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.