VA Healthcare or Medicare

After four applications over a period of three years, I finally met the income requirements to be accepted into VA Healthcare. Every year, I must submit a form to requalify for the coming year. I am also approaching my 65th birthday, which raises the question of how does VA dovetail with Medicare, especially in regards to Medicare Part B and D. The answer to Medicare Part D was easy, but not so for Medicare Part B.The prescription drug plan for VA Healtcare does qualify for Medicare Part D. Whether it is the best option depends on your VA Healthcare priority group and your choice of how to handle Medicare Part B. In regards to Medicare Part B, I could not find an answer on either the VA Healthcare Web site or the Medicare Web site. I fired off a e-mail to Medicare on Sunday and got an answer Monday morning. Following is the answer that I received:

“Enrolling in Medicare is your choice.

“The Department of Veterans Affairs (VA) provides health care benefits to veterans. The VA covers a number of health care services, including preventive services, diagnostic tests, and hospital stays. It may also cover nursing home and other long-term care options.

“If you have both Medicare and Veterans benefits, you may be eligible to get health care services under either program. However, you’ll have to make a choice. Claims cannot be paid by both programs for the same dates and services.

“If you elect to have your claims submitted to Medicare, you will have to pay any deductible or coinsurance charged. However, any Medigap or supplemental policy you have may cover some or all of these charges.

“VA claims might require a co-payment for some services. You should call the Department of Veterans Affairs for more information.

“To get services under the VA, you must go to a VA facility or have the VA authorize services in a non-VA facility. If the VA authorizes services in a non-VA hospital but doesn’t pay for all of the services you get during your hospital stay, then Medicare may pay for the Medicare-covered part of the services that the VA does not pay.

“VA coverage is not considered creditable coverage for Part B.”

In terms of Medicare Part B, the key lies in the last sentence. Medicare Part A is free, but Medicare Part B costs around a $110 a month. If you choose not to accept Medicare Part B, theWelcome to Medicare booklet issues the following warning”

“If you don’t keep Part B when you’re first eligible, you may have to wait until the General Enrollment Period (January 1 – March 311 each year) to sign up, and you coverage would start July of that year. You may also have to pay a Part B late enrollment penalty.”

There is no single correct answer to this dilemma. Wihout a crystal ball, I don’t know if there will be a period when I do not qualify for VA Healthcare. Since the penalty for late enrollment in Mediare Part B never goes away, it like rolling dice over future events. For those vets covered, TRICARE is a qualified substitue for Medicare Part B. If you have any doubts, call Medicare.

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#2 Ashlea Heddlesten on 02.16.10 at 6:36 pm

Thank you for your hard work on the post. I’m trying to compile a list of people that write about this stuff, let me know.

#3 Dominique Ahsing on 02.18.10 at 2:05 pm

Interesting article. Were did you got all the information from…?

#4 admin on 02.21.10 at 7:46 am

I found the information for the article on the VA Healthcare site, and by submitting a query to Medicare on their site. Neither bits of information was easy to find, but they do exist. I mentioned what I found to a fellow Vet, who has a 100% service rated disability. He thought VA Healthcare was a substitute for Medicare Part B, and is now paying a monthly penalty for late signup.

#5 admin on 02.21.10 at 7:50 am

It takes a lot of patience to search through all the pages, but you can find a lot of information on the VA Healthcare and Medicare Web sites. I was researching this question after reading the Medicare pamphlet about qualifying health plans. The pamphlet was not clear about VA Healthcare as a substitute for Medicare Part B. So I started to research the issue. It took three days to find the answer.

#6 Article Directory Free Articles on 03.01.10 at 4:24 pm

Do you have to include a web directory on your website in order to have the other sites link to you? No, there are paid options that allows you to get the links without linking back. This is known as ‘one-way’ linking.

#7 admin on 03.07.10 at 8:19 am

This is a Weblog site, and I do not maintain a separate resource directory.

