Military Benefits and Medicare
Veterans Administration
The VA is an integrated health care system providing care at 1,255 health care facilities and serving 9 million enrolled Veterans each year. You must apply to be considered for coverage. Once accepted, you will be assigned a priority group based on various factors. Group 1 will receive the highest level of benefits, group 8 will be the lowest benefit level.
VA benefits will include hospital coverage, provider services, and drug coverage.
Veterans who have VA benefits can be unsure of whether they should sign up for Medicare A and B when they become eligible. It is strongly encouraged that they DO sign up. The VA itself provides the following reasons why you should:
- Due to unknown future funding, there is no guarantee that all veterans will receive care.
- Having Medicare means you will be covered if you have to go to a non-VA hospital or doctor, so you have more options.
- If you delay signing up for Part B and sign up at a later date, you will pay a penalty which gets larger the longer you wait. You would have to pay this extra amount for as long as you are on Part B.
- If you enroll in a Part D plan, you will have more options in filling your prescriptions and also a better chance of having a drug covered. However, you will not pay a penalty for not signing up for Part D.
Signing up for Part B will require you to pay the Part B premium. You will then have the option of adding a Supplement or Advantage plan as a backup, with or without drug coverage. A low to zero-premium Medicare Advantage plan works well with VA benefits, as opposed to paying an additional premium for a Medicare Supplement. Doing this allows you to gain access to benefits that the VA may not provide, such as dental, while receiving more coverage options. In addition, if the advantage plan does not have drug coverage, you will receive a part B premium reduction of anywhere from $40 to $100. The VA and Medicare do not coordinate, they act as separate programs.
Helpful Contact Information
www.va.gov
www.va.gov/healthbenefits
1-877-222-8387
Tricare for Life
Tricare for Life (TFL) is Medicare wrap-around coverage for Tricare eligible beneficiaries who have Medicare Parts A and B. Enrollment is not required, and coverage will be automatic once you have Medicare Parts A and B. You will be required to pay the Medicare Part B premium.
The way TFL works is that your provider files a claim with Medicare. Medicare pays its portion and then sends the claim to TFL to process.
You do not receive an ID card. You use your Medicare card, along with your military ID.
Tricare for Life members can enroll in a Medicare Advantage Plan. The reason they may want to do this, is to obtain benefits that they are not currently receiving with TFL, such as dental coverage. The Advantage Plan would pay first, TFL would be secondary. Should you decide to do this, for the Advantage Plan to pay, you would need to use the plan’s network of providers.
Depending on your copays and the medications you are on, a Medicare Advantage Plan with drug coverage may reduce your medication cost. Your pharmacy would need your Medicare Advantage card and your Tricare information. They then should bill advantage first, Tricare second.
If you enroll in an advantage plan without drug coverage you will receive a reduction in your part B premium.
Helpful Contact Information
Champ/VA
Champ/VA beneficiaries are the spouses, widow(er)s, or children of a qualifying Veteran sponsor.
When you become eligible for Medicare, you must enroll. To continue your Champ/VA eligibility, you must remain enrolled in Medicare Part B and pay the Part B premium.
You would send a copy of your Medicare card, along with VA form 10-7959c, to Champ/VA to continue benefits without interruption.
Like TFL, Champ/VA works similar in that claims are sent to Medicare first, then to Champ/VA for processing.
Also like TFL, it is not necessary to have a Medicare Supplement or Advantage plan, but having an Advantage plan would provide for extra benefits and could help reduce medication cost.
www.va.gov/health-care/family-caregiver-benefits/champva/
It is always recommended to keep your information updated in DEERS (Defense Enrollment Eligibility Reporting System). Champ/VA provides drug coverage, so if you enroll in an advantage plan without drug coverage you would receive a reduction in your part B premium.
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