VA and Medicare (what Veterans need to know)
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- Опубликовано: 10 авг 2022
- www.abtinsuranceagency.com | (888) 465-9728 | email info@abtinsuranceagency.com | VA and Medicare benefits don't work together, but can compliment one another, depending on your needs. Today's video reviews VA and Medicare benefits and how they work for veterans who may have both. We review how VA benefits work when you are Medicare - eligible, whether or not you need to enroll in Medicare if you have VA benefits, how Rx coverage works for folks with VA coverage, and what types of Medicare plans are best for veterans.
Medicare Advantage Versus Medicare Supplement Plans: • Medicare Advantage vs ...
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Thank you so much for this video!! You totally answered my questions and concerns. As a Veteran, I’m covered for V A medical services, but didn’t think about the “what if’s “, cut-backs, certain medical services or prescriptions” and that is so important because we don’t
know what our future holds.
I have another year, so I’ll narrow the choices and will probably feel safer calling you prior to my selection. Thanks for listening to our concerns! I feel like this video was just for me! 😂😂😂
I am so glad to hear that!
@@AbtInsuranceAgency do you have another channel? I subscribed a couple of years ago and I just had to resubscribed today??
Been watching your videos when they pop up and I just knew you would have the info I needed❤.
Two big options for VA
- fully retired VA so 20+ years service everything is covered, also you get TRICARE which will morph into TRICARE For Life (TFL) at age 65, TFL requires you take Medicare A and B or you will be cancelled from TFL.
- or a part timer with a service connected injury, only the injury is covered.
The V.A, has a program called Community Care that allows veterans to have V.A. pay for civilian doctors and hospitals.
🎉🎉
It's trash
Does this automatically cover community care?
@daustin439 no, you have to qualify by basically living a certain distance from the nearest VA hospital or having some hardship that makes transportation to the hospital difficult. At least that is my understanding working with community care referrals in a specialist's office.
@@clark4193 yes, if you live within 40 miles, there isn’t a reason to not go to the VA.
We have commented below about our grandpa who has VA Priority 5 level care. You can read that. For his friends who only have Medicare and are not veterans they are very excited about the reported cap on Medicare out of pocket drug expenses that are reported to be in the new Inflation Reduction Act being signed by Potus today. According to a cousin who does elder care law she said that in her reading of the bill, Medicare will now be able to negotiate prices for drugs, which the VA has already had that feature. But more importantly for Medicare recipients who need a Part D drug plan, the new law supposedly puts a cap on out of pocket drug expenses at $2000.00 per calendar year. However she further opined that, the cap on drug expenses at $2000.00 does not kick in until "2025". If true it does nothing to give relief on high med cost now or next year. The cap inside the VA for our grandpa meds is $700.00 right now. Again, everyone check all this against your own personal needs and your plans for 2023 and forward. And of course there is always Abt just a phone call away.
Great summary and explanation of VA benefits. I live in Michigan and went to Vietnam full-time Navy. Went back in military reserves then retired after being called for the Persian Gulf and hitting the tail end of Kosovo. Needless to say the worst was with the ex wife. At the time I was working and had insurance through civilian employment. Age 60 I was was placed on Tri Care for Life and was told by VA that I had to obtain part A & B Medicare to qualify to use VA. In order to keep my medication I HAD to get my meds through the mail and my civilian Dr. at the time had to coordinate meds with the VA which created conflict of obtaining my drugs though VA mail. I pay for Dental coverage through TriCare. Now looking for a change to an advantage plan that pays for part or partial on B part, lower deductible than 4000, free gym membership, and has a better Dental coverage. Looking forward to work with you at opening enrollment
You don’t need part B for VA. You need part B for Tricare for Life.
My husband is a veteran. He opted out of part B and only has A because he gets all his treatments at the VA. He's had two surgeries and is currently undergoing chemo, all free. He's disabled so he got Medicare at just 62.
Is your husband retired from military or totally disabled from military?
@@raymondshartrand40 Neither. He did a 6 year stint in his 20s and was honorably discharged. Honorably discharged is all that’s required to get VA benefits.
