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I am a Veteran; Do I Need Medicare?

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Marsha, one of our former Medicare supplement agents and a proud veteran, wrote this post. She gives insight into the benefits of enrolling in Medicare & Medigap as a veteran, as well as factors to consider when deciding what’s best for your situation.

 

I’m a Veteran; Do I need Medicare and Medicare Supplement Insurance?

I proudly served our country as an aviation electronics technician in the Navy from 2000 to 2005. Because I am a Veteran and I do use my VA benefits, other Veterans feel comfortable talking to me. They use me as a resource when inquiring about differences and asking why they should pick up a supplement.

I get asked every day:

“Do I need Medicare Supplement Insurance if I have VA benefits?”

The short answer is: maybe.

It really depends on your situation and preferences.

Of the 21.5 million veterans (2011 Census) in the United States, about 9.2 million are over the age of 65. Many, if not most, of those veterans, are qualified for Medicare. Many may not be optimizing their opportunity to get the most out of their Medicare benefits.

Keep in mind, Medicare and VA health benefits are different types of coverage. You can have both at the same time, but you cannot use both at the same time. I use my local VA for some of my regular health checkups and my prescriptions. However, I still have other health insurance for the day to day stuff.

VA Health Benefits

VA health benefits are generally available if you served in the active military service. It also applies if you separated under any condition other than dishonorable. Current and former members of the Reserves or National Guard who were called to active duty by a federal order and completed the full period for which they were called or ordered to active duty may be eligible for VA health benefits as well.

If you are a veteran and wonder if you qualify for VA health benefits- check here or use the VA Health Benefits Explorer. There are different levels of coverage with the VA, check your priority group and understand how much you can utilize your benefits.

Medicare Health Coverage and VA Health Benefits

When it comes to Medicare and VA health benefits, there are some important differences to note. These are the reasons why I generally recommend that veterans consider Medicare with a Medicare supplement:

  • Time: As much as I love the VA, every time I go to the clinic I realize that the military is a “Hurry up and Wait” world. The urgency that I have seen in most of the VA clinics and hospitals is not there. I went the other day to draw blood for my annual physical. I walked in and drew a number from a little kiosk. After 15 minutes, I was then called and they asked me why I was there and took my information. They gave me all of the labels for the blood draw, then asked me to sit down and wait. I waited for another hour and 15 minutes until they called me to draw my blood. I walked into a little room and sat down and waited for my name to be called again! They called about 5 minutes later and then the blood draw was quick and efficient. I was there for an hour and 45 minutes!
  • Doctors Network: The doctor’s network with Medicare is expansive. You can go to any doctor that takes Medicare, which is many of the doctors and hospitals in the 50 states. Under Medicare, if you don’t like the doctor you have, you can pick up the phone and make an appointment with another doctor, just as long as they take Medicare. However, with the VA network of doctors, you have a limit to the VA doctors and hospitals that are nearest you. You can apply to see someone outside of the VA network, but if there is a doctor that is in the network they can deny or delay your request. One of my clients with VA benefits told me a story of the time he had a heart attack.  Because he only had VA health benefits and lived a 30-minute drive outside of a major city, and an hour and a half away from the nearest VA hospital, he was driven to the closest county hospital (about 30 minutes from his home).  He was “stabilized” within a few hours of being at the county hospital and within that same day was transported via ambulance to the VA hospital (about an hour drive away) to be further treated.  He felt terrified that he might die during the transfer.  Shortly after, he turned 65 and immediately switched to Medicare and a Medicare insurance supplement.
  • Travel: How close is your VA clinic? What about the VA hospital? What happens when you travel? Where is the local VA clinic or hospital then? If you are traveling and something happens, what would you do? Where would you go? How much would you spend? If you had Medicare Part B with a supplement, you could go to any doctor or hospital as long as they accept Medicare. This allows you the freedom to travel the United States and go to over 90%+ of all doctors and hospitals. However, with VA health benefits, if you go to a clinic outside of the VA and don’t have a referral, you will be paying out of pocket. You could try to get into the local VA clinic, but I have often called to make an appointment and been asked to wait a few days, or weeks and sometimes even months.

Medicare Health Coverage or VA Health Benefits?

