Medicare Blog

when are you eligible for medicare if disabled and a veteran

by Austen Rodriguez Published 2 years ago Updated 1 year ago
image

Medicare is available to veterans over the age of 65 or under 65 if they have certain disabilities. You'll automatically be enrolled in Medicare Parts A and B if you receive Social Security or Railroad Retirement Board (RRB) benefits for at least four months before your 65th birthday.

Do disabled veterans have to have Medicare?

Do disabled veterans need 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.

When should veterans with VA health care enroll in Medicare?

The VA itself strongly recommends that veterans with VA health care also enroll in Medicare Parts A and B as soon as they become eligible (unless they have group insurance from a current employer).

Are you eligible for Medicare based on disability?

But some people may be eligible for Medicare even sooner. We’ll discuss each eligibility scenario in detail below. To become eligible for Medicare based on disability, you must first qualify for Social Security Disability Insurance.

What should a veteran 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

image

Can you get Medicare with VA disability?

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 pay for Medicare?

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.

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.

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.

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...

The Veterans Administration suggests all vets sign up for Medicare when they're eligible - even if they have VA coverage

Even if you already have health coverage through the U.S. Department of Veterans Affairs (VA), it's recommended that you sign up for Medicare when you're eligible. You are not required to do so, but there are several benefits to having both VA and Medicare coverage.

Can you have both VA healthcare and Medicare?

You can have both VA healthcare and Medicare, and in fact, the VA encourages you to sign up for Medicare as soon as you can. There are a few reasons for this:

How much does Medicare cost?

Monthly premium: You do not have a monthly premium for Part A coverage if you or your spouse paid Medicare taxes for at least 10 years (40 quarters) while working.

How your VA benefits and Medicare work together

If you have both VA and Medicare benefits, how services are covered typically depends on where you get care.

When is the best time to sign up for Medicare?

You should sign up for Medicare Part A and Part B as soon as you are eligible.

Do you need Medicare Advantage if you have VA benefits?

Medicare Part C, or Medicare Advantage (MA) plans, offer the same coverage as Original Medicare Part A and Part B. Many plans also provide additional benefits like prescription drug coverage, vision, hearing, and dental.

Do you need Medicare Part D if you have VA benefits?

Medicare Part D is prescription drug coverage. It's not included with Original Medicare and you must enroll in a stand-alone Part D plan in order to get the coverage. Or, you may receive drug coverage through a Medicare Advantage plan.

When will Medicare be available for seniors?

July 16, 2020. Medicare is the government health insurance program for older adults. However, Medicare isn’t limited to only those 65 and up—Americans of any age are eligible for Medicare if they have a qualifying disability. Most people are automatically enrolled in Medicare Part A and Part B once they’ve been collecting Social Security Disability ...

What conditions are considered to be eligible for Medicare?

Even though most people on Social Security Disability Insurance must wait for Medicare coverage to begin, two conditions might ensure immediate eligibility: end-stage renal disease (ESRD) and Lou Gehrig’s disease (ALS).

What is ESRD in Medicare?

ESRD, also known as permanent kidney failure, is a disease in which the kidneys no longer work. Typically, people with ESRD need regular dialysis or a kidney transplant (or both) to survive. Because of this immediate need, Medicare waives the waiting period. 2

What to do if your income is too high for medicaid?

If your income is too high to qualify for Medicaid, try a Medicare Savings Program (MSP), which generally has higher limits for income. As a bonus, if you qualify for an MSP, you automatically qualify for Extra Help, which subsidizes your Part D costs. Contact your state’s Medicaid office for more information.

How long does it take to get Medicare if you appeal a decision?

The result: your wait for Medicare will be shorter than two years.

How long does a disability last?

The government has a strict definition of disability. For instance, the disability must be expected to last at least one year. Your work history will also be considered—usually, you must have worked for about 10 years but possibly less depending on your age.

Does Medicare cover ALS?

Medicare doesn’t require a waiting period for people diagnosed with ALS, but they need to qualify based on their own or their spouse’s work record. 3

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% ...

What is the difference between veterans with service related disabilities and veterans with higher incomes?

Whether you receive additional benefits. Veterans with service-related disabilities are put in the highest priority group, whereas veterans with higher incomes who don’t have any service-related disabilities are generally put into lower priority groups.

How to apply for VA benefits?

Eligible veterans can apply for VA benefits in one of five ways. Fill out an online application on your VA.gov account. Call 877-222-8387 Monday to Friday from 8 a.m. to 8 p.m. Eastern Time. Fill out and mailing the application form. Apply in person at a local VA medical center or clinic.

What is TFL for Veterans?

Veterans who are eligible for Tricare and have Original Medicare can be automatically enrolled in Tricare for Life (TFL), a program that provides “wrap-around” Medicare coverage.

How many veterans are covered by the government?

To support the health care needs of about 19 million veterans in the United States, the government has a number of health insurance programs available, such as VA benefits, Medicare and Tricare for Life. Veterans can benefit from both VA health care coverage and Medicare if they meet the eligibility requirements.

What happens if you delay Medicare Part B?

Delaying enrollment might result in a permanent late enrollment penalty, which increases the longer you delay signing up.

Do veterans have Medicare?

About half of veterans who have VA benefits also have Medicare coverage, expanding their options for where and how they receive care. This guide covers whether you should enroll in VA benefits and Medicare, how VA benefits work with Medicare, and how Tricare for Life works with Medicare.

Does Medicare cover VA?

VA benefits cover services at VA-authorized or non-VA facilities with pre-authorization, whereas Medicare helps cover services at non-VA facilities .

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 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. ...

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 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.

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.

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 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 ...

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.

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.

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 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 services does Medicaid cover?

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.

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.

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).

Can a survivor of a veteran receive the same benefits?

Survivors of service members and veterans are also eligible for some of the same benefits. However, the rules surrounding these benefits can be complex and may change. Check with your military personnel office or local VA office if you have questions about any of these benefits.

image
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9