For veterans approaching Medicare eligibility, it is common to have questions about whether it is necessary to enroll in Medicare alongside Veterans Affairs (VA) benefits. The short answer is that Medicare does not coordinate with VA benefits. However, you can have both types of insurance at the same time and benefit from doing so.
Full Answer
Should veterans with VA health care enroll in Medicare?
But you may have good reasons to do so. 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). VA health coverage isn’t set in stone and isn’t the same for everyone.
What happens if you have both Medicare and VA health insurance?
If federal funding for VA health care drops or doesn't keep pace with costs, some vets in the lower priority groups may lose VA coverage entirely. 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.
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.
Is a Medicare Advantage plan worth considering for a veteran?
A Medicare Advantage plan may be worth considering if you are a veteran. A Medicare Advantage plan will provide all the same coverage as Original Medicare, and some Medicare Advantage plans may cover some additional benefits that Original Medicare doesn’t.
Are veterans covered by Medicare?
Medicare Coverage and Eligibility 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.
Can the VA be a primary Medicare?
For veterans approaching Medicare eligibility, it is common to have questions about whether it is necessary to enroll in Medicare alongside Veterans Affairs (VA) benefits. The short answer is that Medicare does not coordinate with VA benefits.
Do veterans have to pay for Medicare Part B?
You must continue to pay Medicare Part B premiums to remain enrolled in Tricare, says Daniels. “Tricare pays after Medicare in the U.S. and the U.S. territories,” she says. “Tricare also pays Medicare deductibles and co-insurance.”
Are VA benefits better 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.
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.
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.
Can I have Medicare and VA benefits?
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.
How Much Does VA health care cost per month?
The charge ranges from $5 to $11 for each 30 day or less supply of medications provided on an outpatient basis for nonservice-connected conditions. Outpatient – The copayments will be based on primary care visits ($15) and specialty care visits ($50).
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.
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.
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.
Can a veteran go to any hospital in an emergency?
Eligibility requirements notwithstanding, Veterans should always seek care at the nearest medical facility during a medical emergency, and never delay emergency medical care.
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% ...
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.
Why do VA beneficiaries have to enroll in Medicare?
Even the Department of Veterans Affairs encourages beneficiaries to enroll in Medicare as soon as they’re eligible. The reasons are numerous. They include: VA funding can change at any time. Depending on your priority level, you may lose your VA benefits. Then you’d be left without health coverage.
When do veterans have to enroll in Medicare?
Like everyone who qualifies for Medicare, veterans should enroll during their Initial Enrollment Period (IEP). Your IEP begins three months before your 65th birthday and ends three months following your birth month, for a total of seven months.
What happens if you enroll in Medigap during IEP?
When you enroll during your IEP, you ensure you face no late penalties or gaps in coverage. This is also the best time to enroll in a Medigap plan, since it’s the only time you don’t have to undergo medical underwriting. That means the insurer cannot refuse to sell you a Medicare supplement plan or charge you more.
Why do veterans choose VA prescriptions?
Most veterans choose their VA prescription benefits, because the out-of-pocket costs are lower. In addition, although having VA benefits does not qualify you for an SEP, Medicare considers the VA’s prescription coverage “creditable.”. This means veterans don’t face late penalties if they decide to add a Part D plan later.
What is the maximum out of pocket for Medicare?
However, out-of-pocket costs for hospital stays are usually lower. In addition, MA plans have a maximum out-of-pocket (MOOP) limit, which is $6,700 in 2019. Original Medicare has no limit on out-of-pocket costs.
Can Medicare refuse to sell my supplement plan?
That means the insurer cannot refuse to sell you a Medicare supplement plan or charge you more. If you need help understanding your Medicare options, the licensed agents at Medicare Solutions can help. Just call us toll-free at 855-350-8101 to get started or browse plans here. Share on facebook. Facebook.
Is Donna Frederick eligible for Medicare?
Donna Frederick. August 8, 2019. Educational. It’s not unusual for people who are newly eligible for Medicare to have other coverage options. Although employer-sponsored insurance is the more common scenario, plenty of folks also qualify for VA benefits.
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 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.
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.
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.
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.
Can you use Medicare and Medicare at the same time?
The government can suspend or lower funding at any time, and you don’t want to find yourself without viable medical coverage. 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.
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.
When does Medicare sign up window end?
For example, if the big day is June 15, your signup window begins March 1 and ends Sept. 30. And remember, signing up for Medicare does not affect your VA health-care benefits. Medicare Part A, which provides hospital coverage, costs nothing. The standard premium for Part B, which is for outpatient care and medical equipment, is $135.50 for 2019.
What happens if you don't sign up for Part B?
Like the rest of the population, if you don’t sign up for Part B when you’re first eligible, you could face a life-lasting penalty if you change your mind later. And the longer you delay, the higher the amount that gets tacked on to your premium.
How long does it take to get VA health care?
The VA encourages those who receive health care through its network to sign up for Medicare when they are first eligible. You get seven months to enroll, starting three months before the month in which you turn 65 and ending three months after your birthday month. If you get health care through the Veterans Health Administration ...
What is the guarantee issue period for Medicare?
After that window, unless your state allows special exceptions, you 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 .
Is Part D optional?
Part D, which is for prescription drug coverage, is optional. Some people using VA health care sign up for it so they can get their medicine from non-VA doctors and have their prescriptions filled at their local pharmacy instead of through the VA mail-order service.
Is there harm in not signing up for Medicare?
And, there’s no harm in not signing up: If you don’t do it when you’re first eligible for Medicare and then change your mind later, you won’t pay a penalty because it is considered “creditable” by the Centers for Medicare and Medicaid Services. VIDEO. 14:58. 14:58. How American health care got so expensive.