How does signing up for Medicare work if you're also receiving benefits from the VA?

Sgt William Rushing — Wed, 02 Oct 2019 13:58:11 -0400

medicare for veterans

I'm a veteran getting ready to sign up for Medicare..... looking for guidance from veterans that have both VA benefits and medicare...does anyone here know how that works?

thanks
bill r.

Response by Capt Dwayne Conyers made Oct 2 at 2019 2:45 PM

Capt Dwayne Conyers — Wed, 02 Oct 2019 14:45:22 -0400

That is good info for ALL of us…

Response by CPL Gary Pifer made Oct 3 at 2019 12:13 AM

CPL Gary Pifer — Thu, 03 Oct 2019 00:13:52 -0400

I have been on VA since 1976 and Medicare since 1997. I am 63... I would pick a Medicare Advantage plan and get Silver sneakers for health clubs. I use and jump back and forth between the two and have 2 primary doctors...... I am over 100% VA disabled...I also have government insurance that is secondary to Medicare. Most of my Army buddies have both.... I also use the Misson Act.

Response by SGM Bill Frazer made Oct 3 at 2019 1:18 PM

SGM Bill Frazer — Thu, 03 Oct 2019 13:18:24 -0400

By Law you must sign up for Medicare. If the VA is treating you/providing healthcare (Tricare), you only need to sign up for Parts A and B of Medicare.

Response by PO2 Michael Slachta made Oct 3 at 2019 4:41 PM

PO2 Michael Slachta — Thu, 03 Oct 2019 16:41:19 -0400

You paid for both services, go ahead and use them. There is no effect bearing in mind that Medicare is primary for non VA services and you are subject to annual deductibles. Best bet is to get the VA to provide what ever services you are entitled too and then use the Medicare for everything else.

Response by LTC Gary Earls made Oct 3 at 2019 8:43 PM

LTC Gary Earls — Thu, 03 Oct 2019 20:43:00 -0400

1SG Faircloth is correct. I have Medicare and Tri-Care for Life. Medicare is primary and Tri-Care is secondary. I also have a 10 per cent disability from the VA and use the VA for hearing and dermatology. I have a primary care doctor who knows I have a civilian doctor also. It's good to use both so you are getting better care with having two medical eyes on you. :-)

Response by LTC Lee Bouchard made Oct 4 at 2019 11:03 AM

LTC Lee Bouchard — Fri, 04 Oct 2019 11:03:00 -0400

I have both and use both the V.A. care and Medicare A. and B. The V.A. can function as a supplemental Ins. for medication etc. or part D. If you are away from a V.A. facility and need medical care, Medicare A & B will be necessary.

LTC. L. Bouchard

Response by PO1 John Meyer, CPC made Oct 5 at 2019 4:23 PM

PO1 John Meyer, CPC — Sat, 05 Oct 2019 16:23:25 -0400

Let me start by saying I’m a medical biller/coder, so this is right up my alley along with those who can say been there done that.

Keep in mind that if you use your VA benefits, cost share is either $0.00 or a small co pay depending on where you go, but you already know that.

You’ll automatically be enrolled into Medicare Part A once you become eligible for Medicare. Medicare Part A only covers those services provided by a hospital such a surgery, in-patient stays, out-patient stays, etc. Medicare Part B will cover visits to a doctor’s office, but you need to sign up for that; you won’t be automatically enrolled. Medicare Part D is for prescription drug coverage, but you also need to sign up for that. If you’re getting your medicine from the VA, I wouldn’t bother with Part D coverage.

I don’t know all that much about Part A coverage because I work in a doctor’s office. Part B coverage I know.

Medicare Part B covers 80% of what Medicare allows a medical provider to collect per their contract with Medicare leaving the remaining 20% to you. For example, if you see a doctor as a new patient and Medicare allows that doctor to collect a total of $182.43 for your visit, Medicare will pay $115.52 leaving you responsible for the remaining $66.91. Medicare Part B also as a deductible of $185.00 (which changes from year to year), which you will have to pay before Medicare will start paying that 80%.

Some people get a supplemental insurance to cover the 20% Medicare will leave behind, but take care in the plan that you choose. Some plans will not pay until you meet the Medicare deductible. After that, some will pay 100%, but some won’t. Some have a deductible you have to meet with them before they will start paying. Some won’t even pay 100% of the 20% leaving you always owing something.

I’ve seen some mention that they have what’s call a Medicare advantage plan or Medicare replacement plan. That is, whatever insurance they have, it takes over for their Medicare insurance so Medicare can no longer be billed, but take care in the plan you choose. Some plans are HMOs that require you to have a primary care provider (non-VA). If you need to see a specialist, you will have to obtain a referral from your primary care provider first just like with the VA. Unlike the VA, it’s a much quicker and easier process. Some plans are PPOs that allow you to see any doctor of your choice whenever you want so long as that doctor is in-network. Generally speaking, HMOs are cheaper than PPOs both in co pays and premiums.

This is a “quick” and dirty on the subject. If you want more information, just message me and I’ll answer your questions as best I can.

Response by Sgt William Rushing made Mar 9 at 2020 1:05 PM

Sgt William Rushing — Mon, 09 Mar 2020 13:05:25 -0400

Okay; so after all the great information posted here i decided to sign up for medicare A and B without the the D....I got a bill for $578.40 lump sum for the first four (4) months ($144.60/mos)...I'm using the VA as my primary heath provider but in case i have to use the civilian ambulance / ER / Hospital I'll have the medicare for back up.....i would love to hear how your using the medicare to veteran options to your advantage...thanks for the input and information.

Response by Sgt William Rushing made Oct 10 at 2021 12:27 AM

Sgt William Rushing — Sun, 10 Oct 2021 00:27:57 -0400

Now that i have medicare and the V. A. benefits, what's the next step ? if i have an extreme emergency and have to go to the E.R . from home to the local hospital by ambulance?....will the veterans benefit cover the ride and other costs ?..Thank you in this matter.