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The Differences Between Medicare and Veterans Benefits

Which benefit would work best for your family?

The Differences Between Medicare and Veterans Benefits

It’s important to be aware of your aging loved one’s health benefits before you visit their doctor. While many people think that Medicare and Veteran’s Affairs (VA) benefits work together, the plans do not overlap. Only some benefits work at specific doctors’ offices. For example, VA benefits only cover healthcare at VA facilities and Medicare only covers care at Medicare-assigned facilities.

1. Medigap is not always necessary for veterans.

Veterans will not necessarily need a Medigap plan if they qualify for Civilian Health and Medical Program of the Department of Veteran’s Affairs (ChampVA). If you senior loved one is not enrolled in ChampVA, a Medigap plan can do the following:

  • Help pay copays

  • Help pay deductibles

  • Offer coinsurance

  • Provide additional financial benefits outside VA or the U.S.

Families should speak with your ChampVA or TriCare representative to decide whether enrolling in a supplemental plan is beneficial for your senior loved one.

Here are good reasons to consider a private Medicare Supplement plan:

  1. Your senior veteran does not live close to a VA facility.

  2. Your senior veteran is enrolled in a VA lower priority group and could potentially lose benefits.

It is important to remember that you have to enroll your senior veteran into Medigap when they are first eligible as they might be denied coverage or charged more if they apply outside of their Medigap initial enrollment period. Comparing your rates every year can also help ensure you’re paying the lowest premium for your preferred plan.

2. Veterans can choose whether they enroll in Medicare Part D.

Enrollment in Medicare Part D is completely up to the veteran and their family. Some VA plans offer more coverage than Medicare’s Prescription Drug Plan, so enrollment is not always necessary.

It is important to keep these things in mind to help your family decide whether to enroll in Medicare Part D:

  1. Any prescription prescribed by a non-VA doctor needs to be approved by a VA doctor for the VA to approve it.

  2. If medications are not approved through a VA doctor, sometimes it’s stated the prescription is unnecessary and time and energy are wasted.

Deducing which doctor your loved one will visit on a regular basis will help your family decide whether to enroll in Medicare Part D. The good news is that if your senior veteran does not enroll in Part D when they are first eligible, they can enroll in the plan without paying a penalty.

3. You should enroll in Medicare Part A, even if you have VA benefits.

Financial advisors strongly recommend veteran seniors enroll in Medicare Part A for hospital coverage. There is usually no additional cost to enroll and if the senior goes to a non-VA hospital, they’ll have coverage for their hospital stay. It’s always a good idea to have private coverage, just in case of an emergency or hospital stay where coverage hasn’t been researched ahead of time.

4. You should enroll in Medicare Part B, even if you have VA benefits.

Financial advisors and the the U.S. Department of Veteran’s Affairs highly recommend that senior veterans enroll in Medicare Part B’s medical coverage. Even with the monthly fee, it is worth it to have medical coverage if your local VA facility doesn’t cover all health services or your family’s VA benefits are dropped at some point. In instances where veterans’ benefits don’t include health services, your family may have to pay 100% out-of-pocket expenses for a serious illness.

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