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The Cafe - 'TC' So? Your daughter wants her belly pierced? Your cat keeps using the couch as a litter box? Your husband taped the Hockey game over your wedding video? Your neighbor has a gnome collection and it makes you mad? Pour yourself a cup of coffee and come on in to The Café! Talk amongst yourselves...discuss, question, reply, or respond to many subjects!

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Old 10-20-2007, 06:05 PM
KellyJef's Avatar
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Question do you need Medicare if you have VA medical coverage

DH is on social security disability and has had Medicare part B which costs almost $100 a month.

He is covered under the VA and gets his prescriptions from them.

Since we have not used the Medicare once in the three years he's had it, I'm really tempted to drop it, but for some reason, I just can't bring myself to do it.

Does anybody else pay for Medicare even though they are covered under the VA?

Is there any reason to keep the Medicare that I'm not aware of?

Thanks for any input.
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Old 10-20-2007, 06:21 PM
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I would keep it. My DH gets medicare and VA benefits. The VA hospital is 2 hours away, and the nearest clinic is 45mins away. We just started using the VA for treatment only because we were having trouble finding a doctor that would take him. (his old doctor was great and stopped doing outpatient care). I do like the VA but a lot of his meds are not on the formulary and it is a pain to get them filled through the VA, so his local dr does it for him and the medicare prescriptions pay for it.

Also if you are away or have an emergency and need to get care, is the VA close enough or would you go to another emergency room? That wouldnt be covered from the VA.

Also if he is 100% through the VA, you can get Champva if you don't already. Plus the education benefits (I went back to school this year and it is all covered). Also my DH just found out he can get his dental care through the VA. He has a bunch of dental work he needs done, so that will all be covered.
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Old 10-20-2007, 06:21 PM
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If a Veteran receives care in a VA facility for a service-connected condition, the VA covers incurred expenses. For non service-connected conditions, the VA is required to also bill other health insurance carriers that the veteran may have. The VA cannot bill Medicare for services, but they will bill a supplemental policy. The funds collected help offset the cost of care and allow the VA to provide services for more veterans.

Answers to some of the more frequently asked questions:

"Do I need Medicare Part B?" - The VA's funding for non service-connected conditions may be limited; therefore enrolling in Part B allows the veteran to be able to receive covered healthcare services in non-VA facilities. If a veteran travels or lives some distance away from VA facilities, having Part B assures coverage when it is necessary to get services in non-VA facilities. To avoid incurring possible penalties, it is advisable for the veteran to enroll into Part B when the veteran becomes eligible for Medicare if they are not covered by an Employer Group Plan or a spouse's plan due to active employment.

"Do I need a Medicare Prescription Drug Plan (Part D)?" - The quick answer is NO. If the veteran is eligible by priority status to obtain medication thru a VA Outpatient Pharmacy, they do not need to enroll into Part D. The VA Pharmacy Benefits are considered "creditable coverage" so a veteran may chose to enroll into Part D at a later date and will not incur any penalties. A veteran may want to enroll into Part D sooner if accessing VA medications is difficult due to distance, if the prescriptions are not available thru the VA pharmacy, or if the veteran qualifies for "extra help" with Part D and would therefore have low costs with the Part D plan. (Annual Election Period to enroll into Part D is November 15th thru December 31st of every year.)

"Do I need a Medicare Supplement or other healthcare insurance?" - As long as a veteran receives services thru a VA facility, there is no need for other coverage. However, if a veteran receives services in non-VA facilities, they will only have Medicare A&B and will be subject to the out-of-pocket deductibles and coinsurance (except for certain circumstances with emergency care for service-connected conditions). These costs can add up so it may be preferable to also purchase a Medicare Supplemental policy to cover expenses after Medicare A&B. Having this coverage also gives more freedom of choice in selecting health care providers. Some veterans have opted to enroll in Medicare Advantage Plans (plans which replace Original Medicare A&B) to minimize the impact of the cost of care outside a VA facility in the event of an emergency or if they choose to see a non-VA provider.

