Medicare & Veterans Administration Benefits

As a Veteran who is newly eligible for Medicare, there’s things to learn and choices to make. Let’s face it, even though you’ll never lose your fighting spirit, you’re not the strapping young lad or lass that you were when you joined the military. The choices you make with Medicare can affect your health, happiness, finances, and peace of mind. This guide can help you simplify things so you can make the best decisions for you. Let’s start with some basic facts you need to know.

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Facts To Know

  • You are eligible to start Medicare the month that you turn 65.
  • When you are enrolled in Medicare you are responsible for paying a monthly premium, most pay $148.50 per month in 2021. If you are considered low income and qualify for Medicaid, you don’t pay anything.
  • As a Veteran with VA benefits, you have the option of opting out of Medicare so you don’t have to pay the premium.
  • The Veterans Administration doesn’t recommend opting out of Medicare.
  • If you do not take Medicare Part B when you’re first eligible, you will have to pay a penalty if you choose to enroll later. At this point, the penalty may be too high and prohibit you from getting Medicare.
  • Having Medicare will give you more healthcare options. This can be especially useful for benefits not provided by the VA as well as treatment, second opinions, and emergency situations.
  • As a Veteran you will have good Medicare choices. There are even plans that can lower your monthly Medicare cost and give you more benefits (See down the page).

Need To Know

“The VA does not recommend that veterans cancel or decline coverage in Medicare (or other health care or insurance programs) solely because they are enrolled in VA healthcare.” Source: VA.GOV

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 Veterans Get The Most Medicare Coverage & Lowest Monthly Cost

As a Medicare recipient, you have the choice of getting your benefits directly through the government (Original Medicare) or through a private insurer (Medicare Advantage). Medicare Advantage are health plans provided by private insurers. Both Original Medicare and Medicare Advantage include Part A coverage for hospitalization and Part B for doctors & outpatient care. 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. The “Advantage” in Medicare Advantage is that they include more benefits than Original Medicare, at the same or lower monthly cost. The additional benefits you can get with Medicare Advantage include;

  • Dental, Vision, and Hearing Aid coverage.
  • Silver Sneakers – Gives you free access to exercise facilities and online exercise videos.
  • Part B Giveback – This is a benefit included with some plans that gives you a monthly dollar amount to help you pay your Medicare cost.
  • Prescription – There are Medicare Advantage options that include pharmacy coverage and some that do not. You have choices.

Medicare Advantage Vs. Original Medicare Comparison

To get a better idea of how Medicare Advantage and Original Medicare compare, here are sample features & benefits. As we’ve said, Medicare Advantage is available with and without prescription coverage.

FeatureOriginal MedicareMedicare Advantage
Total Monthly Cost$148.50 In 2021$68.50 – $148.50 in 2021 (Varies by plan)
Hospitalization & Doctor CoverageYesYes
Max Out Of Pocket ProtectionNoYes
Rx Included?NoChoices with and without Rx
Dental & VisionNoYes
Hearing Aid BenefitsNoOften Included
Gym & Health ClubNoYes

How can I get more benefits and also pay less with Medicare Advantage? The simple answer is that Original Medicare is one size fits all for everyone in the country. Medicare Advantage has choices designed with Veterans in mind, so the benefits and cost are tailored to you.

Medicare Supplements

How Veterans Get The Most Medical Coverage & Lowest Medical Bills Outside The VA

If you prefer to use see private doctors for your healthcare, rather than the VA, Medicare Supplement insurance is an option to consider. It is an alternative to Medicare Advantage because you can only have one or the other. Medicare Supplements are insurance policies that help cover out of pocket medical costs with Original Medicare (Medicare A & B directly through the government). These costs are deductibles and co-insurance that you normally have to pay when you have medical care. The primary benefit of Medicare Supplements is setting yourself up to have nearly full coverage for medical costs.

Things To Know About Medicare Supplements

  • Medicare Supplement’s are provided by private insurance companies.
  • They are separate policies and are secondary to Medicare A & B. Therefore, they have a monthly cost that you pay in addition to Medicare.
  • Medicare supplements cover you at any doctor that accepts Medicare A & B, there are no networks.
  • Medicare Supplement policies are represented by a letter, which means the amount of coverage you get.
  • The top Medicare Supplement plans can help you limit your annual out of pocket medical bills to around $200 per year.

Get More Info

Click Here to learn more about specific Medicare Supplement plans. To get back to this page use the menu at the top and select Veterans & Military.

Don’t Delay, Contact Us For More Information

Call Us

Call 855-625-7633 to request more information. We are available Monday through Friday from 8:30 A.M. to 6 P.M.

Email Us

Email with your questions and to request details about your Medicare options.

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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. 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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