865-203-2040 karen@sisgrouptn.com

VA Benefits and Medicare

First, we would like to thank all of our Veterans for your service and sacrifice. You have given us the freedoms we experience in the United States of America today.

Medicare Part B Options

If you are a veteran who is almost 65, you are ready to tackle learning your Medicare options. There are a lot of pieces to the puzzle we would like to share so that you are successful in your Medicare journey, beginning with Medicare Part B. As you are considering your choices, it is important to know that although you can choose to take Part B or not take it, it is HIGHLY recommended to take Part B when you are first eligible. Although it may be tempting to decline Part B if you get all of your medical services from the VA, if something changes later on and you decide you need Part B, you will get a penalty from the government. A medical is not considered creditable coverage with Medicare. Part D, on the other hand, is creditable with Medicare so if you are getting all of your prescriptions from the VA you can choose to not take a prescription drug plan and if you change your mind later you will not incur a penalty.

Integrating Veteran Benefits with Medicare Advantage Plans

It can be complicated integrating VA benefits with Medicare Advantage plans. If you have Tri-Care for Life or Champ VA you should be very careful before you choose an Advantage Plan. When you have Medicare and Tri-Care or Champ VA, Medicare pays first, then Tri-Care or Champ VA. If you add an Advantage plan because you may want the Dental, Vision, Hearing, OTC products, or a gym membership, your Tri-Care or Champ VA will then pay after your Advantage Plan. So, the Advantage plan pays first, and then Tri-Care or Champ VA. Many offices and facilities do not know how to bill this, and you could end up having to pay the co-pays from the Advantage plan and trying to get them back by submitting information to Tri-Care or Champ. More times than not it is usually not worth the trouble for the extra benefits from the Medicare Advantage Plan. If you do decide to attempt to add a Medicare Advantage Plan, NEVER EVER get one with Prescription drug coverage! This will not work with Tri-Care or Champ VA.

If you have VA benefits, it is the exact opposite. An Advantage plan can back up your benefits and work interchangeably. You can still get all your services from the VA and use the benefits from the Advantage plan too! You can:

  • See a VA doctor or a Doctor on the plan.
  • Take advantage of the dental, vision, hearing, OTC products, and gym memberships if offered on the MAPD plan.
  • If you get your prescriptions from the VA, you can choose to get some from the VA and some from a local pharmacy as long as it is an MAPD plan and the pharmacy is in-network. This allows you to pick up a medication right away without waiting for the VA to mail it.

Prescription Drug Coverage

Additionally, some Veterans prefer to get all of their medications from the VA so they can take a MA or Medicare Advantage with no prescription drug coverage. Many MA plans have a give-back option that will pay some towards your Part B premium. Another big benefit is if you end up needing emergency care at ER or are admitted to a hospital and do not get transferred to the VA hospital you may or may not be covered by the VA. The advantage plan could save you over original Medicare since you would only have the hospital co-pays for the Advantage plans.

>>Related Read: 10 Common Annual Enrollment Period Questions

I know this is a lot of information, and it can be difficult to sort out. But that is what we are here for. As Medicare Insurance Specialists, we offer cost-free assistance, so you feel secure in the Medicare decisions you are making. For more information reach out to us via our website, follow us on Facebookemail, text, or call us at 865-203-2040.

*Medicare Insurance Specialty Group is Not Approved By, Endorsed By, or Affiliated With A Government Agency. We do not offer every plan available in your area.  Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Share on Facebook

Share on Linkedin


Call Now