#8 Richard Milyard on 03.20.10 at 4:15 pm

I retired at 57 from a CAD managers job in San Diego to take care of my
Mother. She passed a couple of months ago and I will be 65 in July.
During the eight years I took care of my Mother I received quite an education as far as insurance companies and medicare are concerned.
I am a VietNam Vet who served 4 years and 4 months in the Marine Corps.
I have Soco and another 1K a month misc. income on top of that, so I ain’t rich, but comfy as all is paid off.
My recommendation for part B is: STAY THE HELL AWAY FROM IT IF YOU CAN!
The big problem with part B (medical) is that not only do you have to pay $110.00 a month for it, but you will end up paying for supplemental insurance on top of that; just go to the emergency room once without supplemental and you will be bombarded with bills. (as they say in the ARRP adds “May not cover everything”) You get part A whether you want it or not and it does not cost anything, but if you can possibly stay away from the rest of it, DO IT.
As far as you loosing your VA benefits, I don’t see it, unless you make to much money and then you may think about using part B and D.

#9 admin on 03.21.10 at 4:21 am

It all depends on your circumstances. While there is a VA Clinic in Billings, MT, I would sent to Fort Harrison in Helena for any surgery. Helena is 4 1/2 hours away, and they do not have Internet access in the VA hospital. Due to the distance, I would be staying in Helena longer than if I were to have the surgery done in Billings. I am looking at the possibility of 5 to 8 bone grafting surgeries. After going to Fort Harrison four times for surgery, a friend of mine decided it was far easier to do it locally. He initially opted out of Medicare Plan B, and is now paying a penalty. In addition, I travel on a regular basis, and a VA clinic is not always readily available. I carefully weighed my options before adding a taking a no-cost Medicare Advantage plan. VA is still my primary treatment, but I need a backup plan. You just need to know that VA Healthcare is not considered a substitute for Medicare Part B, and you will pay a penalty should you ever decide to opt in.

#10 Richard Milyard on 03.23.10 at 2:22 pm

You are correct in saying that the VA does not make it easy to use their facilities unless you are in a major city where clinics and hospitals are close by (like San Diego and Las Vegas) and this is a major factor in the individuals decision. As you stated, your friend decided “it was easier” to have surgery done close to home. Rarely have I know the VA to make anything easy unless you walk into one of there hospital emergency rooms with proper ID card in hand, then stand back, I have never seen a hospital move faster. I recently had a detached retina in my right eye that made me basically blind. (Try that panic button on for size) I knew the system ahead of time and that the San Diego VA had the best in the US (Vegas will fly you to San Diego for this type of surgery). I drove myself to San Diego (a six hour drive) and walked into the VA hospital and had eye surgery a couple of days later.
I had to make five trips to San Diego (at six hours one way) before the whole eye thing was done and I had most of my eye sight back. The VA is not as easy as your local hospitals.
This is the real decision you have to make. Can you get yourself to the VA clinic? Can you get yourself to a VA hospital? If you can do these two things then why be pulled into the $200.00 a month minimum you will have to pay for part B and supplemental. Part D is another bag of worms; DON’T GO THEIR. The insurance companies have what is called a formulary which is there way of saying “If we know you need the drug, we will jack up the copay cost to just under what you could buy it off the internet for” Remember I have dealt with all of these insurance scams first hand over the last nine years and have a lot of first hand experience at it. Also, don’t get to comfortable with your no-cost advantage plan because the monthly premiums will be going up every year; been their, done that!

#11 admin on 03.23.10 at 2:44 pm

For me, the VA clinic is an hour away, and the nearest VA hospital is 4 1/2 hours away. There is a DAV van that goes from the Billings clinic to the hosipital in Helena every day, which makes it a 5 1/2 hour trip for me.

In addition, I went with a Medicare Advantage plan that does not cost me anything other than the $110 a month for Part B Medicare. The VA drug plan does qualify for Medicare Part D, which saves me $20 a month. I would never go with a Medicare Supplement plan as they are outrageously expensive.

#12 Richard Milyard on 03.23.10 at 3:02 pm

Please see:
http://www.bloomberg.com/apps/news?pid=20601103&sid=av1lMcI6E1no&refer=us
This is just one example of the (initial) no cost advantage plans and what they REALLY do to you over the next few years. The only solution I found for this yearly cost escalation (and it will happen) is to switch carriers on a regular (no less than every two years) bases. This is a pain in the ass, but it will save you a bundle. These carriers are by law required to give you a heads up before your new sign up date; pay attention to this documentation. By the way, my VA clinic is at least an hour away from me also. The closest VA hospital for me is in Las Vegas (about three hours from me), so we are in about the same boat. I think we have pounded on this one about as much as two men can.
I’ll admit, I can be one cantankerous son of a bitch, but I figure going through a few fire fights with my ass on the line while ingesting agent orange is going to get me something from this Government even if I got nothing from the population on my return.

