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Veterans New to Medicare - Most Frequently Asked Questions
#1 Question: If I have health coverage with the VA, do I still need to enroll in Medicare when I'm eligible?
Answer:
When you are first eligible for Medicare Part B, you are automatically enrolled in Part B if you are collecting Social Security. If you are not collecting Social Security, you will need to apply for Medicare. You are not required to enroll in Medicare, however, there are reasons that you may want to. The Veteran's Administration recommends that you do and here are several reasons why:
1) Having both Medicare and VA benefits broadens your coverage and fills the gaps. For example, if you need to go to a non-VA hospital or doctor, you would be covered under Medicare Part A (hospitalization) and Part B (doctors, labs, ambulance, outpatient, etc), whereas with VA coverage alone, you may end up having to pay the full cost yourself. The VA has rules about who qualifies for coverage at non-VA facilities, even in emergencies. An ambulance ride alone could end up costing you over $2000 out-of-pocket.
2) VA health coverage isn't the same for everyone and funding may change. The VA assigns different priority levels according to various factors, such as income and whether you have a medical condition that was the result of your military service. If federal funding gets cut, Veterans in the lower priority levels could lose VA coverage entirely.
3) If in the future you happen to lose VA coverage or otherwise decide that you need Medicare and are not already signed up for Part B, you would incur a penalty for late enrollment. The Part B penalty permanently adds an extra 10 percent to your monthly premium for each year that you didn't enroll in Part B. For example, let's say four years from now you decide you want Medicare Part B and you haven't had any other health insurance other than the VA, you would pay a penalty of 40% more for the same coverage for the rest of your life.
Question #2: Will I get penalized for not enrolling in a Part D Prescription Drug Plan?
Answer:
No. If you are getting your prescription drugs from the VA, then you have "creditable coverage". If you later enroll in a Part D prescription plan, you would not incur a penalty. The advantage of having a Part D prescription drug plan with Medicare is that you could go to a non-VA doctor and get your prescriptions filled from a local pharmacy. This is especially helpful if you live a distance from a VA medical center or if you experience long waiting periods to get an appointment. With some Medicare Advantage plans, generic co-pays are often $0.
Question #3: When do I become eligible for Medicare?
Answer:
Please note that most people first become eligible for Medicare Part A and B when they turn 65 years of age. If you have a disability, your Medicare eligibility occurs the first day of the 25 month that you are receiving disability benefits. Most people will automatically be enrolled in Part A and B at that time, unless they are still working and on their employer's or union's health plan. If you wish to disenroll, you must sign your disenrollment form. If you haven't received this form 30-days prior to becoming Medicare-eligible, you will want to visit or call your local Social Security Administration office. Their toll-free number is 1-800-772-1213. You may also visit them on-line to access local numbers ( www.ssa.gov).
Question #4: What does Part B Cost?
Answer:
This depends if you are a high income earner or not. Check out our Medicare page for the current year's premium.
FOR MORE INFORMATION ON MEDICARE, PLEASE VISIT OUR MEDICARE PAGE.