Yes I know. I’m a veteran honorably discharged. My coverage is based on income? I’m in Priority Group 7. I’m not sure what my hospital coverage is if I’m admitted. I hope your husband is doing well & glad to know that you folks don’t have to pay & it’s covered 100%. 👍🙏
@@raymondshartrand2417 He died from his cancer, but the chemo bought him some time
@@newbirth35if he is not disabled from the military he can’t get all of that treatment for free! Because if he did that’s a new one
Hey, thanks a lot for this. You answered so many questions for me. I’m a 100% disabled vet. You’re the best. This was so very very much helpful.
I’m so happy to hear this!
I'm 100% veteran too, I'll have to choose a Medicare plan next year. What do you have? I don't want to lose my house to Medicare.
Excellent video, clear and short without unnecessary filler. Great job.
I want tot thank you for all your videos on Medicare. The videos are put in laymen's terms and detailed in general to cover most questions and if not you offer a number/email we can connect to. I have been retired now for over seven years and my wife will retire in 3 years at age 67. Your videos will more than likely assist my wife with some of her decisions with the upcoming Medicare Election Period.
I am a veteran and use my VA benefits and appreciate that they are there to use. Your video on the VA and Medicare opened my eyes to a few solutions I was not aware of. Thank you so much for being a Caring, Wealth of Information with a HEART of GOLD. God bless you.
Exceptional video. Options and requirements were clearly and concisely articulated. I am a retired veteran and receive SSA/Medicare parts A & B plus I have Tricare for life. Could you at some point discuss Tricare for Life benefits and how they work for veterans and dependents. Keep up the great informational videos. I very much appreciate them and is helping to make some future decisions on my medical coverage. Peace.
Does TFL completely cover 100% -> all the CoPays that Medicare (Plan A &/or B) do not cover????
Also, Tricare for Life covers if you travel outside to U.S. like overseas.
Most veterans (retired) also have Tricare coverage beside the qualified VA benefits. In this case, the Veteran will lose his Tricare coverage if he/she doesn’t enroll in part B. Not everything can be covered be the VA; thus, having Tricare along with part B definitely release lots of pressure. Hope you have / or will have an educational video for how Tricare benefits and Medicare work (together). Thanks.
Grandpa has VA healthcare as Priority 5. That means no service connected disability and depending on income prescriptions and doctor services with copay. No dental and no free inpatient care at a VA hospital. He also gets a vision checkup and one free pair of glasses per calendar year. He does have copay for meds but he falls below dollar threshold and does not have copay for doctor services. He has an outpatient clinic only 17 miles from his home and a VA Medical Center about 48 miles from his home. He gets services at both. He just had 2 cataract surgeries at the medical center 4 weeks apart at no charge except for the medications associated with the surgeries. He had copay for the eye drops. He does have quite a few medications he takes for COPD and blood pressure and all come with copay, but much less expensive than any Medicare Plan D would be. And importantly in his case, he can get a prescription from an outside doctor or and CAT scan order from an outside doctor and have them both fulfilled at the VA, after an appointment with his VA primary care doctor. He must bring the outside doctor summary notes of that visit to the VA primary doctor in order for that VA primary doctor to order the meds or the diagnostic test. Grandpa also had bladder surgery outside the VA in 2021 but the VA provided BCG immunotherapy inside the VA. Anyway Grandpa has always had a Medicare Advantage plan as a backup without PART D. The only recommendation for any Veteran in Priority 5 is keep your appointments they give you and also VA rules and regs and services can change from year to year. Abt agency videos are the best source for Medicare info on RUclips. Thank yoyu
Thank you for sharing this!
