Question: I am a Veteran and am turning 65. I would like to know why I should join Medicare A & B or even Part D? I am eligible for A with no premium, but Part B will cost me $134 per month now & next year $135.50. I use the VA Healthcare system, will I use Medicare at all?
Answer: First and most importantly, Thank You for your service to our country! Now onto your question.
Some Veterans are eligible for Health Benefits from the VA system. This means that they can see VA doctors, go to VA clinics and hospitals and get medications from the VA at little or no cost to them.
Many veterans then wonder why they should get additional coverage through Medicare. I strongly encourage all Veterans that I talk with to join Medicare A & B. I do this because you never know how, when, or where, you will be ill or need medical attention. If you could plan your medical emergencies, you would be certain to be near a VA hospital or clinic. Using the example of living in Jamestown: you are walking down the street, trip and fall and break your leg. An ambulance comes and takes you to the closest hospital (WCA). You would be covered for that emergency if you have Medicare. If you don’t, you would have to pay for that care out of pocket and then file to have the VA pay you back, if you meet the eligibility criteria for that reimbursement. That emergency would be at full cost to you and you may not get paid back by VA, if it isn’t reimbursable.
There are also benefits to having two types of Health Care available to you. You should use the VA system whenever you can, but if something can’t be done by the VA locally, or in the time frame that you need it done, the Medicare system available to the rest of us (non-VA) could be useful to you.
Another reason is the VA system and the Medicare system are Government funded. That means that both programs could change. The VA system has changed in many ways and has improved a lot in our part of the country. VA benefits as well as Medicare benefits may change in the future, limiting one’s benefits or increasing cost to the individual. I would hate to see an individual shut out without any alternative.
If you decided now to say NO to Medicare and at a later date decided to join the Medicare system, you would have a premium penalty of 10% per year for each year you didn’t join. This can quickly amount to a significant increase in monthly premiums for the rest of your life. You also would have restrictions on when you could join during the year and a delay in the start of your benefits.
I therefore would strongly encourage you to join Medicare Part A & B. If the premiums are a hardship for you, you may be eligible for help from the VA to pay the premiums or other government programs through Department of Health & Human Services.
Now to the part of the Question about Part D-Prescription Drugs. This is a slightly different situation. If you get your medications from the VA Healthcare System, you have creditable coverage for your prescriptions, so there is no penalty accruing against you for saying NO to Part D enrollment. With the VA system, all medications are mailed to you, and are usually generic medications. If you decided to buy something that wasn’t generic or needed something the VA system wouldn’t provide, you would have to pay cash for it. That may not happen at all or often, so saying NO to Part D is easier to justify in your situation.
Some veterans decide to enroll in a Part D Plan or even Medicare Advantage with Part D included, because it gives them some extra coverage. In some situations, you can get those medications through your Medicare Advantage plan even cheaper than the VA co-pay charges for them.
So the Medicare Parts A, B & D are slightly different answers. I would strongly encourage you to enroll in Medicare Part A & B, but understand and can agree with your decision to not enroll in Medicare Part D.
To contact Janell Sluga, GCMC with questions or concerns, call 716-720-9797 or e-mail her at email@example.com.