With my being a 100% DAV, is signing up for Medicare necessary?

2022-12-16T10:25:33-05:00

I'll be 65 in 7 months. I have a 100% rating and am on community care already due to distance to nearest VA Clinic. Do I really have to sign up for medicare and all those other things associated with it? Who's the SME?

Response by COL Randall C. made Dec 16 at 2022 10:59 AM

2022-12-16T10:59:36-05:00

BLUF: There will be no change in your VA coverage when you turn 65 and Medicare only gives you more options at a cost of premiums.

The SME is obviously the VA - VA health benefits hotline, [login to see] , Hours: Monday through Friday,
8:00 a.m. to 8:00 p.m. ET

Rick, you are not required to have Medicare with VA, but you are if you have TRICARE (in order to keep your TRICARE benefits). Medicare and the VA are two entirely separate programs and operate independently from each other (unlike TRICARE and Medicare).

However, the VA recommends that you do for a very simple reason. If you go to a non-VA hospital for anything, you'll have more options (i.e., non-VA doctors). Additionally, they state the following:

● Funding for VA health care could change in the future. We encourage you to sign up for every health care benefit that you’re eligible for so you have options if you need them.
● If you delay signing up for Medicare Part B (coverage for doctors and outpatient services) and then need to sign up later because you lose your VA health care benefits or need more choice in care options, you’ll pay a penalty. This penalty gets bigger each year you delay signing up—and you’ll pay it every year for the rest of your life.
● If you sign up for Medicare Part D (coverage for prescription drugs), you’ll be able to use it to get medicine from non-VA doctors and fill your prescriptions at your local pharmacy instead of through the VA mail-order service. There’s no penalty for delaying Medicare Part D as long as you enroll when you’re first eligible or within 63 days of when you no longer have VA health care or other creditable prescription drug coverage. Learn more about how to avoid the Part D penalty on the Medicare website.
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* VA and OHI - https://www.va.gov/health-care/about-va-health-benefits/va-health-care-and-other-insurance/
* How do Medicare and VA work together (they don't) - https://www.medicareinteractive.org/get-answers/coordinating-medicare-with-other-types-of-insurance/veterans-affairs-va-benefits-and-medicare/making-part-b-enrollment-decisions-with-va-benefits

VA health care and other insurance | Veterans Affairs

If you have other forms of health care coverage (like a private insurance plan, Medicare, Medicaid, or TRICARE), you can use VA health care benefits along with these plans. Learn more about how VA works with other health insurance.

Response by SFC David Reid, M.S, PHR, SHRM-CP, DTM made Dec 16 at 2022 12:40 PM

2022-12-16T12:40:18-05:00

Colonel Cudworth! Thanks for your excellent and detailed commentary!

Response by SGT Private RallyPoint Member made Dec 16 at 2022 8:00 PM

2022-12-16T20:00:31-05:00

When you file for SS they will take the premiumf or parts A&B. You can do what I did and find a Part C that gives money back. I'm getting $125 back from my Part C plan. I get my silver sneakers benefit, fall detection and a few dental cleanings. Eye also.

Response by CPT Aaron Kletzing made Dec 16 at 2022 10:02 PM

2022-12-16T22:02:54-05:00

Others here have better answers than I would ever have -- but I just wanted to post here and wish you only the best with your healthcare situation, SGT Private RallyPoint Member.

Response by A1C Medrick "Rick" DeVaney made Dec 17 at 2022 3:27 AM

2022-12-17T03:27:52-05:00

Our VA DOCTORS Disabled Me.
Drove Me Insane Due To Wrong Medications For Problem I Didn't Even HAVE.
Followed By NO A NON-Diagnosis For An Extremely Dangerous Liver Infection Which I DID Have,,,,Then Hospitalized My ass For An Entire MONTH... After Emergency Surgery, Preformed While I Was Unconscious..........And Damned It I AIN'T Having Trouble Getting The EVIDENCE, When ALL Of It's In Their Computer Records........
"....So You Think You Got Trouble, The More You Try, The Worse It Gets......."

Response by CSM Darieus ZaGara made Dec 17 at 2022 7:34 AM

2022-12-17T07:34:22-05:00

As explained to me and after reading all I could find; since politics rules benefits you never know when they will change, you should sign up for all available coverages to ensure you’re continued medical support in the future.

The VA has been good to me as well, but policy does change.

Response by SGM Bill Frazer made Dec 18 at 2022 12:24 PM

2022-12-18T12:24:59-05:00

By Law even if the VA has you covered- you must sign up for at least Part A and B.

Response by MAJ Ken Landgren made Dec 19 at 2022 7:46 PM

2022-12-19T19:46:08-05:00

Are you getting the VA Caregiver Funds?

