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MEDICARE OPTIONS FOR VETERANS AND THEIR FAMILIES
As the son of a career Air Force father who is laid to rest at Arlington National Cemetery, let me begin by giving a genuine and heartfelt "Thank You" to every veteran and for their families, many of who have given the ultimate sacrifice in defending our country and maintaining the freedoms that too many people take for granted.
When it comes to Medicare for Veterans, Veterans and their families are required to be enrolled in Medicare Part B in order to receive and take advantage of their VA Health Benefits. Whether you have VA Benefits, CHAMP VA, TRICARE, or TRICARE FOR LIFE. The government requires this because Medicare is the National Health Plan for All Americans 65 and older. Medicare is the primary payer and your individual VA benefits pay second to Medicare. This is why the VA specifically says you need to be enrolled in Medicare to receive your VA Benefits, whether you are a Vet or a family member of a Vet. Why do Medicare and the VA mandate this? Simply put, it is to give everyone the best healthcare options available. Not everyone lives on or near a base or a VA Healthcare facility, so being able to go to the nearest Hospital or clinic for treatments is extremely important.
As a Veteran you have the option of either enrolling in Original Medicare (Medicare Parts A & B) or you can also enroll in a Medicare Advantage plan. If you enroll in Original Medicare, your VA Benefits will act as a Medicare Supplement and pay for your 20% share of all approved Medicare expenditures (After the annual Medicare Part B Deductible which is $233 in 2022). If you choose to enroll in a MA (Medicare Advantage plan), your plan pays 80% and your VA benefits will cover the remaining 20%. And, just about every major Medicare Advantage provider offers at least one plan that has been designed with Veterans in mind. Most of these plans are PPO plans instead of HMO plans, so you have more freedom and choices of Doctor's, usually from a nationwide network to choose from. And, because of the excellent Prescription Drug Program the VA has, you will not need to choose a plan with Prescription Coverage because your VA Prescription coverage is as good if not better than Medicare's PDP options.
So, what is the best plan to choose? The answer is the option that fits you, your lifestyle and your family the best. What do we mean by that? Well, let's say you currently have a membership to a Gym or Health Club, and you want to continue that Medicare will not have Gym Memberships included, but Medicare Advantage plans do, so there is an immediate savings there. And, lets say you opted in for TRICARE Dental and Vision Benefits that is costing you $37 per month, most MA plans will include Dental, Vision and Hearing benefits with their plan so there could be more savings for you there as well. What are the drawbacks to having a MA plan then vs Original Medicare?
There are really 3 things to keep in mind, 1) With Original Medicare you can go to any Doctor or Hospital in the Country that accepts Medicare, you are not limited to a particular network. 2) If you like the Mayo Clinic Hospital, they do not accept Medicare Advantage plans in Arizona, so the Mayo Clinic is out. 3) This is the trickiest part, if you choose a Medicare Advantage PPO plan, your provider (Doctor) should bill both the Insurance Company and your VA Benefit Company, but.................they do not have to do that. If they don't, you will need to submit a copy of the bill to Wisconsin Physicians Services and they will reimburse you for the bill within 30 Days.
More information is available on the VA website, Tricare For Life Website and Tricare website. We always suggest that before committing to a plan, you call and speak with a Benefits representative with your VA plan, tell them what plan you are considering and verify how your VA Benefits will work wit that specific Medicare plan so you do not have any "surprises" later.