I brought my dad to the Veterans Association Healthcare center in La Jolla for one of his regular check-ups. And it got me thinking about doing this blog about VA and Medicare coverage and what extra options are available. First off I want to say thank you to all of our veterans and active military and everything they do for us. Also, a thank you to all the medical staff and volunteers at the Veterans Association medical centers around the country.
My clients that have VA and Medicare all rave about the care they get from their local VA. My dad had another great experience. He had an appointment with a specialist but wasn’t feeling well in general. We got here early and without an appointment. He was able to quickly see his regular doctor before his scheduled specialist appointment. These guys are awesome here. But let’s get back to why you’re here.
Medicare Penalties for Part D Prescription Drug Plans
I want to hit on a few common questions that come to the top of my head that veterans ask me about VA and Medicare. The first question they usually ask is about the penalties they may incur. If they don’t elect a Part D prescription drug plan. Or if they don’t elect one when they are initially eligible to get a Part D drug plan or don’t elect Medicare Part B. First, let’s talk about the Part D penalty. If you have VA benefits and don’t elect a Part D Prescription when first initially eligible, and you would like to get one later you will not incur a late enrollment penalty.
Veterans association prescription drug coverage is considered creditable which simply means it is at least as good as Medicare Part D coverage. The drawback though of not electing a Part D prescription plan when initially eligible, this, by the way, is called your Initial Enrollment Period and lasts for seven months.
Three months before your Medicare Part A and or Medicare Part B becomes effective. The month it becomes effective, and three months after it becomes effective. Getting back to the drawback of not initially electing Part D drug coverage when you have VA drug benefits and you want to get one later. If you don’t get Medicare Part D and then you want Medicare Part D later you have to wait for the Annual Enrollment Period also known as the AEP. This is between October 15th and December 7th. Any decision you make during this election period becomes effective January 1st.
How Initial Enrollment Period Works
To give an example, let’s say you are outside of your Initial Enrollment Period and it is June and you say you would now like to enroll into Medicare Part D. Because you are outside of your Initial Enrollment Period and the Medicare Annual Enrollment you will not be able to enroll into Medicare Part D until January 1 unless you have a Special Enrollment Period. These special enrollments are for another blog post but to give a quick example if you have Medicaid also called Medi-Cal in California, this is a Special Enrollment and you can get the Medicare Part D effective the first of the following month after applying.
Also, if you have moved from one service area to another and there are many others as well but that is for a different blog. In all likelihood, if you have VA prescription coverage and would like to enroll outside of your initial enrollment period you will have to wait for coverage to become effective January 1st.
Why have more than only the VA
I am also asked if I have VA prescription benefits why would I want to pay for a Medicare Part D plan. And simply because there can be medications not covered by the Veterans Association that are covered under Medicare Part D. Or there are extra medications that a Medicare Part D plan will cover that VA will not cover. Also depending on your level of VA prescription coverage there can be medications that are less expensive in a Medicare Part D plan than on the VA coverage.
VA and Medicare Part B
Next, let’s talk about VA and Medicare Part B coverage. On VA’s website, they recommend if you have VA coverage that you elect to get Medicare Part B. When I’m asked, “Chris do you recommend me getting Medicare Part B if I have VA coverage?” My answer is I don’t know right now. Let’s go over all of your options. And let’s talk about what is important to you and this will tell us if getting Medicare Part B is right for you. I am asked why do I want to pay for Medicare Part B if I have VA coverage. And the most common reason my clients that have VA and elect to get Medicare Part B in addition to VA is simply they want more options of care.
Reasons Medicare Part A and Medicare Part B are Sweeter than Christmas Morning
By having Medicare Part A and Medicare Part B, you have access to any doctor hospital provider across the United States that accepts Medicare. By only having VA, then you only have access to VA facilities. If you have Medicare Part A and Medicare Part B you are now eligible to get a Medicare Advantage plan. I have many clients including my dad, and this is why he elected to get Medicare Part B. My dad, for example, uses the VA for all of his routine doctor visits. And then gets a Medicare advantage plan with a zero dollar premium in Southern California. He enjoys the extra coverage the Medicare Advantage plan provides him.