When it comes to choosing either Medicare with a supplement and/or VA health benefits, it is important to remember the issues of time, networks and travel.

I encourage all Veterans to look into using their VA Benefits. And when you have Medicare call us and we will help you maximize your Medicare Benefits. You probably do not need full Medicare supplement coverage. So, let us guide you through the other plans and options that will fit your situation the best.

And one additional note. Tricare for Life is a different health insurance program for veterans. Tricare for Life works like a Medicare supplement and allows you access to the Medicare network.

If you still have questions about Medicare and VA health benefits, give me or any of our GoMedigap experts a call at (800) 310-2550 and we can discuss your options and see what might work best for you and your situation.

Compare Your Medicare Supplement Rates Immediately!

10 Replies to “I am a Veteran; Do I Need Medicare?”

  1. Hi Marsha!! and thank you for your service. There is another option some of your older veterans may have over looked or like my husband (during his out processing when he retired) was told he would never qualify for Tricare. Ever time we talked to a government agency or supplemental insurance company or Medicare, they all would say you also have Tricare & our response was no we don’t. We never received any info or cards in the mail.

    If a military retiree has Medicare, the minute Part B “kicks” in so does Tricare For Life but they must have retired from the military unlike what you talked about VA Health care.

    Just thought you might want to think about asking a client if they were a Military Retiree.

    Thank you again for your service to our country.

    Norma Powell

  2. have va health in austin texas.i have been going to outpatient clinic for years.i turn 65 this year guess i will have to start paying for health care since medicare and va suggest i get medicare a and b. and the new thing is medicare only pays 80%…..dont really know what the 20% is except drugs.so if i go to non va emergency room with only a and b medicare i guess i will b stuck with a bill unless i have a supplement plan….so what i see if i have to do all of that is i might as well quit the va if i have medicare….or do i just need medicare part a and b is my concern. seems confusing since i am supposed to get medicare. thanks for a reply….by the way i am getting ready to retire and my social security will be my main or only income

    1. Hi Mr. Stolle,

      I understand that this is a confusing time. Many people are extremely confused during this time of life.

      While Medicare only pays 80%, Medicare supplement insurance covers the remaining 20%. Prescription drug coverage is separate.

      I think your needs may be best met if you we speak to you directly. Our professional agents can understand your situation, and explain anything that may be a bit confusing. Please give us a call at (800) 310-2550 for a free consultation, and one of our agents will be readily available to help you with any questions you may have. Have a great day!

  3. I am a 49 y/o, disabled veteran receiving 100% disability with full healthcare benefits at VA, which I use and appreciate. Now that I am due to receive SSD, can I elect NOT to enroll in any of the Medicare parts?

    1. Hi there,

      You can certainly elect to not enroll in Medicare. It really depends on your situation and preferences.

      Keep in mind that if you only have healthcare through the VA, you will be limited to the VA network of doctors. You can apply to see someone outside of the VA network, but if there is a doctor that is in the network, they can deny or delay your request.

      If you are okay with that, then VA coverage may be enough for you.

      Please let me know if you have any additional questions.

    1. Hi there,

      That’s a great question.

      Here’s some information directly from the VA website:
      “VA will provide medications that are prescribed by VA providers in conjunction with VA medical care. Medications are prescribed from an approved list of medications called a formulary. VA will fill prescriptions prescribed by a non-VA provider only if all of the following criteria are met:
      1. You are enrolled in VA health benefits.
      2. You have an assigned Primary Care Provider.
      3. You have provided your VA health care provider with your medical records from your non-VA provider.
      4. Your VA health care provider agrees with the medication prescribed by your non-VA provider.

      Your VA health care provider is under no obligation to prescribe a medication recommended by a non-VA provider.”

      I hope this helps. Please let me know if you have any additional questions.

  4. I retired at 62 and have been using my va benefits I turn 65 in july so i will be elegible for medicarere do I still need another supplement insurance plan, thanks

    1. Hi Larry,

      That is a great question. Many veterans choose to pick up a Medicare Supplement plan so that they have more freedom and better access to a wide range of healthcare providers. Everyone’s situation is different, so if you’d like to speak with an expert that will assess your situation, give us a call at (800)310-2550.

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