Veteran Medicare Supplement (Medigap)
2018 Medicare Open Enrollment fall of 2017, from October 15 to December 7.

During this annual enrollment period (AEP) you can make changes to various aspects of your coverage.

 

  • You can switch from Original Medicare to Medicare Advantage, or vice versa.
  • You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
  • And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

 

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

 

  • You must be enrolled in Medicare Part A and B.
  • You must live in the plan’s service area.
  • You cannot have End-Stage Renal Disease(some exceptions apply).

Veterans May Choose Veterans Affairs (VA) Benefits and Medicare

 

As a Medicare-eligible Veteran, you have options when it comes to healthcare. You will find information that all Veterans should know when they become Medicare eligible.  To confirm your options call the VA directly 1-877-222-VETS (8387).

 

Call 888-654-3129 today to schedule a time to discuss Medicare plan options for:

 

  • Medicare Supplement Plan,
  • Medicare Advantage Plan and
  • Medicare Part D Plan.

 

Choose from the top Medicare Carriers.  See your plan options from Aetna,  Humana,  AARP and UnitedHealthCare.

 

Veteran’s Affair (VA) Benefits and Medicare

Although the VA Veteran’s Affair (VA) and Medicare are both Government Health Programs and if you are eligible for both, it is important to know your options.

 

You can have both Medicare and VA benefits. However, Medicare and VA benefits do not work together. Medicare does not pay for any care that you receive at a VA facility.

 

  • VA plans only cover care at VA facilities,
  • Medicare only covers care at Medicare assigned facilities.
  • The VA and Medicare plans do not overlap.

 

Enroll in Medicare Part A If You Have VA Benefits

Both Medicare and the VA suggest you should enroll. You can have both Medicare and VA benefits at the same time and this is recommended.  It is strongly recommended that all veteran seniors enroll in Medicare Part A (Hospital Coverage) and usually there is no additional cost. This will allow you receive hospital coverage should you go to a non-VA facility.  According to the VA’s website “[We] encourage you to keep your private [Medicare] health insurance.”

 

Medicare Part B If You Have VA Benefits

Although it’s not absolutely necessary, it is strongly recommended that any Veteran senior enroll in Medicare Part B (Medical Coverage, Dr’s, other outpatient services, etc).

 

There is usually a monthly fee for Part B but it is worth it. If your VA Benefits are dropped at some point or, and this is important, if your local VA facility does not cover all health services, you could pay 100% out of pocket for a serious illness. The VA highly recommends that you enroll in Part B as well.

 

Many veterans use their VA health benefits to get coverage for health care services and items not covered by Medicare, such as over-the-counter medications and annual physical exams.

However, you may want to consider enrolling into Medicare Part B (medical insurance), even if you have VA coverage. Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. In addition, if you do not enroll into Part B when you are first eligible to do so, you will most likely incur a Part B premium penalty for each 12-month period you were without Medicare Part B coverage. In addition, you may also experience gaps in coverage.

 

Please contact Veterans Affairs directly (1-877-222 8387) with questions about specific care at your local facility.

 

Some say Veterans will not need a Medigap plan if they qualify for VA benefits. It is important to consider the option of Medicare with a Medigap plan will fill in the gaps such as deductibles, copays, and coinsurance, as well as other benefits when seeking care outside of the VA, or outside of the U.S. and its territories.

 

Here are just a few reasons why Veterans may consider enrolling in a private Medicare Supplement plan:

 

  1. You do not live near a VA facility
  2. You are enrolled in one of the VA lower priority groups, and could potentially lose your benefits*
  3. Option to use local Doctors and Hospitals

 

*“There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.” Source: VA.gov website.

 

Buy a Medigap policy or Medicare Advantage (part C) when you’re first eligible

The best time to buy a Medigap policy or Medicare Advantage Part C is during your 7-month Medicare open enrollment period. During that time you can buy any Medigap policy or Medicare Advantage Part C  in your state, even if you have health problems. This period automatically starts the month you’re 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you’re able to buy one, it may cost more.

 

During Initial Enrollment Period (IEP)

Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, even if you have health problems, during your Medigap open enrollment period you can buy any policy the company sells for the same price as people with good health.