#13 Richard Milyard on 03.23.10 at 3:21 pm

As a side note.
I fell off a ladder a month ago.
Not far, just forgot an extension ladder does not have an out rung on the third one up, so just fell a few feet, but landed on a big boulder just above my right butt on the hip bone; hurt like hell, but thank God is was not a few inches higher on the small of my back. I could have broken it.
The point is, if I can fall off of a ladder after owning a sign business for over 5 years and doing things on ladders that would scare the crap out of most people and NEVER FALLING. There is only one thing we have in common: AGE
If you are in your sixties, stay off of ladders, or be overly cautious when you do.

#14 admin on 03.23.10 at 3:35 pm

If you read my other posts, you know that I fell off a ladder almost 8 months ago, and broke my femur in two places. It doesn’t take long to fall 8 feet, but it sure takes a long time to heal. My wife has banned me from ladders, but I still have to work on the house. I just avoid extension ladders and roofs, especially metal roofs.

#15 Richard Milyard on 03.23.10 at 5:07 pm

I found a nice stars and stripes article:
That your VA readers might be interested in that concerns what effect all this new healthcare may have on there benefits. Set my mind at ease. http://blogs.stripes.com/blogs/stripes-central/health-care-bill-wont-impact-tricare-va-health-programs

#16 admin on 03.23.10 at 5:13 pm

The American Legion National Commander posted the same comments on Facebook and Twitter yesterday morning. He apparently received a bunch of phone calls for congressman regarding the Legion’s position after the news release from the VFW. As the Webmaster for American Legion of Montana, I try to keep track of this information. I wore my fingers out the last few days between Twitter and Facebook.

#17 Rick on 04.08.10 at 5:56 pm

Bill,
I have been researching the VA versus Medicare part B situation since my last blurb, and I do mean research; Whewww
I think fingers are worn out all the way around. :>)
I have decided to not go with Part B for many reasons:
1) I have VA
2) Part B goes up just about every year and you have no control over it.
Like many people I need my Soco checks (I worked 40 years for them) and don’t want to see them dwindle as I get older.
3) If you have Part B you also need supplemental.
4)Obama is going after the Advantage plans with a passion.
5) VA does not go away just because you have Medicare, you just have to choose.
6) I talked to a 75 year old vet friend of mine today that is about to go in to the VA for his second hip replacement and recommended I do not get the part B (he has never had it)
7) If I am in that bad a shape that I can’t get to the VA facility then I really don’t want to live any longer.
I hope you are doing better, but it sounds like complications are doing there job of screwing things up.

#18 A.J. Meunier on 06.24.10 at 5:45 am

I will be turning 65 this October and still debating whether or not to opt out of Medicare part B. I am in VA priority group 2. If I opt out of Medicare Part B I understand that if I am transported to a non VA emergency room if closer than my VA hospital that I have 72 hours to call VA and that it will be taken care of. Can anyone tell me what it means “that it will be taken care of”?

#19 Bill A on 06.24.10 at 11:11 am

As I understand it, the VA does cover emergency care. If given a choice, most hospitals would prefer to bill Medicare over VA. VA is not fast in paying, put they do pay. I know that the VA Clinic transfers emergency patients to a local hospital.

#20 A.J. Meunier on 07.04.10 at 6:28 am

Should I opt out of Medicare Part B when I turn 65 later this year? I am a disabled vet in Priority Group 2. The wife and I could certainly use the extra $110.50 per month to pay off other bills.

#21 Bill A on 07.11.10 at 1:01 pm

Since you have a service related disability, your decision could be different than mine. First, does the VA provide 100% of your health care needs? If so, is there a chance that this status may change in the future? It is a balancing act. You can refuse Medicare Part B now, but you will pay a penalty if you need it later. The penalty is a permanent increase in your monthly Medicare payment. Since I am in priority group 5, the VA can change my priority group every year based on income. Thus, there is a chance that I may reach a point that I am not covered by VA Healthcare. Should this happen, Medicare will be my only option.