I'm a veteran and I turn 69 the 17th of this month. I've been on the VA service connected for quite a while. The VA has worked on my teeth until the first wave of COVID-19. They say I'm not eligible for dental anymore and now I have severe dental issues right now. I live in Pennsylvania so I'm going to call the number in your video tomorrow hopefully your able to help me figure something out. Love the video
Vietnam Army Vet here, I retired @ 65 and signed up for Medicare parts A & B..I then went to the VA and I have been getting my medical needs taken care of by the VA since then. I have a VA medical disability rating from the VA because of exposure to Agent Orange in Vietnam. In January of this year I had to go to the Emergency room at. my local hospital, I told the hospital staff about my VA coverage. I called the VA's community care # the next day so the VA ended up covering all the expense of that. Interesting thing is this, because I have Medicare the hospital and the doctors all billed Medicare completely ignoring the fact that I also have VA coverage. Medicare rejected all the bills that they received because I have VA coverage (They Know about it).
Bottom line question is this, why should I continue paying for Medicare when I will never be able to use Medicare?
Medicare told me that all bills submitted to them will be rejected because I have VA coverage even though I have paid and continue to pay into the Medicare program. ThankYou for answering my question.
😳😳😳😳😲😲😲😳😳that’s exactly what I’ve been looking for, this need to be pinned! I will never get Medicare part B. Why am i paying when i can go to VA for free, im 100% P&T but even if i wasn’t i would still just do my VA since healthcare is covered for all vets now. Your story confirms what I plan to do!!!!!
I am trying to sort through things for my veteran hubby. Thanks for confirming what I've been chasing down for months. Looks like I should have just come here. 😄
As a veteran with a disability who also has VA health benefits, the only reason I will have Medicare Part B is for the ambulance coverage. It's literally possible to be financially devastated for one air ambulance ride if you do not have ambulance coverage. Even with Part B you have to meet certain guidelines but you should know what those are before you call an ambulance anyways. People have gotten six figure bills for air ambulance transportation when they were not conscious to ask for. If you are in an accident and are unconscious and a police officer has you air medevacked to a hospital, that will be 80% covered under Medicare Part B.
I'm a veteran, and thanks for the great info.
Your videos are so very helpful and you are so thorough in your explanations. Thank you!
Thank you! You have cleared so much up for me. Much appreciated!
Stephanie, I am a USMC veteran and I came across your video. I'm 40 years old and have no idea what Medicare and all the parts are. I have 100% disabilty service connected. For someone like me who don't know a lot of healthcare/health insurance, you are basically speaking a foreign language when you are talking about Medicare Part A, B and D. What I wanna know is as a veteran with 100% service connected disability, do I need Medicare and why?
It’s best to keep part b
Omg, I'm a newly hired medicare agent and we just went over this in training today. Thank you for the thorough details and clarity.
I'm part -time selling, only during AEP. My company sends me elsewhere the rest of the time. Earlier this year they sent me to H&R Block for 6 months. My commissions are very low, but I get $16 hourly.
Thank you for this information. I love your "book tree" Back there in the corner behind you! A great way to measure your reading. 👍😁
Thank you for this video, for more information concerning Part D.
as a diabetic I receive medication from the VA however I am not on insulin therefore testing supplies are obtained using my Medicare coverage currently that would be under Plan B not d this can change under Medicare at any time as you may not be aware that Medicare plans change yearly pay attention to those changes when open enrollment occurs
Noel, I receive my diabetic meds and testing supplies from the VA by mail. I'm 100% permanent which may be why.
Thank you so much good information for veterans. I had some question but you answer them. I will reach out to you if I have more questions. Thanks 🙏🏾
If you are a Veteran and you are considering not taking part B, be sure to think about your medical needs long term, not just now. I understand that not having to pay that $165 part B premium sounds good. If you live within 20 or so miles of a VA Hospital (VAMC) that is probably going to be a safe choice. But what if you are like most of us Veterans and have a good outpatient clinic nearby, but have to drive a long way to a VA hospital for treatment for some conditions it may not be your best option. Take me for example, I have a great outpatient clinic where I live but I have a medical issue that needs to be treated a couple time of year at a VAMC which is 150 miles away. Right now I can make the drive just fine, but what about in five, seven or ten years from now. Granted I can enroll in an advantage plan if I can no longer make that drive, but at 10% penalty per year how much will that part B premium be? If you think you can't afford it now, you surely won't be able to afford it then. Also, if you take part A only and have an emergency, and end up in a local hospital you are on the hook fore your part A deductible and copays. The provisions of the mill say if you have insurance that pays any part of your bill the VA won't help you pay the rest.
