Medicare & VA benefits: how they work together
- When You Use a VA Hospital. If you get medical care at a VA hospital, your VA benefits will generally cover the costs. ...
- When You File Your Own Claim. Some disabled veterans don’t live near VA hospitals. ...
- Try VA benefits drug plans. Unfortunately, many patients fail to enroll in a Medicare Part D plan on time. ...
- Also Get Medicare. ...
Full Answer
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.
Can the VA bill Medicare Advantage plans?
VA medical centers can bill Medicare Advantage plans (supplemental Medicare), as these are private insurance policies purchased through a third party. By law, however, the VA cannot bill traditional Medicare (Medicare Part A Part B) plans issued by the federal government. How Is Medicare Advantage Billed By the VA?
How does Medicare work with coverage for veterans?
Here’s why:
- VA health coverage isn’t set in stone and isn’t the same for everyone. ...
- 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. ...
- You may be subject to penalties in the future. ...
How does VA work with Medicare Advantage plans?
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.
Can you have a Medicare Advantage plan and VA benefits?
You can have both. Coverage through a Medicare Advantage Plan does not conflict with VA health care services and would increase your flexibility and options in terms of how and where you receive health care.
Do veterans get a discount on Medicare?
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 premiums or a monthly fee for your other Medicare coverage depending on your plan.
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.
What is the best Medicare plan for military retirees?
Military retirees with TRICARE For Life coverage may consider the AARP Medicare Advantage Patriot Plan. This plan provides the freedom to visit doctors and hospitals in our network for a $0 monthly premium and additional benefits that may include: Monthly credits applied to your Medicare Part B premium.
Do veterans get free HealthCare for life?
You can get free VA health care for any illness or injury that we determine is related to your military service (called “service connected”). We also provide certain other services for free.
Does VA require Medicare Part B?
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.
Will the VA pay for my prescription drugs?
Typically, VA drug coverage has no premiums and no or limited copayments for prescriptions—but you must use VA pharmacies and facilities. You may want Part D coverage if you: Live far from a VA pharmacy or facility, or do not want to use a VA provider to get prescriptions.
Is VA creditable coverage for Medicare Part B?
Under Medicare Part B, VA health care is NOT creditable coverage. Creditable coverage under Medicare Part B can only be provided through an employer.
Is Medicare primary or secondary to VA?
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 .
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.
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.
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 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.
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 ...
Do You Need Medicare If You Have VA Benefits?
Having both VA benefits and Medicare increases your options for where and how you receive health care services.
How Do VA Benefits Work with Medicare?
Medicare and VA benefits seldom work together. This is a major reason the VA recommends that veterans enroll in Original Medicare even if they have VA benefits.
Prescription Drug Coverage Through VA Benefits or Medicare Part D
If you have both VA and Medicare Part D prescription drug coverage, you have the option of using either to pay for your prescriptions.
Using Medigap or Medicare Advantage and VA Benefits
Medicare supplement insurance plans — also called Medigap — and Medicare Advantage plans are sold by private insurers that contract with Medicare.
When is Medicare enrollment for VA?
Medicare Annual Enrollment, which runs from Oct. 15 to Dec. 7 , is nearly upon us. It could be a great time to shop, and check out the costs, limitations and specific details. Here are seven things to consider as you weigh a decision to supplement your VA health care with a Medicare Advantage Plan:
How much does Medicare Part B cost?
In 2017, the standard cost of Medicare Part B is $134 per month, but those with higher incomes may pay more. And, if you sign up late you’ll pay a higher premium. Generally, you sign up around the time you hit age 65.
Why is Medicare not paying for hearing?
It could be because lots of people are interested in getting extra coverage. Some Medicare Advantage plans offer hearing, dental and wellness programs that aren’t paid for under Medicare. It also could be that many Medicare recipients want the peace of mind that comes with limiting maximum out-of-pocket outlays.
What is the number to call for Medicare?
Details for 2018 plans become available Oct. 1, so beat the rush and give them a call at 877-699-2654.
Does Medicare Advantage Plan conflict with VA?
Coverage through a Medicare Advantage Plan does not conflict with VA health care services and would increase your flexibility and options in terms of how and where you receive health care. Second opinion. With Important health issues, you may want to get a second opinion. Having two separate health care sources— the VA and a Medicare Advantage plan ...
Does Medicare cover vacations?
And while Medicare doesn’t cover you if you’re on vacation outside the U.S., a Medicare Advantage plan could provide worldwide emergency coverage.
Is VA coverage guaranteed?
Eligibility for VA health coverage is not guaranteed and could change over time. This could be true, especially, at times when budgetary issues are top-of-mind in Washington. A Medicare Advantage plan could be your fallback. You can have both.
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:
Why should veterans consider Medicare Advantage?
Another reason why veterans should consider Medicare Advantage is that VA health coverage can change. According to the American Association of Retired Persons (AARP), health coverage with the VA varies from person to person and can change based on trends in federal funding or changes in VA priority groups. By enrolling in a Medicare Advantage plan, ...
What is Medicare Advantage?
Medicare Advantage plans are supplied by private insurers, and come in a variety of coverage models. The specific plans available to you will vary according to your region. You can use the official U.S. government website for Medicare in order to find and compare your plan options.
Can a veteran get Medicare Part D?
In terms of drug coverage, it doesn’t always make sense for a veteran to join Medicare Part D because they can get their medications through VA. However, because drug coverage is usually included in Medicare Advantage plans, enrolling can widen your options at no additional cost.
Does Medicare overlap with the VA?
Next, it’s important to understand that the VA system and Medicare have no overlap in benefits. To get VA benefits, you must use VA facilities, according to the official website of the U.S. Department of Veterans Affairs. This can be a big deal if your local VA hospital is far away.
Is Medicare Advantage a good option for veterans?
However, a Medicare Advantage plan can be a very sensible option for veterans. Here’s why. Find a Medicare Plan that Fits Your Needs. Search 200+ Medicare Plans in Your Area.
Can I get Medicare Advantage if I am a veteran?
If you're a veteran, enrolling in a Medicare Advantage plan can make a lot of sense—even if you already have Veteran’s Affairs (VA) benefits. Here are some reasons why. Veterans are entitled to enroll in both the Veteran’s Affairs (VA) health system and Medicare.
Can you be late to enroll in Medicare?
government website for Medicare. However, if you enroll in a Medicare Advantage plan right when you're eligible, there will be no penalty.