#22 Armand Maranda on 12.02.10 at 10:44 pm

I want to thank all of you for your generous comments. I too am on VA and will be turning 65 in May nest year. Not knowing what the future will bring for Medicare and the part B part I am still at a loss for what option I might choose when the time comes. I guess education onself is certainly a must do.

I am in the Las Vegas area and so far I can not complain about my experiences with the care I have gotten so far. If I arrive on time for my appointments I am seen within 15 minutes max. I think this is a Nevada requirement. All my meds are available and the refills are easy I just call and within days I get them in the mail.

Thanks again for the info on this site.

Armand

#23 Armand Maranda on 12.02.10 at 11:13 pm

please check this out at www4.va.gov/healtheligibility/cost/medicareeligibility.asp

I found this in my research and I hope it helps others that are in our situation.

#24 Jim on 02.01.11 at 11:51 am

I turn 65 in May and have been receiving VA healthcare for the last 10 years. I’m 5 min from a VA clinic and one hour from a VA hospital. I’ve declined to take Medicare Part B. $110 a month is money that can be used in better ways and Obama can KMA.

#25 Bob Workman on 03.15.11 at 8:23 am

I am thankful to get VA health care benefits but I’m only a priority group 7 member…about the lowest priority you can be and still get coverage. I will be taking Medicare part B because I do not trust our bankrupt government not to change the VA eligibility rules and squeeze out anyone they can. I expect that my priority group will be targeted first.

#26 Dwayne on 04.16.11 at 1:36 pm

My concern is quality of care. If you have a choice between VA and Medicare benefits, wouldn’t opting for Medicare be a better option in terms of quality? It has been my experience that quality of care is a very serious issue inside VA hospitals. Wouldn’t paying the extra $ for Medicare deductibles be a better choice for most since quality of care is the most important issue for most?

#27 medicare supplement on 06.29.11 at 7:01 am

it’s interesting to see what the VA and other Medicare healthcare systems provide their users with and what they don’t. Good article!

#28 Christel McKinney on 08.16.11 at 8:20 pm

Hi there-

I am trying to help my father who will turn 65 in Nov and is currently being faced with “Medicare or no Medicare”, he is currently enrolled in the VA benefit plan and resides in Las Vegas. He is confused about his options. I understand he is automatically enrolled in Part A, Does he have an option for Part B, if he opts out on Part B does he lose his VA because he is eligible for Medicare and choses not to take it, If he enrolls in Part B does he lose his VA or is that considered his supplemental coverage? What about Part D if he has a RX benefits through the VA? Does he have to take Part D? Thank you for your help with this. I am in Texas and like I said he is in NV and I am trying to help him with this :)

#29 Bill A on 09.14.11 at 9:35 am

I am on both Medicare and VA. Part A is automatic. I opted for Part B and Part D, as some drugs are a lot cheaper through Wal-Mart. For Part B, you can look for a very cheap plan. I use it to get the free care provided by Medicare.

#30 Bill A on 09.14.11 at 9:45 am

I have only been to the VA Clinic in Billings, MT. A brand new clinic. I have never experienced a VA Hospital, so cannot comment about them. The Doctors at the clinic were great. At the same time, I completely trust the Doctor that I have seen for years. He still does my annual Medicare checkup. Not a great answer, but it reflects my situation.

#31 Rick in Arizona on 10.10.11 at 1:56 pm

This is a great Blog with lots of info! I recently had this same discussion at our VA satelite facility. My situation, Age 65, have medicare original (A only) and VA, priority group 2. When I ask about VA Vs Medicare part B the physician said to think about a high deductable emergency hospitalization insurance policy to cover situations where you might find your self needing emergency care and did not have access to a VA facility.

Then if you found yourself in that situation and ended up spending time in an ER facility for ‘xx’ days, your only debt would be the deductible, and not the entire bill. I have ask a couple of people that have ‘catastrophic’ hospitalization ins and they said, its only ~$300/yr. That’s better than $115/mo for B I would think.

