There are many people who along with Original Medicare have health benefits through Veterans Affairs. Some use VA benefits as to avoid the gaps in Medicare and the costs they would incur.
On the flip side, there are also many Veterans who recognize that those gaps can be covered through Medicare insurance plans.
It Doesn’t Have To Be One Or The Other…
The good news is you can choose to have both VA benefits and Medicare Supplement insurance or even a Medicare Advantage plan.
Here are a few things to consider:
- VA cannot bill Original Medicare, but can bill Medicare Supplement insurance for a covered service.
- For Medicare coverage, you must receive care at a Medicare approved facility.
- For VA coverage, you must generally receive health care services at a VA facility.
Medicare and the VA are separate
Medicare and VA are separate entities. VA facilities are not Medicare approved providers. Beneficiaries usually use their VA benefits when they need help with health care items not approved by Medicare (hearing aids, over-the-counter medications).
Medicare insurance plans pay after Medicare pays, or instead of Medicare, in the case of a Medicare Advantage plan. There are many types of Medicare insurance plans, but they all help to pay for medical expenses not covered by Original Medicare…such as coinsurance and deductibles.
If you have Medicare Part A and B (Original Medicare), you may want to consider supplementing with a Medicare insurance plan and not relying exclusively on VA benefits or Original Medicare.
Live a long way from the VA hospital?
If you travel, you will always need to know where the nearest VA facility is located…there is no guarantee there will be one near you. If you use your Original Medicare, you’ll be subjected to the bills Medicare doesn’t pay.
Adding a Medicare Supplement insurance to your health care portfolio will make traveling easier.
One Example…
One of our dear family members is 74 years young. He served in the Army and receives VA benefits. He visits the VA often…mainly for prescriptions drugs and hearing aids.
But his Florida Medicare Supplement plan has been invaluable for many years. Most recently he needed to see a dermatologist the day he was leaving for a trip.
We were able to find him a Medicare approved doctor and get him an appointment that morning. The doctor billed Medicare and the Medicare Supplement Plan G paid the remainder of Medicare approved charges.
Another Veteran, Mr. L, is a client who has a Medigap Plan F in South Carolina. He lives 125 miles from the nearest VA facility.
He takes a full day to drive to the VA center, have the appointment and drive home. In certain situations, Mr. L doesn’t mind making the trip if it’s for an item that Medicare doesn’t cover.
However, Mr. L likes having peace of mind about his healthcare coverage. With his Medicare insurance plan, he’s able to stay in town and visit any Medicare approved doctor, hospital, or specialist he desires.
Quality of care
Perhaps you have a conveniently located VA hospital, but it’s quality of care is not the highest compared to other hospitals in your area. Medicare is a back up option, but it still has gaps in coverage. Medicare insurance plans are designed to fill those gaps. It provides peace of mind knowing that your medical needs are being attended to and your bills are being paid by the insurance company.
In a recent phone conversation with a gentleman in Colorado, he shared with me how he was given a different primary doctor at the VA facility where he’s been going for years.
His other physician was still there; someone just decided to change his doctor. He was not thrilled with the idea that someone else made this decision for him. He wanted some information on a Medicare insurance plans so he could have more control over his health care and choose which Medicare doctor he wanted to see.
Takeaways
Our veterans are often unaware of all the benefits available to them. You can choose to have Medicare insurance plans with your VA benefits. The ability to use your benefits with Veterans Affairs can sometimes be limited based on location, quality of care and appointment availability.
Often times, Medicare Beneficiaries will opt to purchase Medicare Supplement (Medigap) insurance or Medicare Advantage plans to help fill in the gaps that Original Medicare doesn’t pay. This helps broaden their ability to have more control over their own health care needs. Medigap plans, and some Medicare Advantage plans, come with a monthly premium that you pay to the insurance company while many Medicare Advantage plans have no monthly premium.
As a Medicare recipient, you are entitled to find a lower premium for the same Medigap Plan at anytime throughout the year, while Medicare Advantage enrollments are mostly based in the October-December part of the year. Medicare Advantage plans are also available January-March for those that are already enrolled in one, and available for enrollment year-round if you qualify for a special enrollment period (SEP). Contact us to know if you qualify for a SEP, as we are an independent insurance agency with access to multiple insurance companies and their rates.
Contact Us To Discuss Your Medicare Options
Our team specializes in working with Medicare beneficiaries to walk them through their options and put together a plan that is best suited to their healthcare needs. Get the process started by clicking below for a no obligation quote.