can also enroll in Medicare upon turning 65. Because each offers different benefits, having both at your disposal will broaden your health insurance coverage options.

Who is eligible for VA health care?

Who is eligible for military health-care benefits? In general, active service members, retirees, and veterans, other than those who were dishonorably discharged, are eligible for military benefits.

What is Medicare Part A?

Medicare Part A, which is also known as “hospital insurance,” covers services associated with inpatient care in a hospital, skilled nursing facility, or psychiatric hospital.

What are the benefits of medicaid?

Typical Medicaid programs cover inpatient and outpatient hospital services, physician and surgical services, lab tests and X-rays, family planning services, and prenatal and delivery services for pregnant women. There are also numerous optional benefits that states may choose to provide for Medicaid recipients.

What age does Medicare cover?

Medicare provides health insurance for individuals 65 years of age or older, individuals under 65 with certain disabilities, and individuals with End Stage Renal Disease (ESRD), regardless of any pre-existing medical conditions.

What are the three government programs that offer healthcare?

There are three major government programs that offer healthcare benefits: Medicare, Medicaid, and the U.S. Department of Veterans Affairs (VA, formerly the Veterans Administration). Eligibility is different for each program and will depend on things like income level, age, veteran status, and other requirements.

Can you get medicaid if you are blind?

In accordance with federal law, states are required to cover certain individuals, including, but not limited to low income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI). Individuals may be eligible for Medicaid based on blindness, disability, or age. Although some individuals are exempt from this, some financial eligibility is based on MAGI, or Modified Adjusted Gross Income. To be eligible for Medicaid, individuals must also meet non-financial criteria, including being a resident of the state you receive Medicaid in, and either be a United States citizen or qualified non-citizen.

Who is eligible for medicaid?

Medicaid is a health insurance program that is jointly administered by state and federal governments.It serves low-income and needy individuals who are also over 65, disabled, blind, or parents of minor children. Active military service members and veterans are eligible for health care through the U.S. Department of Veterans Affairs (VA).

Why do veterans use VA benefits?

Some use VA benefits as to avoid the gaps in Medicare and the costs they would incur. On the flip side, there are also many Veterans who recognize that those gaps can be covered through Medicare Supplement insurance.

How to contact VA insurance?

This is often best done through an independent insurance agent who has access to multiple insurance companies and their rates. Please call me (1-888-411-1329) if you have any questions about your VA benefits and Medicare Supplement. I look forward to speaking with you.

Why do people buy Medicare Supplement?

Often times, Medicare Beneficiaries will opt to purchase Medicare Supplement (Medigap) insurance to help fill in the gaps that Original Medicare doesn’t pay. This helps broaden their ability to have more control over their own health care needs.

How does Medigap work?

Medigap plans come with a monthly premium that you pay to the insurance company. As a Medicare recipient, you are entitled to find a lower premium for the same Medigap Plan at anytime throughout the year. This is often best done through an independent insurance agent who has access to multiple insurance companies and their rates. ...

What is Medicare Supplement?

Medicare Supplement insurance is designed to fill those gaps. It provides peace of mind knowing that your medical needs are being attended to and your bills are being paid by the insurance company.

Does Medicare Supplement pay after Medicare pays?

Medicare Supplement ( Medigap) insurance pays after Medicare pays. There are many types of Medigap Plans; but, they all help to pay for medical expenses not covered by Original Medicare…such as coinsurance and deductibles.

Is Medicare and VA separate?

Medicare and the VA are separate. Quite simply, Medicare and VA are separate entities. VA facilities are not Medicare approved providers. Beneficiaries usually use their VA benefits when they need help with health care items not approved by Medicare ( hearing aids, over-the-counter medications ). Medicare Supplement ( Medigap) ...

Why do you need a Medicare Supplement Plan?

Because both of these plans provide you with more coverage than Original Medicare ( Part A and B ). A Medicare Supplement plan helps fill in the gaps (deductibles, copayments, out-of-pocket expenses, etc.) left by Medicare.

What happens if you don't want Medicare?

If you don’t want Medicare now, you may have to pay a late enrollment penalty for signing up later on.

Is Medicare Advantage the same as VA?

Medicare Advantage. Combining Medicare Advantage and VA benefits is a great way to have more options with your coverage. There are many Medicare Advantage plans to choose from. Most plans include the same benefits as Medicare Part A, Part B, and a Part D prescription drug plan.

Does Medicare Supplement cover out of pocket expenses?

A Medigap policy helps pay for certain out-of-pocket expenses that Parts A and B do not cover. For example, Medigap can provide extra help with deductibles, copayments, coinsurances, and even medical emergencies that occur while traveling abroad.

Do veterans need medicare?

So, do veterans need Medicare? No, they don’t. That said, veterans’ benefits only cover your care at VA clinics. Medicare covers you ANYWHERE that accepts Original Medicare. So, adding Medicare is a great way to save on costs and have more choices with your health insurance. For even more coverage, savings, and flexibility, you can add a Medicare Supplement or switch to Medicare Advantage.

Does Medicare cover VA hospital?

For example, when you go to a VA hospital, your VA benefits will cover it (Medicare will not). When you go to a non-VA hospital in your network, your Medicare plan will cover it (VA benefits usually won’t).

Do VA benefits work together?

This leaves many veterans wondering how (or if) Medicare and VA benefits can work together to provide them with the healthcare they need. Moreover, if you already get VA health benefits, you may want to know if you should buy a Medicare Supplement (Medigap) plan.

How to contact the VA about a lost Medicare plan?

Call the U.S. Department of Veteran Affairs at 1-800-827-1000 for information on Veteran's benefits and services in your area. If you lose your VA coverage and join a Medicare drug plan, in most cases, you won’t have to pay a penalty, as long as you join within 63 days of losing your coverage. TRICARE EXPLAINED.

What is tricare for medicare?

For service members who are entitled to Medicare Part A and B, TRICARE provides Medicare “wrap-around” coverage.

What is the law for TRICARE?

The law requires TRICARE beneficiaries who are entitled to Medicare Part A based upon age, disability, or End Stage Renal Disease (ESRD) to enroll in Medicare Part B to retain their TRICARE benefits.

Is VA health insurance creditable?

However, there is one significant area in which VA health care is NOT creditable coverage: Medicare Part B (outpatient health care, including doctors’ fees). Creditable coverage for Medicare Part B can only be provided through an employer. As a result, VA health care benefits to Veterans are not creditable coverage for the Part B program.

Can you change your Vet Eran coverage?

Vet eran Benefits (VA) It will almost always be to your advantage to keep your current coverage without any changes. However, if you have limited income and resources, you may qualify for extra help from Medicare. Before making any changes to your coverage, contact your benefits administrator for more information about your VA coverage.

Is Medicare Part D coverage good?

If you are eligible for Medicare Part D prescription drug coverage, you need to know that enrollment in the VA health care system is considered creditable coverage for Medicare Part D purposes. This means that VA prescription drug coverage is at least as good as the Medicare Part D coverage.