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Medicare Advantage Plans May Complement VA Benefits
NEW YORK (Profitable.com) The nation pauses to honor its veterans on Nov. 11 for their patriotism, love of country, and willingness to serve and sacrifice for the common good. Naturally, we want our veterans to be taken care of, especially when it comes to their health. Those who have served their country through the United States military have several options when it comes to their health care coverage.
Qualifying veterans receive care at VA facilities. Additionally, those 65 years old and older – and those with certain disabilities – may qualify for Medicare. “Many veterans don’t know about their Medicare rights,” said Krista Bowers, president of senior business at Empire BlueCross BlueShield. “Most have earned access to the Medicare system, just as they’ve earned their VA benefits. They shouldn’t lose the opportunity, especially since some of these benefits may be offered at low or no cost.”
VA and Medicare offer different, yet valuable, benefits to veterans, according to Mark Wagar, President and CEO of Empire BlueCross BlueShield.
Through the VA, eligible veterans have access to a full range of preventive outpatient and inpatient services as long as they stay within the VA health care system, which includes hospitals, clinics, nursing homes, pharmacies and doctors nationwide. VA co-payments and deductibles, including the costs of prescription drugs, are generally less than Medicare. Eligibility for benefits is based on a priority system. According to the United States Department of Veterans Affairs website, there are more than 8 million people covered by the VA Health Care System.
Medicare has four parts – A, B, C and D. Part A covers inpatient services, including hospital, skilled nursing facility, home health and hospice care. Part B covers outpatient medical services, such as doctor visits, preventive care and durable medical equipment. Part C, also known as Medicare Advantage (MA), combines Parts A and B into one plan that is run by private insurance company, like Empire BlueCross BlueShield, rather than the government. These plans may also include Part D, which is drug coverage.
Most people, including veterans, don’t pay a premium for Part A. In most cases, these costs have been covered by payroll taxes. In contrast, Part B generally requires a monthly payment. Some companies offer Medicare Advantage plans (Part C) that cover everything included in Parts A and B, and more, including preventative services, at no additional cost. These are known as “zero premium plans.” Some of these plans could also include dental, vision and hearing coverage. Other plans provide the same services, but require a monthly premium.
Enrollment processes and eligibility differ for VA and Medicare. Veterans can choose to participate in one program or the other or both. Enrollment in a Medicare plan does not affect an individual’s VA eligibility.
On its website the VA recommends veterans not decline Medicare based solely on their VA coverage. The VA says there is no guarantee funds will continue to be appropriated for medical care for all enrollment priority groups. This could leave some veterans, especially those enrolled in one of the lower priority groups, with no access to care. For this reason, having a secondary source of coverage, like Medicare, may be in a veteran’s best interest, the VA says.
Additionally, people who decline Medicare Part B when they are first eligible to receive it face substantial financial penalties if they decide to enroll later. The initial enrollment period typically occurs in the three months before the person’s 65th birthday, their birthday month and the three subsequent months. There is no similar penalty for veterans who delay Part D enrollment because the VA’s drug coverage is deemed equal to or better than Medicare.
Other benefits of Medicare for veterans include having access to doctors, hospitals and pharmacies outside the VA network and potentially having a larger list of covered drugs. Wider access could be important in case of an emergency or if a veteran needs a second opinion or specialized care.
There are additional benefits to having a Medicare Advantage plan. They vary by insurer, but may include some or all of the following:
- Limits to total out-of-pocket costs
- Fitness programs, such as free gym memberships
- Preventive dental and vision care
- Programs that help people with chronic diseases, such as diabetes and asthma.
- Discounts on non-covered health-related products
- Chiropractic and podiatry services
It’s important to remember that Medicare cannot generally pay for the same service paid for by the Department of Veterans Affairs (VA). Nor can the VA generally pay for the same service paid for by Medicare
“Obviously, this can get very complicated,” said Wagar “There are many things for veterans to consider when selecting health care, including premiums, copayments and access. At Empire BlueCross BlueShield we provide health benefits to many veterans and are happy to answer their questions to help them understand their options. After all, they deserve the absolute best health care coverage they can get.”
Empire BlueCross BlueShield
Serving New Yorkers for over 75 years, Empire BlueCross BlueShield is the largest health insurer in New York supporting nearly six million members and more than 38,000 business, union and small employers in New York. Empire BlueCross BlueShield (Empire) is the trade name of Empire HealthChoice Assurance, Inc., and Empire Blue Cross Blue Shield HMO is the trade name of Empire HealthChoice HMO, Inc., independent licensees of the Blue Cross Blue Shield Association, serving residents and businesses in the 28 eastern and southeastern counties of New York State. Additional information about Empire is available at www.empireblue.com.