Q: I served in Vietnam from 1969 to 1970 and I am just now starting to get Veterans Affairs (VA) benefits. I am paying $104 for Medicare Part B. Can I stop using Part B and paying for it because I have VA? I am 68. — Lanny Smith, Cody, Wyo.
A: First and foremost, thank you for your service. “I appreciate your sacrifice and the sacrifice all of our active service men and women make, to keep my family and me safe here in the U.S.,” says Diane Daniels, author of The Medicare Survival Guide.
As for your health insurance, we don’t know whether you are enrolled in Tricare for Life or VA Health Care.
“You are entitled to Tricare for Life if you are a retired service or reserve member, or if you are a Medal of Honor recipient,” says Daniels. “Tricare for Life is Medicare ‘jacket’ coverage for Tricare-eligible beneficiaries who have Medicare Part A and B.”
You must continue to pay Medicare Part B premiums to remain enrolled in Tricare, says Daniels. “Tricare pays after Medicare in the U.S. and the U.S. territories,” she says. “Tricare also pays Medicare deductibles and co-insurance.”
If, however, you’re enrolled in VA Health Care, consider this: You can have both Medicare and Veterans Affairs (VA) benefits, according to MedicareInteractive.org. However, Medicare and VA benefits do not work together. Medicare does not pay for any care that you receive at a VA facility. According to MedicareInteractive:
In order for Medicare to cover your care, you must receive care at a Medicare-certified facility that works with your Medicare coverage.
In order for your VA coverage to cover your care, you must generally receive health care services at a VA facility.
And with respect to Medicare Part B and VA coverage, MedicareInteractive.org notes the following:
“Many veterans use their VA health benefits to get coverage for health-care services and items not covered by Medicare, such as over-the-counter medications, annual physical exams and hearing aids. However, you may want to consider enrolling into Medicare Part B (medical insurance), even if you have VA coverage. Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. In addition, if you do not enroll into Part B when you are first eligible to do so, you will most likely incur a Part B premium penalty for each 12-month period you were without Medicare Part B coverage. In addition, you may also experience gaps in coverage.”
Of note, if you are enrolled in VA Health Care, you may be able to receive care from non-VA facilities, instead of waiting for a VA appointment or traveling to a VA facility, says Daniels.
How so? You are eligible for what’s called the Veterans Choice Program, which is part of the Veterans Access, Choice and Accountability Act of 2014 (VACAA), if any of these situations apply to you:
You have been (or will be) waiting more than 30 days for VA medical care.
You live more than 40 miles away from a VA medical care facility or face one of several travel burdens.
The Choice Program does not affect your existing VA health care nor any other VA benefit.
It’s also a good idea to call 866-606-8198 to make sure you qualify for the Veterans Choice Program and to schedule an appointment to enroll, says Daniels.
Since you have both Medicare and VA benefits, you can get treatment under either program,” she says. “You will need to ‘choose’ which benefits to use if you see a doctor or use a health care facility, a lab for bloodwork for example. Medicare cannot pay for the same service that was covered under the VA benefits, and vice versa. It is important to note that Medicare is never the secondary payer after the VA.”
Daniels also notes that in order for the VA to pay for services, you must go to a VA facility or have the VA authorize services in a non-VA facility. “Medicare Part B may also pay for Medicare-covered services that the VA didn't authorize,” she says.
All that said, the answer to your question is not a simple yes or no, says Daniels. By outlining some of your options, with hope, you have enough information and resources to help you make your decision. “The decision to remain in Medicare Part B and continue paying a Part B premium, must be yours and only your decision,” says Daniels.
A: First and foremost, thank you for your service. “I appreciate your sacrifice and the sacrifice all of our active service men and women make, to keep my family and me safe here in the U.S.,” says Diane Daniels, author of The Medicare Survival Guide.
As for your health insurance, we don’t know whether you are enrolled in Tricare for Life or VA Health Care.
“You are entitled to Tricare for Life if you are a retired service or reserve member, or if you are a Medal of Honor recipient,” says Daniels. “Tricare for Life is Medicare ‘jacket’ coverage for Tricare-eligible beneficiaries who have Medicare Part A and B.”
You must continue to pay Medicare Part B premiums to remain enrolled in Tricare, says Daniels. “Tricare pays after Medicare in the U.S. and the U.S. territories,” she says. “Tricare also pays Medicare deductibles and co-insurance.”
If, however, you’re enrolled in VA Health Care, consider this: You can have both Medicare and Veterans Affairs (VA) benefits, according to MedicareInteractive.org. However, Medicare and VA benefits do not work together. Medicare does not pay for any care that you receive at a VA facility. According to MedicareInteractive:
In order for Medicare to cover your care, you must receive care at a Medicare-certified facility that works with your Medicare coverage.
In order for your VA coverage to cover your care, you must generally receive health care services at a VA facility.
And with respect to Medicare Part B and VA coverage, MedicareInteractive.org notes the following:
“Many veterans use their VA health benefits to get coverage for health-care services and items not covered by Medicare, such as over-the-counter medications, annual physical exams and hearing aids. However, you may want to consider enrolling into Medicare Part B (medical insurance), even if you have VA coverage. Part B may cover services you receive from Medicare-certified providers and provide you with medical coverage outside the VA health system. In addition, if you do not enroll into Part B when you are first eligible to do so, you will most likely incur a Part B premium penalty for each 12-month period you were without Medicare Part B coverage. In addition, you may also experience gaps in coverage.”
Of note, if you are enrolled in VA Health Care, you may be able to receive care from non-VA facilities, instead of waiting for a VA appointment or traveling to a VA facility, says Daniels.
How so? You are eligible for what’s called the Veterans Choice Program, which is part of the Veterans Access, Choice and Accountability Act of 2014 (VACAA), if any of these situations apply to you:
You have been (or will be) waiting more than 30 days for VA medical care.
You live more than 40 miles away from a VA medical care facility or face one of several travel burdens.
The Choice Program does not affect your existing VA health care nor any other VA benefit.
It’s also a good idea to call 866-606-8198 to make sure you qualify for the Veterans Choice Program and to schedule an appointment to enroll, says Daniels.
Since you have both Medicare and VA benefits, you can get treatment under either program,” she says. “You will need to ‘choose’ which benefits to use if you see a doctor or use a health care facility, a lab for bloodwork for example. Medicare cannot pay for the same service that was covered under the VA benefits, and vice versa. It is important to note that Medicare is never the secondary payer after the VA.”
Daniels also notes that in order for the VA to pay for services, you must go to a VA facility or have the VA authorize services in a non-VA facility. “Medicare Part B may also pay for Medicare-covered services that the VA didn't authorize,” she says.
All that said, the answer to your question is not a simple yes or no, says Daniels. By outlining some of your options, with hope, you have enough information and resources to help you make your decision. “The decision to remain in Medicare Part B and continue paying a Part B premium, must be yours and only your decision,” says Daniels.
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