This is what the VA told me when I had Kaiser for my husband. They are not a secondary, but only pay on first place. So if a primary pays they cannot bill the VA for the secondary.
BUT, he could choose “which” to bill. With Medicare can he choose to have only the VA billed?
@@hollyegee2199Actually you can't chose which one to bill. The mill bill clearly state that if you have any insurance it pays first.
Great video! Answered all my questions. Thank you!
Glad it helped!
Thank you for this video very helpful
Be carefully if you are in a VA and that doctor recommends nursing home care for rehab, but your primary doctor is in a Medicare Advantage who will know nothing about approving coverage.
If you have Tricare for life as a military retiree and you don't enroll in Medicare part A and B, you lose Tricare for life benefits.
Thank you!
The VA pharma formulary doesn't include some drugs that are covered via Part D. And you would need to go through the bother of having a non VA prescription rewritten for VA dispensing.
Hi Steph, great educational videos!! Wondering if anyone from your team speaks Spanish please?! My dad lives in Miami, FL and about to turn 65... we are struggling with Medicare options. Thanks again!
Luis
Wow, you really know your stuff. Great info...
Stephanie, I'm almost 60 and will start Medicare (24 months SSDI) in October. I am 100% VA permanent disabled and currently use the VA for most medical care. I also start Tricare for Life when my Medicare starts. I guess I'll opt for Medicare A&B (already got card and deductions from SSDI scheduled.) My wife is 55 and not working but covered by Tricare Prime. Any recommendations for my situation?
Thanks
Awesome information. Thanks
very helpful thank you
I am a military retiree enrolled in Medicare Part A and B, with Tri-care for life and am in the process of receiving a VA disability rating and due to my combat deployments have just filed for VA health coverage. I am curious if the VA medical coverage penalizes for income like Medicare does? Also how does the coverage vary due to VA disability?
I have a 60% VA disability and a United Advantage Plan. Who is the first payor on ambulance service and emergency services - VA or UH? I can't get a definitive opinion from either organizations. Any answer? Thanks. Tom PS love your videos
When it comes to income test, is va using individual or household income?
Champva’s and Medicare plan f. Should I keep both?
If all coverage with VA and referred to Community Care (outside VA provider) that should also be paid by VA.
This shouldn’t be a problem, since a referred out for care, right?
I have Part A and B with a 100% VA Disability. Do I need a Medicare Supplement with Prescription? I am satisfied with VA Health Care with Prescriptions
I am 100% VA disabled plus am SMC housebound. I am a retired Army Officer. I am 84 so have Medicare and Tri-Care for life. The VA gives me three care in the community Sleep, Cardiology and Urology. Will I be penalized if I refuse Medicare? I get all prescriptions except one from the VA.
Does zero premium advantage plan satisfy part B requirement for Tricare for life?
Very interesting 🧐😎🤔
Excellent video. What if you have VA healthcare coverage and Tricare Standard or Tricare for Life. How does this impact Medicare options? Thank you.
Tricare for life acts as a Supplement for Medicare. You must be enrolled in Medicare A and B.
If a doctor or hospital charges Medicare before charging the VA. The VA won't pick up the left-over charges, and you will be responsible for all other charges.
So I should have the VA as my primary provider no matter where I go? & Medicare secondary ?
Is there a part C designed for 100 percent P&T disabled Veterans?
I’m 50, and 100% service connected….. what is the age criteria for Medicare & should I consider it as a force multiplier?!?
Thank you.
65 is the current Medicare age!
How does this work if you’re paying for tricare? Does tricare have a Medicare program?
Tricare becomes “tricare for life” when you are Medicare eligible.
Can my Veteran husband drop his advantage plan and go back to Original Medicare in order to be admitted to rehab, which the advantage plan denies him? He would probably not medically qualify for a supplement plan, but at least he'd be getting the care he needs, and we'll just make payments toward the 20% we still owe? There's no Vet rehab in our area, and the Veterans home only takes 100% service connected, which he is not.
