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Do VA Healthcare and Medicare work together?
VA Healthcare and Medicare are two distinct benefits that provide their own coverage. Many veterans are taking advantage of the fact that they do not overlap in benefits to get the best of both worlds. This means that if you have VA Healthcare, you will not be affected if you get Medicare coverage because your eligibility is not affected. You can use the VA benefits to have access to the doctors you know and trust and use your Medicare Advantage plan to receive additional benefits such as dental, vision, and hearing, over-the-counter benefits, or even a Part B Giveback. There are plans that are provided by carriers like Aetna, Humana, and United Healthcare. These plans help provide more freedom when it comes to receiving healthcare and since you already have prescription drug coverage with the VA– these MA-only plans are a potential option. These plans provide predictable copays and many have a low or $0 monthly premium. The expanded network, added benefits, and predictability of these MA-only plans can help in maximizing the availability of coverage and obtaining a more comprehensive unit of care.
Does my Medicare Advantage plan work at the VA?
Since VA Benefits and Medicare are two different plans, you can expand your coverage by having access to more services. You can be seen by physicians at the VA or you can use a network of doctors outside the VA that works with your Medicare Advantage plan. Since they don’t overlap in coverage, you will need to decide what benefit to use. Medicare does not cover services at the VA clinic. This means that the VA cannot bill Medicare Advantage and Medicare Advantage cannot bill the VA because Medicare does not cover services at the VA. This is why you must present different cards at different locations based on where you are receiving your treatment. This means that you can extend the reach of your network far beyond VA boundaries for situations such as emergencies, and have peace of mind knowing you have the benefit of your Medicare Advantage plan.
What about prescription drug coverage?
A veteran can have both VA benefits and a Medicare Advantage plan! The two drug coverages will not coordinate or interfere with each other. The copays associated with the VA are determined by the priority group of the veteran. The beneficiary can take advantage of both benefits by choosing where the more favorable copays will occur, whether it be at the VA (perhaps with some specialty medications since the VA can actually negotiate drug costs) or at their local pharmacy (some plans have a $0 copay when using the mail-order pharmacy or $0 copay for generic medications). It is important to note that the VA benefits count as creditable coverage for the Part D component of Medicare and no additional plan is needed, but having additional drug coverage may be beneficial in some cases. You should always thoroughly review your needs and understand what solution would best fit your situation. It is important to note that the VA will only fill prescriptions written at the VA. If you need medications filled at the VA, you must coordinate with your physician at the VA to write you a prescription that can be filled at the VA pharmacy. This will ensure you are making the most of your benefit (if you get better copays at the VA) and also help your physicians understand what kind of treatment you are receiving for your conditions.
Agents
We hope that this information on VA benefits and Medicare is useful to you.
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