The other thing I heard about Part B (from a tax specialists) was that it was scheduled to go way up in 2013 but I have not confirmed that yet. Bottom line, since I am still employed and hopefully should be until age 66 next year I have some time to think about it. Medicare doesn’t start the clock on choosing part B if you have employee healthcare coverage…

Rick

#32 Cheryl W on 10.28.11 at 11:40 am

Recently we thought my father was having a stroke and ended up in a non-va hospital. the hospital never contacted the VA and we wanted to leave the non-va hospital to take him to the VA but ER doctor who was very upset said he could die and needed to be admitted. My father never provided Medicare information but the hospital billed medicare and now the VA said he is not eligible for any coverage because Medicare paid a portion of the bill. My father is now facing $1500 in medical bills for this hospital. Can we appeal? Has anyone done this before? I feel that had the hospital contacted the VA immediately the VA would have arranged transportation to the VA and cover the ER charges.

#33 Bill A on 10.30.11 at 5:25 am

When I asked Beartooth Hospital in Red Lodge, their comment was that they automatically bill medicare, and only bill VA at the patients request. I suspect that you may have to argue with hospital billing. You can also request a reduction in the bill due to your father’s limited income.

#34 Bill A on 10.30.11 at 5:29 am

The Medicare web site has links to insurance programs for each state. I maintained a supplement plan for emergencies, as the ambulance takes to you to a hospital and not a VA clinic.

#35 Zack on 11.10.11 at 1:25 pm

From what I have gathered from reading what folks have said here, does it make any sense to sign up for Medicare part b if a VA clinic is nearby, and you are in a lower priority group? I just sent in my application to the VA for benefits so don’t yet know what priority group I’m in but will likely be higher rather than lower. I just turned 65 in October so have 3 months to sign up for part b of Medicare, but not sure what I should do. I also have Cigna insurance from my previous employer, but now Cigna tells me they will only cover the amount they would of had to pay for a recent doctor’s visit as if I already did have the part b, which means they don’t cover much. I mean, at $110 a month, thats $1300 a year-yikes. This stinks.
.

#36 John on 11.17.11 at 9:23 am

Well, it appears that being rated at 100% by the VA and have been receiving Social Security Disability now for a year. I just received notice from Medicare that I am now eligible. Yes, it is a dilemma trying to determine your choices. For vets in this situation, it is my opinion to take the no-cost Part-A Medicare and use your VA for all you can, provided you are close enough to a VA facility & like your doctors. Understand that if you are enrolled in the VA Healthcare System, and you are in need on life threatening medical care, you can go to any hospital. You must notify the VA immediately of where you are. They are to transport you to the nearest VA facility as soon as you are stable. It appears to me, those Vets in this position just don’t need anything but the free Part-A. Just my 2¢ worth.

#37 Bill A on 11.27.11 at 12:00 pm

If you are in a low priority group with a nearby VA clinic, VA may be the way to go. I lived in a rural area of Montana, and it was a lot closer to drive to a Medicare doctor than the VA clinic. Plus, VA decided to put me in a higher priority group, where the copay was higher than the Medicare copay. Now, that I am living in Costa Rica, I am back to just Medicare Part A.

#38 Ron Myers on 11.29.11 at 4:47 pm

I am 65 and in VA priority group 1.
There is VA clinic within 5 miles and a VA hospital within 10 miles.
The VA hospital will not accept a patient via ambulance.
I currently have Medicare parts A & B and a Kaiser Senior HMO at $95 a month.
Would I do better to dump the Kaiser and the Part B, either or both?

#39 Bill A on 12.03.11 at 10:24 am

Emergency medical care is the key. An ambulance would transport you to the nearest hospital. You need to check with them to see if they would accept VA as a payment alternative. Most hospitals automatically go for Medicare, as VA involves a lot more paperwork and is slower paying.

#40 Bob Nicholson on 02.14.12 at 11:30 am

First off, thanks Bill for your blog as this is a subject that seems to defy a pat answer or easy access to all the pertinent information. Once we are faced with this choice each one of us needs to make the correct decision. In my case, I will be 65 in August, 2012 and I am a Viet Vet living in the San Francisco Bay Area with relatively quick access to all VA health services. I have now also a 30% PTSD disability rating which did away with co-pay and income eligibility reequirements. Please correct me if I am wrong but it appears to me that this is a no-brainer in my case since the disability rating is for life. My only concern was that I would be required somehow to sign up for Part B whether I wanted to or not either by the VA or Medicare. That is definitely not the case. What I am finding out is that the “new VA Healthcare System” is excellent. I never have a wait to see a doctor either in an emergency or scheduled visits. Two months ago I got a nasty spider bite on my foot that got infected and swelled up. I called the 24-hour nurse’s hotline and was immediately called back and told to get to the closest Emergency room preferably in 12 hours which in my case was Travis AFB. I drove in on my own and was treated immediately. They even had a sonogram done to make sure it wasn’t a blood clot. Regarding emergencies for trauma it is my understanding that Vets are able to go to any emergency room and get treatment. The only stipulation in this case is that the VA has to be notified by the veteran of the visit within 72 hours of its’ occurance.

