Two is Better than One: Combining the Power of VA Benefits & Medicare

Approximately 22.6 million Americans are veterans — 9.1 million of which are over the age of 65, according to the 2010 Census. From World War II veterans to Vietnam War veterans, senior men and women all over the nation have served in active duty positions.

Since the American Revolution, the U.S. government has committed itself to providing and supporting veterans through a variety of programs and initiatives. These programs have evolved into the most comprehensive system of assistance for veterans in the world — the Department of Veterans Affairs.

Part of that program includes health care. We’ll take a look at what Veterans Affairs (VA) health care means to seniors looking into Medicare, and what it means for agents that welcome a veteran as a client.

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How VA Benefits Are Distributed

Individuals who served on active duty in the military and were discharged or released, for reasons other than dishonorable discharge, can apply for VA health benefits. Eligible veterans are assigned to coverage based on a priority level of one through eight. The VA uses priority levels to balance the demand for VA health care enrollment resources.

From 2001-2014, @DeptVetAffairs saw a 78% enrollment increase, which could impact available resources.

From 2001 to 2014, there has been a 78% increase in Veteran Affairs enrollment, which may mean changes in available resources. Ultimately, this may reduce the number of priority levels for certain beneficiaries. An individuals’ priority level determines the priority of access to facilities and benefits, as well as copay amounts for things like inpatient hospital stays and medication. For this reason, seniors that are on low priority might not be getting their optimal options for care through the VA alone. That’s where Medicare comes in.

The Power of Two

Original Medicare creates a secondary option for clients who have VA benefits, giving them more flexibility in their healthcare options and possible cost savings. When seniors turn 65, they are eligible to enroll for Part A, which covers hospitalization, as well as Part B, which covers doctors and outpatient services.

Original Medicare creates a secondary option for clients who have VA benefits.

This coverage allows them to see any provider accepting Medicare, so there’s no waiting for a pre-authorization to use a non-VA approved facility or other provider. VA benefits may deny coverage to some veterans, even in emergency situations, if care was at a non-VA approved facility. Medicare is an easy way to prevent this disaster.

When Should Clients Enroll in Medicare?

Your veteran clients should enroll when they are first eligible for Medicare benefits, which typically means when they turn 65. Down the road, if your client is older than 65 and loses VA coverage or decides to enroll in Part A and B afterwards, he or she will have to pay a late enrollment penalty that will permanently increase their Part B premium for the rest of their life. Encourage your clients then to give themselves double protection and prevent any unnecessary expenditures.

What About Medicare Part D?

VA drug coverage is considered creditable, which means it’s as good or better than Medicare’s options. It also means your client doesn’t need to enroll in a Part D drug plan. Should your client lose their VA coverage down the road and choose to enroll in a Part D drug plan, they will not be subject to a late enrollment penalty as long as they enroll within 63 days of losing their VA benefits.

One reason a client may benefit from both VA coverage and a Part D plan is if they move into a nursing home outside of the VA health system that provides them medications. VA benefits only cover the drugs a beneficiary gets from a VA pharmacy, and Part D plans cover drugs within the plan’s network.

Cover Veterans with Medicare

The Department of Veterans Affairs strongly encourages senior veterans to enroll in Medicare as soon as they become eligible. By enrolling on time, they can avoid a lifelong Part B penalty and they can have a secondary source of health care coverage in case their VA benefits are ever reduced or removed.

The @DeptVetAffairs strongly urges senior veterans to enroll in Medicare as soon as they’re eligible.

With that kind of coverage, the nation they once protected can offer them a nationwide network of doctors, facilities, and professionals ready to offer great care. As an agent, you can help veterans get this peace of mind. Show them the way to amplify their coverage and get the care they deserve.

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