Why My Dad Enjoys the extra coverage Offered by Medicare Advantage Plan
It includes extra Medicare Part D coverage. My dad’s Medicare Advantage is an HMO but that still provides him extra options for doctors hospitals and other providers. It also includes gym membership, dental coverage, coverage for glasses and hearing aids, and over-the-counter pharmacy benefits. When he became eligible for Medicare we weighed out the additional cost for Medicare Part B. With the extra benefits of a zero-premium Medicare Advantage with prescription drug coverage and it made sense to him. Also, it made sense because if he didn’t get Medicare Part B when initially eligible and wanted it later he would not incur a late enrollment penalty.
Medicare Penalties for Medicare Part B
That takes me to the next question I get asked a lot. If I don’t elect Medicare Part B now and I want it later will I incur a penalty? The answer is yes even though you have VA coverage and you will also have to delay Medicare Part B coverage as well. The penalty is 10% for each 12 month period you could have had Medicare Part B and didn’t sign up. And you have to pay the penalty for as long as you have Medicare Part B.
VA, Original Medicare, and Medicare Supplement
Getting back to more coverage options. I have clients that have VA coverage but also get Medicare Part B with a Medicare Supplement as well. The reason they do this is they want to have all of the benefits VA coverage affords them. But also want to be able to see any doctor hospital provider across the nation that accepts Medicare and couple it with a Medicare Supplement plan. So they can have all or most of the deductibles, copayments, and coinsurance Original Medicare doesn’t pay for covered by the Medicare Supplement.
Some of these clients do buy Medicare Part D coverage but most do not. Most that do this option decide to forgo the Medicare Part D coverage because their medications are covered by VA. They also know if they want Medicare Part D later there is no penalty. And accept the fact they will have to wait for the Medicare Annual Enrollment. Also, they may have to wait until January 1st of the following year for Medicare Part D to be effective.
How my goals could Help you Make the Best Decision
The reason why and why not to get Medicare Part D or Medicare Part B if you have VA coverage is endless. You need to decide what is best for you. I am here to present facts and options. My goal is to educate you so you make the best decision for your needs. There are many videos and websites that present material in absolutes. Some bash Medicare Advantage, some bash Original Medicare, or Medicare Supplements or bash VA or Medicare Part D.
Because I have taken the time to learn about all parts of Medicare and all options. What I have learned is all of them are great in their own way. There is no one size fits all. There are positives and negatives to all options. What I don’t like is when someone only touts one type of coverage because either they haven’t learned about all the options. Or they are simply lazy and don’t want to dig and find out how to best help. It doesn’t take but 15 minutes of questions and discussion to start learning what options are best for you.
VA and Medicare: Understanding Your Options is Important. Consult an Expert
I really like all of the different options there are for all people that have Medicare and or VA benefits. When talking to seniors I understand it can be frustrating and confusing trying to figure out all of these options. But that is why you should consult experts like myself and others.
Conclusion — VA and Medicare: Are The Extra Costs Worth It?
I hope this article has answered some of your questions about the VA and Medicare. If you have any more, please leave a comment below!
About The Author — Christopher Duncan
I’m Chris Duncan, owner of Trusted Benefits Direct. As your Medicare advisor, I want you to know that my business offers superior solutions for everyone. I do not work for insurance companies, which allows me to serve you at a high level without any hidden agendas or conflicts of interest. All resources are provided at no cost. Because people must find peace of mind when looking ahead years down the line.
As an insurance agent, it’s my goal to make your life easier. That includes the process of securing all types of coverage for you and your loved ones, including Medicare Supplements, Medicare Advantage, Medicare Part D, Final Expense life insurance services, and retirement security plans. You can reach me toll-free at 800-910-3382 or get a free quote on MedicareRateQuote.com with just a few clicks! Don’t forget that I also offer contact forms if you would like more information from trustedbenefitsdirect.com – click here now!
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