#41 Bill A on 02.14.12 at 1:09 pm

It is very much an individual decision. When I was living in Montana, the nearest VA clinic was in Billings, and the nearest VA Hospital was in Helena. The nearest hospital was only 21 miles away versus 55 miles to Billings. The hospital would automatically bill Medicare, unless specifically directed to bill VA. The VA would then decide if it was a true emergency. In my case, Medicare made sense. With a zero cost Medicare Part D plan, I could get my prescriptions at Walmart cheaper than the VA. However, I had to get my VA primary care physician to explicitly write the prescription for WalMart.

Once I move to Costa Rica, Medicare no longer applies, but I keep my VA. Unless, it is an emergency, I can fly back to the USA.My step-son is a nurse, and he comes by every Sunday to check my blood pressure, and make sure that I have no problems.

#42 RUSS on 03.26.12 at 6:10 am

CURRENTLY 67 STILL EMPLOYED WITH A GREAT INSURANCE PLAN….QUESTION IS I AM IN CATEGORY 1[0NE] VA HEALTH…OUTSIDE OF “CHOICE” OR PERHAPS MORE CHOICE AM I REQUIRED TO TAKE MEDICARE PART B WHEN I FINALLY STOP STOP WORKING??

#43 W.G.R. on 06.20.12 at 5:22 am

Re: #18, A.J.Meunier
I am 100% VA disabled. I had a heart attack two years ago and was taken to the nearest hospital for care (four stents).
My wife called the VA within the 72 hour notification period, explained my situation, and was told that the the nearest VA hospital was full and to continue my care at my local hospital and they would take care of the bill. They did pay in full………….$169,000!
Hope this helps.

#44 Bill A on 06.24.12 at 2:05 pm

You are not required to enroll in Medicare Part B. In your case, you will be covered by VA for life. If you have any prescription medications, you may wish to add Medicare Part D. I found that some prescription drugs were cheaper outside of VA. If the medication is prescribed by VA, you would have to have the VA Doctor write the prescription for a non-VA pharmacy.

#45 Jim B on 06.27.12 at 8:40 am

You made the statement in #44 that it is confusing? First off, if you are declared 100% disabled by the VA why would you want to enroll in Part D? ALL prescription medications through the VA are Free for 100% service connected disabilities. You can’t get any medications cheaper than Free! In addition, if you are not satisfied with the doctors at the VA, and you don’t enroll in Part B then you will be stuck with paying the bill if you have to go to a non-VA hospital.

#46 MrBob on 08.07.12 at 1:05 pm

Bill,
Re:#44
If you are 100% Service Related Disabled, then there is no copay for prescription drugs. The VA hospital where I receive my care and drugs even pays for aspirin that the Dr. prescribed for my heart related problems.

#47 Bill A on 09.03.12 at 5:12 pm

This post was made several years ago. I am not living in Costa Rica. Medical expenses in Costa Rica are not covered by Medicare. I am down to Medicare Part A only. Sometime this month, I become eligible for CAJA (Costa Rican government insurance, which will cost me about $70 a month and covers both me and my wife.

#48 NY-Bob on 09.12.12 at 2:42 pm

As MrBob stated (#46), Vets rated 100% disabled from service connected disabilities can receive ALL medical care from a local VA hospital or clinic. If you are fortunate enough to be within reasonable distance to a VA hospital, EVERYTHING, including DENTAL and Chiropractice care for the 100% rated Veteran.

BTW – Vets rated 100% disabled are entitled to MILEAGE reimbursement for appointments at the VA hospital (including eye exams, dental cleanings, you name it).

