Medicare And CHAMPVA

As a spouse or dependent of a disabled or deceased military service member, you may be covered by CHAMPVA. Prior to becoming eligible for Medicare, you may have more than likely been using this as your main coverage. But, when you become eligible for Medicare at age 65, this changes. When you start Medicare it will be your primary medical insurance and CHAMPVA will become your secondary. As a CHAMPVA recipient, it’s important to know that when you become eligible, you must enroll in Medicare A & B.

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Important Medicare & CHAMPVA Facts

  • When you become eligible, Medicare becomes your primary medical insurance and CHAMPVA your secondary.
  • CHAMPVA covers deductibles & co-pays with Medicare, so you are 100% covered for covered medical services.
  • You can choose to receive Medicare coverage directly through the government (Original Medicare) or through private health plans known as Medicare Advantage.
  • When you start Medicare, CHAMPVA continues to provide you with prescription coverage. You can join a Medicare drug plan but you may lose part of your CHAMPVA benefits if you do.
  • CHAMPVA can be your secondary insurance to Original Medicare or Private Medicare Advantage. So, you have a choice between the two.

Need To Know

As a CHAMPVA recipient, it’s important to know that when you become eligible for Medicare, you must sign up for it to maintain your CHAMPVA benefits.

The Parts Of Medicare

Medicare has 5 parts, with the main ones being Parts A & B. Medicare Part A covers inpatient hospitalization, skilled nursing facility, and home health care. Medicare Part B covers doctors, outpatient treatment and testing.

The Other 3 Parts

  • Part C – More commonly known as Medicare Advantage, these are private insurance plans. You have the choice of being covered directly through Medicare or a Private Insurer.
  • Part D – Medicare prescription pharmacy benefits. Medicare does not provide coverage directly but instead through private insurers.
  • Supplements – Medicare Supplements are insurance plans that supplement Medicare A & B. They are offered by private insurers and help cover medical costs. CHAMPVA provides the same function, so in most cases, Medicare Supplements aren’t needed by CHAMPVA recipients.

Medicare Advantage

How CHAMPVA Recipients Get The Most Medicare Benefits For The Lowest Cost

With Medicare you have the choice of getting your benefits directly through the government (Original Medicare) or through a private insurer (Medicare Advantage). Both Original Medicare and Medicare Advantage include Part A coverage for hospitalization and Part B for doctors & outpatient care. CHAMPVA can be your secondary insurance to either Original Medicare or Medicare Advantage. Original Medicare is “one size fits all” and the same for everyone in the country. Medicare Advantage, however, gives you various choices that may be a better fit for your unique situation.

In addition to choices, the “Advantage” in Medicare Advantage is that they include extra benefits, more than what’s provided with Original Medicare. These extra benefits vary, depending on the plan, but may include; dental, vision, hearing aid, health club memberships, & more. The best news is that these benefits are often provided for little or no additional cost. Some Medicare Advantage plans include prescription coverage and some do not. With CHAMPVA, you will more than likely not want or need a plan with prescription coverage, because CHAMPVA will continue to provide these benefits.

Need To Know

CHAMPVA can be your secondary insurance to Original Medicare or Private Medicare Advantage. You have a choice between the two.

Medicare Advantage Vs. Original Medicare Comparison

To get a better idea of how Medicare Advantage and Original Medicare compare, here is a comparison chart of the different features. As we’ve said, Medicare Advantage is available with and without prescription coverage.

FeatureOriginal MedicareMedicare Advantage
Total Monthly Cost$148.50 In 2021$50.00 To $148.50 In 2021
Hospitalization & DoctorsYesYes
Doctor NetworksNo NetworksYes: PPO & HMO
Rx IncludedNoSome With & Without
Dental & VisionNoYes
Hearing AidNoOften Included
Fitness Club / Gym MembershipNoYes

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Honor Plans

There are Medicare Advantage options for Military, Veterans, Families called “Honor Plans.” These plans give you more benefits and a lower monthly premium than Original Medicare. Contact us for more information on this.

Contact Us For More Info

Call Or Text

Call 512.537-7847 to request information on your options. Text the same number to request a call at a particular time and we will contact you. We are available Monday through Friday from 8:30 A.M. to 6 P.M.

Email Us

Email ben@lonestarmedicare to request information and guidance on specific plans & providers that may be a good fit for you.

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Medicare Frequently Asked Questions

When will I start Medicare? If you are turning 65, you are eligible to start Medicare the first day of the month that you turn 65. If you are over 65 and have or are leaving employer insurance; you are eligible to start Medicare anytime. If you are disabled you will typically start Medicare 24 months after being awarded disability. If you have End Stage Renal Disease or ALS, you are usually awarded Medicare immediately.

What Costs Are Associated With Medicare? Medicare has 2 types of costs; Monthly premiums and medical cost sharing. A premium is the cost you pay to have the coverage, typically monthly or quarterly. Cost sharing is what you pay when you have medical care. These are items such as deductibles and copay’s. If you have secondary insurance such as CHAMPVA, it can cover your medical cost sharing. The standard monthly premium most people pay in 2021 is $148.50. There are ways to lower your monthly premium such as Part B giveback and state programs.

When should I apply for Medicare? First, if you are already receiving Social Security payments when you become eligible for Medicare, you don’t need to apply. You will be automatically enrolled in Medicare. If you are turning 65 and need to apply, you can do so 3 months before the first day of the month that you turn 65. If you are over age 65 and have insurance through your employer; you can apply anytime and your coverage can begin as soon as the first day of the next month.

How do I enroll in Medicare? 1. Apply Online through the Social Security website. 2. Call the Social Security Administration at 1-800-772-1213 and schedule an appointment to enroll by phone. Instead of calling the main Social Security 800 number, you can call your local office to schedule a phone enrollment. To find your local office click here.

What is the benefit of working with Lone Star Medicare? Medicare can be confusing and the government doesn’t directly provide you with all benefits. So, you have choices to make and things to do. As a top independent agency, we are a one stop guide and resource to help make your life easier. We can help you get the coverage you need and save money. There are also no fees or costs for you, it’s a win win.

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