Veteran’s Administration healthcare coverage is quite different from Medicare and the coverage benefits may vary over time, but you can still enroll in Medicare or Medicare Advantage even if you receive VA benefits. Both plans don’t affect each other but will work together to cover important healthcare costs.
VA Benefits
Veteran’s Benefits are received by individuals who have served for at least 24 months of continuous service in active duty and were discharged under normal conditions. People who had a dishonorable discharge do not qualify for VA benefits. If you qualify for VA benefits, you will be placed into a priority group. The priority groups are labeled from 1 to 8. The highest priority group is Number 1, while 8 is the lowest.
The priority group level placement is affected by certain factors such as the individual’s income or if the individual has a service-connected disability. The priority number you are placed in is used to determine copayments, out-of-pocket costs, and medical appointments.
However, if you’re an eligible veteran, you will get the Uniform Benefits Package regardless of your priority number. The Uniform Benefits Package includes certain services that are not covered under Original Medicare, such as long-term nursing care. However, it may include some services that are covered under Medicare Advantage such as dental care. To get full VA coverage, you must receive care in a VA hospital or approved clinic.
Medicare Advantage
Medicare Advantage, or Medicare Part C covers the basic benefits under Original Medicare, in addition to extra services not covered under Original Medicare, such as prescription drug coverage. Medicare Advantage also includes certain services that are not covered by VA benefits.
Why Have Both?
If you have VA benefits, you may need to use non-VA providers at certain periods and you may not receive coverage if you do this. This is where Medicare Advantage comes in. There are some Part C plans with $0 premiums that can provide additional coverage in case you visit a non-VA provider. This will not interfere with your VA coverage but will provide additional healthcare coverage on a monthly basis. If your VA benefits do not include creditable drug coverage, then you can benefit from enrolling in a Medicare Advantage plan that offers prescription drug coverage. Medicare Advantage plans provide some supplemental coverage that you may not get with VA benefits. They can cover hospital services, outpatient coverage, prescription drug coverage, and extra benefits such as dental, vision, fitness memberships, and hearing.
If you have VA benefits and Medicare Advantage together, you’ll also benefit from an extended provider network and more healthcare coverage. This will reduce the time spent waiting for VA-approved healthcare providers.
It’s important to note that VA benefits may also not cover you forever, causing you to lose the coverage. If you do not have coverage outside of your VA benefits, then you will be stuck paying your medical costs out-of-pocket, which could get expensive. However, by having a Medicare Advantage plan alongside your VA benefits, you’ll have the reassurance of still having coverage.
Generations Insurance Can Help
A Medicare Advantage plan can help to fill the gaps in your VA benefits and provides additional healthcare coverage at little cost. For more information, contact us today at 208-709-9898.
