While most citizens aged 65 and above receive healthcare coverage through Medicare, veterans (and sometimes their family members) are eligible for healthcare coverage through the VA benefits, TRICARE or CHAMPVA. Those who have VA coverage and are eligible for Medicare can benefit from enrollment into Medicare plans. In fact, it’s often recommended by the Department of Veteran Affairs to do so, in order to gain access to enhanced coverage options.
Let’s explore the coverage options that veterans have vis-à-vis Medicare.
VA Coverage vs. Medicare Coverage
VA plans and Medicare are independent of each other. It’s important to know that VA plans are only covered at VA facilities whereas Medicare plans provide coverage at the facilities assigned by Medicare. The healthcare coverage from these plans does not overlap.
It’s also important to know that veteran healthcare coverage is not standardized and varies for every veteran. It is also subject to change over the years. Basically, veterans are enrolled into the coverage plan depending on their income and whether they have a medical condition that has emerged from their years in service. Should the federal funding drop or faces budget cuts, low priority coverage may also be slashed for veterans that fall into the category.
This is why having both, VA benefits and Medicare coverage should go hand in hand in order to widen the coverage that veterans have access to. Furthermore, there are two things that should be taken into account: distance from the veteran facility that provides you coverage and future penalties that the veteran may be subject to, if the veteran coverage is dropped.
Distance From The Veteran Facility
If you are a veteran with access to VA benefits, you must know that VA coverage is only granted at VA facilities. If you live further away from the VA facility, your VA benefits will not provide you coverage at a non-VA hospital or doctor. This is where enrollment in the Medicare programs comes in handy, especially Part A and Part B.
Having Medicare means you have coverage in case of emergencies where you may need medical assistance from a non-VA facility, hospital or doctor. Without Medicare Part A and Part B, you would have to pay for the healthcare expense out of your pocket—even for emergencies.
Therefore, it’s advisable to enroll in Part A and Part B is you are eligible for them at the age of 65, since it grants you coverage for inpatient hospitalization, hospice, skilled nursing and outpatient care. Enrolling at the right time can also protect you from penalties and late enrollment payments.
Late Enrollment Penalties
For veterans who rely solely on VA coverage, late enrollment penalties may become a problem in the future if their coverage is dropped. If you are a veteran over the age of 65 and decide that you need Medicare, you may face late enrollment penalties. These penalties are then permanently added to your Part B premiums hence making Medicare plans more expensive for you in the long run.
Prescription Drug Coverage
Generally, VA coverage for prescription drugs is better and cheaper than Medicare Part D. Veteran with VA benefits don’t need to enroll in Medicare Part D from the get-go. If you lose your VA coverage, you still won’t have to pay for late enrollment penalties for Medicare Part D given that you sign up for Part D within two months for your VA coverage ending or being revoked.
It’s crucial to understand that VA systems and Medicare coverage does not overlap. Veterans should use their VA cards at VA facilities and their Medicare cards when receiving healthcare from non-VA facilities.
For more information regarding Medicare plans for seniors and veterans in New York and New Jersey, get in touch with a licensed insurance agent at Seniors for Medicare. You can also reach out to us at 800-276-1753 for details.
Seniors for Medicare 