Medicare Answers: Is Medicare With a Supplement Better for Veterans Than VA Benefits?

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Medicare Answers: Is Medicare With a Supplement Better for Veterans Than VA Benefits?

This week’s Medicare Answers addresses whether veterans are better off with Medicare and a Supplement plan than Veterans Affairs (VA) health care benefits, in light of recent findings of delayed care at a VA medical center. If you have a Medicare question, email AskRoger@SeniorMarketSales.com.

Ashley asks:

With all of the recent news about the Veterans Affairs Hospital and the horrible things we are hearing, would my clients be better off with Medicare and a Supplement. How do they work together? That would certainly give those veterans a better choice in their coverage.

Ashley,

You certainly are correct about Medicare and a Supplement being a better choice, as they would provide your clients coverage to a wider choice of providers on a national basis. Keep in mind, however, that most veterans would have to qualify through underwriting, some GI triggers or certain Special Enrollment Periods. Those who do not enroll into Part B when first eligible will most likely incur a Part B premium penalty for each 12-month period they’re without Medicare Part B coverage.

A veteran can have both Medicare and VA benefits, but Medicare and VA benefits do not work together. Medicare doesn’t pay for any care that a veteran receives at a VA facility.

Medicare Part B and VA Coverage:

For health care services and items not covered by Medicare – such as over-the-counter medications and annual physicals – many veterans use their VA health benefits. However, you may want to encourage your veteran clients to consider choosing Medicare Part B along with their VA coverage. Why? Part B may cover services they receive from Medicare-certified providers and provide medical coverage outside the VA health system.

Medicare Part D and VA Coverage:

Because VA drug coverage sometimes offers more generous prescription drug coverage than Medicare Part D, some veterans only use their VA drug coverage to get their medications. VA drug coverage is considered creditable, meaning it is as good as or better than the Medicare prescription drug benefit. That means a veteran can delay enrolling into Medicare Part D without penalty. If your client does lose VA drug coverage, make sure he or she enrolls into a Part D plan within 63 days of losing VA benefits.

Although your veteran clients can have both Medicare Part D and VA drug coverage, remember that the two do not work together. VA benefits only cover the drugs veterans get from VA pharmacies, and Part D plans usually only cover drugs they get from pharmacies that are within the plan’s network.

In certain situations, veterans may want to join a Part D plan. For example, they may want to enroll in a plan if moving into a nursing home outside of the VA health system and needing coverage for medications from the nursing home pharmacy. Or they may also want to enroll in a Part D plan if they qualify for Extra Help, a federal program that helps people pay for some or most of the costs of Medicare prescription drug coverage.