Do You Know the Answers to these FOUR Questions?
Four questions veterans should understand about Medicare and VA Benefits
1. What is Medicare and what are the Medicare Basics that every veteran should know?
Medicare is a government health insurance program that covers Americans age 65 and older. Original Medicare has two parts – Part A and Part B. Part A is hospital insurance which includes patient care in hospitals. Part A insurance covers about 80% of the hospitalization expenses and is free for most people. In most cases, a person will start receiving Part A benefits the month he or she turns 65. Part B is medical insurance and includes doctors’ and other health care providers’ services. This Part covers about 80% of these expenses and the payment for this comes out of the monthly social security check or is paid for by the individual until they start receiving their social security benefits.
The biggest concern, then, for people turning 65 and who are retired, and have no other health coverage, is - “How will I pay for the other 20% of the costs should I need to go to the hospital or see a doctor, even for just a routine visit?“
The answer to this question is Medicare Part C also known as Medicare Advantage. These health plan options are run by Medicare-approved private insurance companies. Part C combines Part A and Part B and usually Part D and often some additional benefits for little or no extra cost.
If you take any prescription drugs, which seem to increase in cost every time you turn around, you may decide you need to add prescription drug coverage to your insurance. This is called Part D and is purchased from a private Medicare-approved private insurance company also.
Another choice is called Medicare Supplement Coverage policy or Medigap. Those who choose this coverage may need to add a separate Part D prescription drug coverage plan.
Some of the Medicare – approved private companies are: United Healthcare, HealthNet, SCAN, Easy Choice, Humana, Aetna, Care 1st, Kaiser and many others. The list is large. One of these many, many companies offers a Part C, Part D or Medicare Supplement plan in every county in the nation.
2. Why would I, a veteran, need Medicare?
Just as you were trained to be prepared with all the best equipment to go into battle, you were also taught to have a good back-up plan. Medicare Advantage (Part C) and Medicare Supplement coverage are excellent back-up plans.
But there are three other answers to this question:
First, many young veterans, under the age of 65, who served our country, received injuries, became disabled and are unable to work. Social Security automatically gives that disabled person Part A benefits and Part B benefits after they have received certain disability benefits for 24 months. They will get a red, white and blue Medicare card on the 25th month of the disability. Having that card now qualifies that person to apply for Part C Medicare Advantage plan and Part D which could become valuable back-up plans.
Second, The Department of Veterans Affairs “strongly recommends that all veterans who have VA health care enroll in Medicare as soon as they become eligible. . . . . .” The reasons are:
a. VA health coverage is not set in stone and is not the same for everyone.
b. Having both Medicare and VA benefits widens your coverage.
c. If in the future, when you are will past 65, you happen to lose VA coverage or otherwise decide that you need Medicare and are not already signed up for Part B, you’d pay a late penalty to enroll at that time.
d. If you had Part D, you would have the flexibility to use one or the other.
e. Military retirees who have switched from TriCare to TriCare for Life must enroll in Part A and Part B.
f. If you live far from a military facility you would want to have the convenience of a near by networks of doctors and pharmacies.
Third, you can have the best of both worlds! You can receive all the coverage the VA plan offers you PLUS you can take advantage of many other benefits for $0 monthly premium in many counties! A marvelous standby plan for ZERO dollars!!
3. Do I lose VA Benefits if I sign up for Medicare insurance? Is there any problem having two health care plans?
The answer is NO for both questions. VA benefits and Medicare Advantage plans or Medicare Supplement Plans do not conflict with each other. You probably would not need a Medicare private drug plan (Part D) if you have VA benefits. Veterans’ coverage is more comprehensive than Medicare drug coverage and charges no premiums and no or limited co-payments for prescriptions. However, if you added a Medicare Advantage plan to your VA benefits that included Part D drug coverage, you do not have to use it. It would be an added benefit if you ever needed it.
You may want to join a Medicare private drug plan if you live very far from a VA site and the Medicare private drug plan includes nearby pharmacies in its network, or if you live in a nursing home that does not accept your VA drug benefits.
4. Doesn’t the VA benefits take care of all health care needs of veterans?
Again the answer is NO. Medicare Advantage and Medicare Supplement plans increase coverage beyond VA hospitals and doctors, which could be important if you had to be taken to a non-VA facility in an emergency. Not all veterans are on the same level or receive the same healthcare benefits at a VA hospital. Some have to pay a co-pay each time they go and a VA hospital may be quite far away. Some veterans see interns at a VA hospital more often than they see a doctor. Medicare Advantage plans require an applicant to choose a primary care physician who becomes the same, steady, regular physician that patients see at each appointment. Some veterans report that they have difficulty seeing a specialist. Under Medicare Advantage plans the primary care physician can refer you to a specialist and an appointment made the same day.