Yes, we can drop his Advantage Plan every year from Oct. 15th - Dec. 7th and return to traditional Medicare for Jan. 1st. So sad to hear about this repeatedly happening to Medicare Advantage patients concerning skilled nursing care.
Just became eligible for Medicare. My tricare changed from Tricare Standard to Tricare for Life, so I contacted Tricare and was told the I had to enroll in Medicare A and B to maintain my Tricare for life coverage, that Medicare would become primary and Tricare secondary. Have you heard or know anything different than this? Thank you.
As far as I know you are correct also you need to be sure you are enrolled in TFL.
Once you are eligible for medicare, medicare becomes the primary payer and TFL becomes secondary insurance. In effect, TFL is your medigap plan, paying the deductibles and coinsurance from medicare Parts A and B. If you don't sign up for medicare once eligible, TFL is still the secondary payer and YOU get to be the primary. That's a very bad situation to be in, don't do that yourself.
@@barreloffun10 TFL ends as soon as you are 65 and do not enroll in Medicare A/B and pay the premiums, research it if you doubt me.
@@smoke1830 I checked the Tricare website and it seems you are correct.
I must be missing something because I get all of my care outside the VA covered by the VA through community care.
At absolutely no cost to me.
You have to get it pre-approved, but not for ER and Urgent Care visits.
So, I must be missing something here.
I wen to urgent care four times a couple years ago for pneumonia and bronchitis. VA covered three visits. When I called to ask about the fourth, I was told that VA will only cover three urgent visits per year . FYI.
In my case my VA health plan wasn't considered to be credible coverage. So I was required to pay for Medicare at age 66 or face a 10% penalty for each year I chose to wait. However, my VA prescription drug plan was considered to be credible coverage and I wasn't required to purchase a prescription drug plan.
I use VA coverage for 99% of my medical needs. My VA prescription drug plan covers about 95% of my needs.
I have to have a Medicare Advantage plan or I woud face a 10% per year penalty, by law.
What I'm saying is the federal government requires, by the use of monetary penalties, a 100% participation rate in Medicare and PDP plans. This is regardless of my VA coverage.
Fun Fact: the VA uses a drug formulary and PDP plans use a drug formulary. Sometimes an Advantage plan formulary covers a drug that the VA doesn't cover.
I've also found that community care providers only try to treat what the VA consult request asks them to treat. They don't seem to try to treat problems not on the consult. This problem seems to be primarily with my neurology consults.
I have VA healthcare as a Honorable Discharged Army Veteran. I receive SSDI, since 2015, turning 65 in Aug 2024. I pay copay for prescription, last year I paid copay on Dr visits, no travel reimbursement.
Who can advise me on my options
So if your on SSDI @ 60 and get enrolled on medicare 2 years later because they automatically do that after the 2 year mark......and you refuse it till 65 are you then penalized for not taking the coverage ?
Is it true that if the doctor you see under Medicare writes you a prescription, you cannot have it filled at the VA? Same question in reverse, can you fill prescriptions from a VA doctor at your corner pharmacy?
You can get outside doctor prescriptions filled by a VA doctor. They usually require the treatment notes. It has to be on the VA formulary.
I could get everything from VA but I would have to travel to the VA hospital specialists and that makes doing business locally less expensive in most cases. If I drop my advantage plan they will drop my wife, so stuck with both.
F. Miller
What is bothersome, is this! If a veteran calls into speak to pharmacy and orders a refill but a representative says some date is when meds are supposed to be sent out via mail. How can a rep see into the bottle the amount is in line with date, except by spying on a veteran and if meds were ordered via phone call as instructed by operator. Something smells off.
I am 100% P&T with the VA why do I need any other coverage. and my wife is on Champs VA
I am 100% P&T disabled Veteran I had medicare part B for years but I totally do all my medical with VA it includes everything so last year I canceled part B because all my medical needs were from the VA if I decided to go back to part B would I be penalized? It just didn’t seem fair to me to get everything I needed through the VA a pay for part B
As long as you continue with VA services only you can forego Part B, but yes you would be penalized if you do decide to enroll in Part B later on.
