Medicare And Service-connected Veterans

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If you’re a veteran aged 65 years or older, you are eligible to receive VA health care benefits as well as Medicare. It’s a matter of looking at your options.

“Veterans have to enroll in the VA health care system to receive VA benefits,” notes Alan Weinstock, insurance broker with MedicareSupplementPlans.com. “Veterans who are eligible for both Medicare and VA health care benefits might wonder what the benefits are for enrolling in either or both programs.”

Enrolling in VA Health Benefits Only

Any former member of the U.S. Armed Forces – Army, Navy, Air Force, Marine Corps and Coast Guard – who served on active duty and was discharged under conditions other than dishonorable may apply for VA health benefits. The VA will then determine your eligibility based on variables such as length of service, service-connected disabilities, income level and available VA resources.

You do not pay a monthly premium for VA health benefits. However, you may have to pay copayments to treat non-service-connected conditions. Because funding for VA benefits is funded through appropriations and, therefore, ...
... unpredictable, the Veteran’s Administration (VA) recommends that you have other health insurance when possible.

If you are enrolled in VA health benefits only, you are limited to using VA facilities for treatment. However, it also means you do not pay Medicare premiums, deductibles or co-insurance.

Enrolling in Medicare Only

Just like other Medicare beneficiaries, if you choose to enroll in Medicare only, you can only receive services from health care providers who accept Medicare. In addition, you are responsible for all premiums, deductibles or co-insurance payments.

At the present time Medicare Part A covers inpatient stays at hospitals, skilled nursing facilities and hospice as well as home health care and medicines administered to inpatients. There are no fees for Medicare Part A if you paid enough in Medicare taxes while working.

Medicare Part B covers doctor’s visits, outpatient services such as lab tests, preventive services, doctor’s services in the hospital and medicines administered in the doctor’s office. The monthly fee for Medicare Part B is $115.40 starting in 2011.

Medicare Part C is also known as Medicare Advantage. Medicare Advantage Plans combine Medicare Parts A and B and very often include Medicare Part D into a single plan. Medicare Part D is for prescription drug coverage you use at home.

Enrolling in Both VA Health Benefits and Medicare

Veterans who are eligible for both Medicare and VA health care benefits may utilize benefits in either program. They are independent and do not coordinate.

If you choose to use VA benefits, you must go to a VA facility. You cannot use your Medicare card at a VA facility. To use your Medicare benefits, you must go to doctors and facilities that accept Medicare. You will be responsible for paying all Medicare premiums, deductibles and co-insurance. Keep in mind, that if you have other private health insurance, the VA is required by law to bill private health insurance carriers for services provided for non-service-connected conditions.

Additionally, if you have Medicare Part D, you may use either VA pharmacies and mail order services or Medicare’s network of local retail pharmacies and mail order service. Prescriptions written by VA providers may be filled at either VA or non-VA pharmacies or mail order services. Veterans who do not enroll in a Medicare Part D plan must fill their prescriptions only at VA pharmacies. Co-payments may apply in either case, so be sure to check the cost associated with both plans.

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