Medicare provides veterans with more coverage that supplements their VA benefits. The VA assigns veterans different priority levels.
Those who are assigned a lower priority level risk the chance of being dropped entirely from their VA benefits. Leaving them with zero healthcare coverage.
That’s why the Department of Veterans Affairs highly recommends that veterans enroll in Medicare to supplement their benefits.
It’s also important to know that VA benefits are NOT considered creditable coverage under Part B.
Medicare coverage and VA benefits are not the same. You can have both types of coverage at the same time.
Below, we’ll expand on the benefits of veterans having Medicare coverage as well as late penalties they’re vulnerable for.
Medicare Supplements for Veterans
It’s important to plan ahead in case there are not enough funds to provide healthcare coverage to those in lower VA priority groups.
Without adding a Medicare and Medigap plan to your VA benefits, you could be subject to the high cost of emergency services. As well as waiting months before you receive any care.
In the event of an emergency, an ambulance will transport you to the nearest hospital. The nearest hospital is most likely not a VA clinic.
The hospitals default to Medicare when billing. Leaving veterans responsible for the Medicare cost-sharing out of pocket expenses. This includes the Part A deductible of $1,364, as well as the 20% coinsurance that falls under Part B.
Once the hospital bills Medicare and gets their money, the chances of them reversing the transaction to bill the VA is slim to none. If by chance the hospital does attempt to help you, the Department of Veterans Affairs won’t take the time to look at the bill after it’s already been paid by Medicare.
This scenario would never happen if veterans had both VA healthcare coverage, Medicare coverage, and a Medigap plan.
Medicare would’ve covered the hospital expenses minus the deductible. A Medigap plan would cover the $1,364 Part A deductible, as well as the 20% coinsurance under Part B.
Should Veterans Apply for Medicare Part A
Absolutely! Medicare Part A, under normal circumstances, is premium-free! This gives you the option to receive hospital coverage at a non-VA facility.
If you find yourself in an emergency situation and the closest hospital is not a Department of Veterans Affairs approved clinic, you’ll still be covered.
Should Veterans Apply for Medicare Part B
Yes, it’s highly recommended that Medicare-eligible veterans apply for Medicare Part B. Part B does require a monthly premium, but it will give you peace of mind knowing that if the VA ever drops your benefits, you’ll still have healthcare coverage under Medicare.
Veterans Face a Permanent Late Penalty for Delaying Part B
Veterans are not required to enroll in Medicare. However, VA benefits are NOT considered creditable coverage under Part B.
If you don’t enroll when your first eligible, you may be subject to penalties that are forever added to your Part B premiums. This is a huge issue among veterans.
Unfortunately, most Department of Veterans Affairs offices doesn’t share this information with veterans unless asked.
Leaving them unprepared for the permanent late penalty when they choose to enroll in Part B later.
Applying for Medicare Part D as a Veteran
Since VA prescription drug coverage is considered creditable coverage, (unlike Part B) you can enroll in Medicare Part D penalty-free outside your initial enrollment period.
It’s important to note that your VA prescription drug coverage benefits will only cover prescription medications that were prescribed by a VA doctor.
Since Part D Medicare plans are considered affordable, a lot of veterans opt to enroll in this additional stand-alone drug policy so that their medications are covered in the case they see a Medicare-approved doctor.
Medigap Plans for Veterans
Medigap plans for veterans fill in the gaps in health care coverage by providing you with additional civilian benefits.
All veterans are well aware of the reputation that VA facilities have received over the past few years.
Health care at a VA facility is prioritized by who is the illest and who has the lowest income.
They’re known for having a very long waiting period for important treatments and procedures.
Veterans who opt to enroll in Medigap will be able to see a provider sooner and have their out of pocket costs left after Medicare pays their portion covered.
Such out of pocket costs that Medicare Supplements will cover include coinsurance, copayments, and deductibles.
Medigap also includes coverage for veterans when traveling outside of the united states. With veterans having a real concern regarding their finances, more and more decide to enroll in Medigap.
Medicare Advantage Plans & Veterans Benefits
Medicare Advantage plans have lower premiums when compared to Medigap plans. In some cases, you can find plans with a zero dollar premium.
You still have some cost sharing with Medicare Advantage plans, but it’s still better than having no Medicare coverage at all to fill in the gaps with VA benefits.
When to Use Your Veterans Benefits vs Your Medicare Coverage
It may be smarter to use your VA benefits instead of your Medigap benefits if you’re high on the priority list and the waiting period is not too long.
If you are low on the priority level and face an extended wait time for medical treatment, you should consider using your Medicare and Medigap coverage instead.
Veterans Benefits Priority Levels
Congress sets the priority groups and funding for VA benefits each year. Those that are eligible for VA benefits are given a priority level numbered 1-8.
Your assigned priority level is what determines the level of benefits you’re eligible for. With priority number 1 getting the most amount of coverage and priority number 8 getting the least amount of coverage.
The Department of Veterans Affairs recommends that all veterans, with any benefits priority level, should supplement their benefits with Medicare.
However, those with higher priority levels will benefit the most. Your priority level is determined by factors such as the length of your military service and your income level.
There’s no guarantee that Congress will approve enough funds for the VA to provide health care coverage to all priority levels, leaving you vulnerable and without any health care coverage.
That’s why Medicare is a great backup to keep your finances safe.
Veterans Dealing with a Disability Claim Appeal
If you’re a Veteran dealing with a disability claim appeal, there’s a new tool you can use. It shows where your appeal is in the line and how long to expect to wait!
The VA launched a new appeals status tracker so that Veterans with a compensation appeal can view their past and current appeals issues as well as receive alerts.
Thank You for Your Service, We Would Love the Opportunity to Help You!
We thank you for your service. Let us help you compare these options side by side. Give us a call today for more information on plans and prices. You can also use our online rate tool to see rates in your area.