Response by CW2 David Williams made Dec 20 at 2022 9:58 AM

2022-12-20T09:58:10-05:00

It is highly recommended, I did although VA has given me outstanding care, sometimes you need care now. I'm retired I have Medicare and Tricare for life, and I love it. I haven't paid a penny out of my
pocket other than Medicare premium. I don't know who the SME is.

Response by MAJ Elsie Shelton made Dec 20 at 2022 10:25 AM

2022-12-20T10:25:16-05:00

Here’s my take. I am also 100% and 49 miles from my clinic. While the VA is your best bet, I’ve found that sometimes Medicare and Tricare For Life (TFL) can meet immediate needs.
Bottom line is that YOU have to decide. Do you receive disability benefits? Retirement from your branch? Are you TFL eligible? Answering these questions will help you make the decision, but I absolutely recommend getting Medicare!
Good luck!

Response by CPL Sharon Fahey made Dec 20 at 2022 10:40 AM

2022-12-20T10:40:31-05:00

Yes. According to VA but if you have Tricare or Tricare for life, which you should, you won't need Part D, the prescription part, it'll save you money.

Response by PO1 Robert Ryan made Dec 20 at 2022 11:44 AM

2022-12-20T11:44:10-05:00

I am 100% also. I elected to have VA Medical Services. I can't complain Audi Murphy VA Hospital
here in San Antonio has met alll my medical needs. If you plan on a different medical provider than VA you should get part B. With part B you will also have Tricare for life. Part B only picks up 80% of the medical bill, Tri-Care for life picks up the other 20%. Contact Tri-Care for life art [login to see] .

Response by PVT Mark Whitcomb made Dec 20 at 2022 11:57 AM

2022-12-20T11:57:10-05:00

you get medicare automatically anyway. part B would cost you which is hospital care depending on your income. I got it anyway because I travel To see the grandkids and they not near a VA. It just saves on paperwork. whatever medicare doesn't cover the VA does

Response by SPC Daniel Berliner made Dec 20 at 2022 2:56 PM

2022-12-20T14:56:17-05:00

I am 73 and have all my health care and medication covered at my local VA Facility and was told when it was time to sign up for Medicare I did not need to since VA cannot bill Medicare for anything.
It's been 8 years and I have yet been told I need to sign up.
If I have been given the wrong info some one will need to let me know.

Response by Sgt Frank Shelton made Dec 20 at 2022 3:51 PM

2022-12-20T15:51:23-05:00

I have Medicare, supplemental and I am rated Permanent and Totally disabled by the VA. I use Medicare for secondary opinions when the VA suggests a treatment plan that I am not sure of, or would like information from a non-VA doctor. I also use Medicare for some medications the VA will NOT prescribe for me. (Over the counter medications) Social Security does deduct their fee from my Social Security check every month.)

Response by PVT Mark Whitcomb made Dec 20 at 2022 9:56 PM

2022-12-20T21:56:44-05:00

The bottom line is what do you think is best for you??You get your Medicare Auto the month you turn 65 I added on b Just in case. Because of my income level the state covers most of that. Protect yourself and if you can save the VA some doe it may help another VET. It is all from the Gov. just depends on which Budget it comes out of.

Response by SGT Doug Blanchard made Dec 20 at 2022 10:40 PM

2022-12-20T22:40:26-05:00

If you sign up for Medicare, check to see if your state has what is known as "Extra Help" program. This program pays for your Medicare payment that would come out of your social security. You may also be eligible for a Part C prescription drug plan that is covered under the extra help plan. It is all based on your income. But every bit helps.
In my case, even though there is a VA outpatient clinic in the city I live, the nearest VA hospitals to me are both 70+ miles from where I live. Besides Medicare, you might also check into your state's Medicaid program. Different states have different requirements for this program.

Response by PVT Mark Whitcomb made Dec 21 at 2022 12:52 AM

2022-12-21T00:52:32-05:00

It truly depends on your circumstances. I have it because it works for me. If i have an accident and they bring me to another hospital I'm not concerned. They can take all the xrays, etc they want and I know they will go to my doctor at the VA so I always have a 2nd opinion It is all the government paying for. just a different branch. If I can save the VA money by not having it come out of their budget even better it may help a fellow VET.

Response by TSgt James Herslebs made Dec 21 at 2022 12:33 PM

2022-12-21T12:33:00-05:00

Where I live in Missouri there are Insurance programs for Veterans on Medicare that serve as Medicare supplemental policies. They cost nothing for the Veteran and add an additional safety net for you to fall back upon. So it would be beneficial to get Medicare.

Response by SGT Paul Chunglo Jr made Nov 15 at 2023 2:46 PM

2023-11-15T14:46:34-05:00

I'm 70% service connected and also social security disabled they offered me Medicare and I accepted it but they also charge me a $165 premium every month. I receive all of my medical care through the VA at no cost to me. Does it make sense to keep Medicare and keep paying for something I don't use?