 

Find your situation below:

I'm 65 or older

Your Medigap open enrollment period begins when you enroll in Part B and can’t be changed or repeated. In most cases, it makes sense to enroll in Part B when you’re first eligible, because you might otherwise

I'm turning 65

The best time to buy a Medigap policy or Medicare Advantage plan is the 6-month period that starts the first day of the month you’re 65 or older and enrolled in Part B. For example, if you turn 65 and are enrolled in Part B in June, the best time for you to buy a Medigap policy is from June to November.

 

After this enrollment period, your option to buy a Medigap policy may be limited and it may cost more. Some states have additional open enrollment periods.

I'm under 65

Federal law doesn’t require insurance companies to sell Medigap policies to people under 65. If you’re under 65, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65. However, some states require Medigap insurance companies to sell you a Medigap policy, even if you’re under 65. If you’re able to buy one, it may cost you more.

I have group health coverage through an employer or union

If you have group health coverage through an employer or union because either you or your spouse is currently working, you may want to wait to enroll in Part B. Employer plans often provide coverage similar to Medigap, so you don’t need a Medigap policy.

 

When your employer coverage ends, you’ll get a chance to enroll in Part B without a late enrollment penalty. That means your Medigap open enrollment period will start when you’re ready to take advantage of it. If you enrolled in Part B while you still had the employer coverage, your Medigap open enrollment period would start. Unless you bought a Medigap policy before you needed it, you’d miss your open enrollment period entirely

VA Benefits and Medicare Part D

As a Veteran, the choice of whether to enroll in Part D is up to you. You don’t need a Medicare Prescription Drug Plan, aka Medicare Part D, your VA plan may offer more coverage than Medicare’s Rx coverage. Remember that any prescription prescribed by a non-VA doctor needs to be approved by your VA doctor for the VA to approve it.  This may take extra time and your VA doctor can say that prescription is unnecessary.  If you choose not to enroll in Part D when you are first eligible you can still enroll in Part D without paying a penalty later. VA drug coverage is considered creditable coverage.

 

Some veterans only use their VA drug coverage to get their medications, since VA drug coverage may offer more generous prescription drug coverage than Medicare Part D, the Medicare prescription drug benefit. Since VA drug coverage is considered creditable, meaning it is as good as or better than the Medicare prescription drug benefit, you can delay enrolling into Medicare Part D without penalty. If you do lose VA drug coverage, make sure you enroll into a Part D plan within 63 days of losing your VA benefits.

 

Note that although you can have both Medicare Part D and VA drug coverage, the two do not work together. VA benefits only cover the drugs you get from VA pharmacies and Part D plans usually only cover drugs you get from pharmacies that are within the plan’s network.

 

You may want to join a Part D plan in certain situations. You may want to enroll in a plan if you move into a nursing home outside of the VA health system and need coverage for medications from the nursing home pharmacy. You may also want to enroll in a Part D plan if you qualify for Extra Help, the federal assistance program that helps people with Medicare afford their Part D drug costs.

 

If you have questions about VA benefits and coverage, contact the VA Health Administration Center at 1-800-733-8387 or 1-877-222-VETS

 

Medicare  and related issues. If you have questions about your VA coverage, please contact Veterans Affairs directly   877-222-8387

We are Not connected with or endorsed by the United States government or the Federal Medicare Program.

 

The insurance services described on this web site are provided by Military Benefits Services℠ a North Carolina resident insurance agent. Military Benefits Services℠ is also licensed as a non-resident insurance agent, or otherwise authorized to transact business as an insurance agent, in the following states.

 

AL, CA, CO, FL, GA, Il, IA, KS, KY, LA, ME, MD, MI, MN, MS, NC, NE, NJ, NM, NY, OH, PA, SC, SD, TN, TX, VA, WA, WV, WI

 

Military Benefits ServicesSM is not affiliated with Medicare or any Federal Agency. This website is not part of the Federal Government, VA or Medicare. For more information, please consult our Privacy Policy. Not all plans are available in all regions.

 

Call 888-654-3129 today to schedule a time to discuss Medicare plan options for:

 

  • Medicare Supplement Plan,
  • Medicare Advantage Plan and
  • Medicare Part D Plan.

 

Choose from the top Medicare Carriers.  See your plan options from Aetna,  Humana,  AARP and UnitedHealthCare.


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Disclaimers
Medicare plans offered are PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Call today to schedule a time to discuss Medicare plan options. 888-654-3129.

Although the VA Veteran’s Affair (VA) and Medicare are both Government Health Programs and if you are eligible for both, it is important to know your options.

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