So the question is should you get Medicare Part B if you use the VA?
There are a few things you need to know if you are a veteran. I strongly recommend veteran seniors who are turning 65 to enroll in Medicare Part B.
Why? Once you’ve been exposed and incur those kind of costs and decide you want Part B, you’ll pay a penalty for each year you’ve not been not been enrolled in Part B since you first became eligible for the coverage. Let me explain: I met a veteran who was 73 years old and he got some really bad information and was told he didn’t need Medicare Part B (Medical Insurance) he had Part A (Hospital Coverage) every since he was 65 but didn’t enroll in Part B.
He got the scare of a lifetime when he was rushed to a local hospital. He was there 3 days and ran up a $55,000 hospital bill and at first the VA declined to pay. Luckily for him the VA stepped up to the plate and took care of a large portion of his hospital bill. But here’s my point. If the VA for some reason refused to pay his bill he’s now responsible for pretty much 100% of the hospital bill, because he did not have coverage under his Medicare Part B, and believe it or not it only gets worse from there.
If you’re asking yourself. How could that be? Well when he calls Social Security to enroll in Medicare Part B he finds out he’s not going to get the coverage under Medicare Part B immediately. He has to wait until January 1st of the following year which is the General Enrollment period with Medicare and once he enrolls his Part B won’t go effective until July 1st of the same year. Next Medicare fines him a 10% penalty for each year he was not enrolled in Part B. Remember he was 73 years old and being eligible for Medicare at age 65 his penalty was 80% and that’s a lifetime penalty. Instead of paying the premium of $104.90 his premium was $188.82. Another factor that adds to the penalty is the VA Medical Benefits are not considered credible coverage by Medicare.
Medicare and VA Benefits
It is important to note that VA benefits and Medicare do not supplement each other. What do I mean by that? VA benefits can only be utilized at VA facilities and Medicare benefits are only utilized at Medicare assigned facilities. Medicare and VA benefits do not overlap.
All you have to do is choose where you want to receive your medical services. But having both gives you peace of mind and protection, especially if you are not near a VA facility.
VA and Medigap?
If you prefer to use or need to use your Medicare for various reasons a Medigap plan will fill in the gaps such as deductibles, copays, and coinsurance, as well as other benefits.
Here are several reasons why you may want to have a Medigap plan even though you have VA benefits:
- You travel
- You may not live near to a VA Hospital or facility.
- You want to seek a second opinion from another physician who takes Medicare Assignment.
- You can’t wait to see a doctor for your particular situation or medical concern (VA can’t get you in right away)
- If you are enrolled in one of the VA lower priority groups, and could potentially lose your benefits*
*“There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage,” per the VA.gov website.
Important Note: At age 65 you only have One Open Enrollment Period. It’s called your Initial Open Enrollment to Medicare (See page 23 of Medicare and You 2017). Also just as important preexisting conditions can preclude you from gaining coverage. Visit: When can I buy Medigap? Source: Medicare and You 2017
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