There are choices our veterans have when it comes to choosing health care coverage. Contact a County Veteran Service Officer to better understand military benefits (Call 1-800-947-8387 or Wisconsin Department of Veterans Affairs Veterans Service Officers Page for listings of local CVSO's). Also call to speak with a Medigap Insurance Counselor (1-800-242-1060) to learn about the health care coverage's in the event that you should require services outside of the VA system.
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Old 10-20-2007, 07:05 PM
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My dh has been on disability for 2 years now so we got the info for medicare. My dh is not a vet but I work fulltime and I have always carried the health insurance (my plan covered more and was cheaper). Good thing that I did carry it because he has had two separate illnesses in the last 2 1/2 years. When medicare came through we only took part a because it was free and automatic. I pay about $230 a month but it covers both of us.
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Old 10-21-2007, 03:20 PM
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Quote:
Originally Posted by Squeak View Post
If a Veteran receives care in a VA facility for a service-connected condition, the VA covers incurred expenses. For non service-connected conditions, the VA is required to also bill other health insurance carriers that the veteran may have. The VA cannot bill Medicare for services, but they will bill a supplemental policy. The funds collected help offset the cost of care and allow the VA to provide services for more veterans.

Answers to some of the more frequently asked questions:

"Do I need Medicare Part B?" - The VA's funding for non service-connected conditions may be limited; therefore enrolling in Part B allows the veteran to be able to receive covered healthcare services in non-VA facilities. If a veteran travels or lives some distance away from VA facilities, having Part B assures coverage when it is necessary to get services in non-VA facilities. To avoid incurring possible penalties, it is advisable for the veteran to enroll into Part B when the veteran becomes eligible for Medicare if they are not covered by an Employer Group Plan or a spouse's plan due to active employment.

"Do I need a Medicare Prescription Drug Plan (Part D)?" - The quick answer is NO. If the veteran is eligible by priority status to obtain medication thru a VA Outpatient Pharmacy, they do not need to enroll into Part D. The VA Pharmacy Benefits are considered "creditable coverage" so a veteran may chose to enroll into Part D at a later date and will not incur any penalties. A veteran may want to enroll into Part D sooner if accessing VA medications is difficult due to distance, if the prescriptions are not available thru the VA pharmacy, or if the veteran qualifies for "extra help" with Part D and would therefore have low costs with the Part D plan. (Annual Election Period to enroll into Part D is November 15th thru December 31st of every year.)

"Do I need a Medicare Supplement or other healthcare insurance?" - As long as a veteran receives services thru a VA facility, there is no need for other coverage. However, if a veteran receives services in non-VA facilities, they will only have Medicare A&B and will be subject to the out-of-pocket deductibles and coinsurance (except for certain circumstances with emergency care for service-connected conditions). These costs can add up so it may be preferable to also purchase a Medicare Supplemental policy to cover expenses after Medicare A&B. Having this coverage also gives more freedom of choice in selecting health care providers. Some veterans have opted to enroll in Medicare Advantage Plans (plans which replace Original Medicare A&B) to minimize the impact of the cost of care outside a VA facility in the event of an emergency or if they choose to see a non-VA provider.

This was very helpful

Where did you find this information?

Thanks for the other posts as well
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Old 10-21-2007, 03:47 PM
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Join Date: Nov 1999
Location: Boonies of Texas
Posts: 564
Quote:
Originally Posted by KellyJef View Post
DH is on social security disability and has had Medicare part B which costs almost $100 a month.

He is covered under the VA and gets his prescriptions from them.

Since we have not used the Medicare once in the three years he's had it, I'm really tempted to drop it, but for some reason, I just can't bring myself to do it.

Does anybody else pay for Medicare even though they are covered under the VA?

Is there any reason to keep the Medicare that I'm not aware of?

Thanks for any input.
Is your husband rated at 100%? If so you qualify for a lot of benefits that you may not know you get, epsecially if you have children. My DH was only rated at 70%, however since he is fully discabled and unable to work, he was rated at 100% unemployable, total and permenantly disabled. With that we qualify for a lot more stuff.
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