Medicare benefits and VA benefits are completely separate benefits that do not overlap. Medicare covers medical issues addressed by non-VA physicians and treatment outside of a VA facility. VA benefits, unless pre-approved, only cover medical treatment and medical visits by approved VA physicians.
There is an instance where the two insurances will work together. If you seek VA-approved treatment at a non-VA facility, but still need treatment that your VA coverage will not cover, then Medicare may pick up the rest. Remember though, you are still responsible for your Medicare Part B’s premium and 20% copay or coinsurance fees.
Medigap Coverage Options
If you need immediate treatment and are unable to reach a VA-approved facility, then having Medigap coverage along with Original Medicare can come into play, covering the medical costs that would otherwise require you to pay for 100%.
Veterans that are categorized as a “low-priority group” would be wise to consider a Medigap plan due to the fact that if VA funding was reduced, they would be the first in jeopardy of losing their VA benefits. In North Carolina, for example, a Medigap, or Supplement Insurance Plan, could have a monthly premium as low as $30.00. Paying $30 monthly to ensure coverage in the event that Congress cuts VA funding is a cheap plan compared to the alternative. If you lose your VA benefits and never enrolled in a Medicare plan, then you are now responsible for 100% of your health costs.
Do keep in mind that in order to enroll in a Medigap plan, you need to be enrolled in Original Medicare (Parts A and B) first. If you’re enrolled in Original Medicare along with a Medigap plan, and you go to a non-VA facility to receive care, your Original Medicare plan will provide coverage first, and then your Medigap plan will cover what’s left.
Medicare Advantage
Medicare Advantage plans are also a recommended option for those with VA coverage. These types of plans cover more than what Original Medicare covers, such as dental, vision, and hearing. VA dental benefits coverage is complex and only covers certain dental needs according to certain circumstances. Vision benefits are the same way. There are certain circumstances in which you must meet in order to receive certain vision benefits.
Get The Coverage You Deserve
While Medicare does not impact your VA benefits, enrolling in certain Medicare plans can be a beneficial backup tool to have in cases of emergencies, or to receive benefits that otherwise may not be covered. By speaking with an expert agent at Carolina Senior Benefits, we will walk you through all your Medicare options and explain to you how these plans can work with your VA coverage.
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