@@AbtInsuranceAgencywhat if I am in the same situation (100% P&T), but under 65. Doesn't my penalties reset at 65?
@@edmondsmith6008 yes they do
Besides my VA coverage I will have a FEHB upon my retirement. Will need Medicare parts A and B?
This information will be helpful --www.opm.gov/healthcare-insurance/healthcare/medicare/medicare-vs-fehb-enrollment/
I wish you can make a video for Federal workers retiring with FEHB and if they need Medicare and what it will offer you if have BCBS basic.
I heard VA is hit or miss, might depend on the area. I heard horror stories but I've also heard people who use it as primary and are very happy.
I love the VA
After 24 years, the VA is great, no plan is perfect
VA is garbage and is a health benefit not insurance.
i have metatarsalgia on both feet i can barely walk
The real question is...what if a person opts out of the medicare program and just uses the Veterans Care, will they be charged (money removed from their Social Security check) for not accepting medicare? Veterans Care covers all of my medical and that's all I need. But I don't need them taking money out of my Social Security check (it's small enough as it is)
No, you won’t get a Part B penalty as long as you simply never enroll in Part B.
I would like some info on Humana and united Healthcare. How do I get that?
Feel free to contact us - 888-465-9728!
@@AbtInsuranceAgency i have 100 % P&T priority 1 care and am very happy with VA. I have dropped Medicare part B. Are there options that would improve my health coverage?
I recommend everybody keep their medicare A&B I'm 100% service-connected P&T and complain to my doctor for 3 years because there was days that I couldn't stand she dropped the ball lucky I had my medicare and I went to a private doctor.
And they found that I. At Colon cancer, and they operating. On me now my VA doctor is just a liaison to the VA.
If it wasn't for my medicare, I probably would have died and the BA would never did nothing.
@@richrod1678I am 100% P&T too. I was considering dropping part B, but your story is making me rethink my options. Thanks.
If someone doesn't sign up for medicare, can they get the money back that they paid in while working?
Unfortunately no.
If I receive Champva - my husband is a retired vet.. do I have to enroll in Medicare if I receive Champva do I have to enroll in Medicare…..
In most cases, yes www.va.gov/COMMUNITYCARE/programs/dependents/champva/champva-eligibility.asp#:~:text=CHAMPVA%20is%20always%20the%20secondary,B%20is%20required%20by%20CHAMPVA.
What about Medicaid?
1 and 3 are basically the same
Isn’t it against Medicare compliance guidelines to call yourself a “specialist” in Medicare?
Veterans now can see doctors outside Va hospital just have to call Va within 72 hours
VA knowingly told my father his lungs sound clear. VA ignored he has stage 4 lung cancer.
@3:38… “lifetime penalties”What’s these penalties?? I don’t see VA coverage going away. If you’re 50% service connected, medication is free.
Veteran's VA covered...as far as I know the VA will not honor non veteran doctor's RX.
Typically that’s correct
If it's part of a Community Care referral it's not a problem. @@AbtInsuranceAgency
Alot of us vets are tired of phone calls from medicare. I'm dieing and taken care of by v.a. (worthless public employees) I've told and told them I'm v.a. and taken care of and asked to be left alone. It doesn't do any good. Help stop the government jerks
Why are they calling you?
@@SandfordSmythe the free information highway of our country. They can get away with anything. And hide behind the laws that protect them. And harass the public and get away with it.
Medicare you pick everyone the VHA you pick no-one.......
Medicare can take your house to pay the bills
Maybe Medicaid
VA "Healthcare" is not health insurance but a mere healthcare benefit.
Thank you !
What is bothersome, is this! If a veteran calls into speak to pharmacy and orders a refill but a representative says some date is when meds are supposed to be sent out via mail. How can a rep see into the bottle the amount is in line with date, except by spying on a veteran and if meds were ordered via phone call as instructed by operator. Something smells off.
They expect you to follow the instructions for when and how much to take. If you have a 90 day supply and you follow the instructions on the label, then it will take you 90 days to go through all the medication and they will send out the next batch.
What about Medicaid?