If you qualify for VA benefits and Medicare, you’ve probably wondered if it’s advisable to take advantage of both programs. Will you save on healthcare costs by maintaining your Medicare enrollment? Should you go one step further and sign up for a Medigap plan? The answers aren’t always clear, and it will depend on your health, your location and your financial standing.
What’s the Difference?
VA benefits and Medicare are not the same. In fact, they don’t supplement each other either. VA benefits only pay for care provided at VA facilities. Medicare only pays for care provided at Medicare-approved facilities, from Medicare-approved providers.
While you can enroll in both, you must choose a plan to cover the visit or service when you go to the doctor or hospital. They will not pay for the same visit and Medicare will not supplement costs after you’ve selected VA benefits as the primary insurance.
There are rare exceptions to this rule. For instance, if the VA authorizes you to have treatment at a non-VA hospital and you receive additional treatment while you are there that wasn’t approved by the VA, your Medicare plan may cover the cost.
Do You Need Medicare Part A?
Senior veterans should enroll in Medicare Part A, even when they have VA coverage. Usually this plan has no cost and it pays for any non-VA hospital visits and treatments. It’s not realistic to believe you will always be close to a VA hospital when you need one, so having Medicare Part A is strongly recommended.
Do You Need Medicare Part B?
Even if you’re located near a VA hospital and provider, it’s also wise to enroll in Medicare Part B. The premium is worth it because if you develop a serious condition that can’t be treated at a VA facility, you will be responsible for all of the costs. It’s also possible that your VA benefits could be dropped in the future, especially if you are in a low priority group, in which case you will have Medicare Part B to fall back on.
Do You Need Medicare Drug Coverage?
Veterans usually use VA benefits to cover prescriptions because the coverage is more comprehensive. However, consider that for VA benefits to cover a prescription, a VA doctor has to approve it.
When is a Medigap Plan the Right Choice?
Medigap plans are designed to supplement costs that can quickly add up, especially for seniors on a fixed budget. If you depend solely on VA facilities and providers for care, you may not need this coverage. But if you have limited access to VA facilities and are depending more on Medicare for coverage, Medigap can help cover expenses like copays, coinsurance and deductibles. Also, if you could potentially lose your VA benefits, purchasing a Medigap policy may be the right decision.
Talk to a caring team member at My Senior Health Plan to learn more about how VA benefits and Medicare work, and find the right combination of coverage that keeps you healthy, both physically and financially.