Also, dependents UNDER the age of 65 can participate in CHAMPVA or the CITI program (which means no cost for dependents of 100% rated Vets), but ALL care must be at a VA hospital or clinic (which we’ve frequently used for 2 years and have had ZERO issues).

At 65 (or after 24 months of receiving SS disability) the beneficiary (servicemember) may need to decide whether or not to enroll in Medicare B and weigh any costs for Part B (minimally $99.90/month) versus VA medical care. I believe they are mutually exclusive.

Medicare (B) has improved coverage (supposedly no cost) for MANY preventive services, ie., Yearly wellness visit, Annual Prostrate Cancer screening, Mammograms, Glaucoma (see page 7 of Medicare booklet for entire list).

HOWEVER, as it’s been stated, if you are under 65 and you DECLINE Part B (medical Insurance) you MAY have to wait until the General Enrollment Period (Jan 1 – Mar 31 each year) to sign up. Coverage would start July 1st of THAT year. You may also have to pay a Part B late enrollment penalty.

Example: (this is right from their pamphlet). If you waited 2 FULL years (24 months) to sign up for Part B, you will have to pay a 20% late enrollment penalty (10% for each FULL 12-month period that you COULD HAVE BEEN enrolled), plus your standard Part B monthly premium (which is $99.90 in 2012), + $19.98 (10% of $99.90) for EACH full 12-month period.

Hope this information is helpful.

#49 Steve W on 09.17.12 at 10:22 pm

I am about to turn 65. I’ve been going to the VA in Alaska for years and I am pretty satisfied with them. They have a new facility here and I just had my appendix removed and spent two days in the hospital which only cost me $250. (I am in group 6)
I own some land that I have been trying to sell for years, if it ever sells (big if)my income would increase greatly for that year. I assume that the VA would increase my copay if that happens. I believe I would still be eligible for VA benefits though, correct?
I am leaning toward just sticking with the VA and taking part A only.
Question: if you enroll in part B, then cancel it, can you then re enroll at a later date?
Also, if I enroll in B, will the VA deny me any serices that I now have because now I got medicare?

#50 Steve W on 09.17.12 at 10:37 pm

I used to have health insurance as a retired laborer but it got so expensive that I cancelled it and went VA all the way even though I really liked my old doctor. So I considered enrolling in part B just so I could use him again, but I called his clinic and since I hadn’t been there for three years, I would be a new patient and they aren’t accepting any new medicare patients. So I figured what the hell, I may as well stick with the VA. What good is medicare if doctors won’t take it? Have any of you who use medicare had trouble getting doctors to accept you?

#51 t.b. on 10.31.12 at 3:20 pm

I’ve been with the VA for 4 years now and I can’t say enough about the care and service I’ve received. I go to the Sepulveda, Los Angeles clinic. I’m on the co-pay plan with the VA but its only $15 for a visit to be seen by your primary Dr. and $50 to see a specialist or for any procedure. If you have two visits or procedures on the same day you are only charged for the first one. Prescriptions are $8 per 30 day supply, not bad at all. Last year I signed up for medicare A and B just in case. They are taking $115 per month from my social security checks for part B. I’ve also been told by the VA that if you have to go to an outside hospital for an emergency, the VA will only cover costs if you go in an ambulance, not if you or someone drives you. It really has to be an emergency.

#52 Bill A on 03.22.13 at 12:07 pm

You need to ask these questions to someone at your clinic, as I do not know the answers.

#53 Bill A on 07.26.13 at 3:07 pm

When I was living in Montana, I did the same as you. In my case, the Beartooth Hospital preferred not to work with VA in emergencies. They often had to transfer patients to the Billings Clinic via ambulance, and VA didn’t like to pay the extra cost. They would have really balked at my Medivac chopper trip to Billings. In rural areas, VA is great for routine stuff, but not for emergencies.

#54 J.R.B. on 01.09.14 at 10:02 pm

Bill – thanks for a great and informative blog. I am a 65 year old Vietnam Vet and I too had questions about Part A & B of Medicare. I think I will just skip Part B, as I cannot afford it. I have VA health care and have been grateful for all they do; they are just understaffed and underfunded. I think all combat vets should have ALL medical care covered; we earned it.

#55 Bill A on 04.16.14 at 4:18 am

I agree, but it is not going to happen with the current Congress.

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