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.
[...] This post was mentioned on Twitter by Bill Anderson, Bill Anderson. Bill Anderson said: How does VA Healthcare dovetail with Medicare? – http://bit.ly/8YS8kx [...]
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.
Interesting article. Were did you got all the information from…?
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.
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.
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.
This is a Weblog site, and I do not maintain a separate resource directory.
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.
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.
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!
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.
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.
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.
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.
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
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.
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.
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”?
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.
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.
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.