KEY
POINTS
·
The VA encourages
those who receive health care through its network to sign up for Medicare when
they are first eligible.
·
You get seven months
to enroll, starting three months before the month in which you turn 65 and
ending three months after your birthday month.
If you get health care through the Veterans
Health Administration and are nearing your 65th birthday, don’t overlook
whether Medicare would make sense for you.
While not all military veterans rely on VA
health care, those who do might not realize they can use Medicare alongside
their existing benefits.
“Many are in the dark about using both,” said
certified financial planner Hans “John” Scheil, CEO and owner of Cardinal
Advisors in Durham, North Carolina. “But there are a lot of options for
veterans when it comes to Medicare.”
The VA health system provides care for 9 million
veterans each year at its 1,250 facilities, including 172 medical centers and
more than 1,000 outpatient sites across the country. However, it generally
doesn’t cover care outside of those locations.
“With Medicare, you have much broader options,”
said Elizabeth Gavino, founder of Lewin & Gavino in New York and an
independent broker and general agent for Medicare plans. “You can have access
to doctors and hospitals not near a VA facility, or you might want a second
opinion from a doctor outside the system.”
The program encourages those using VA health
care to sign up for Medicare when first eligible. Doing so has no impact on
your VA coverage.
You get seven months to sign up; the enrollment
period starts three months before the month in which you turn 65 and ends three
months after your birthday month. For example, if the big day is June 15, your
signup window begins March 1 and ends Sept. 30. And remember, signing up for
Medicare does not affect your VA health-care benefits.
Medicare Part A, which provides hospital
coverage, costs nothing. The standard premium for Part B, which is for
outpatient care and medical equipment, is $135.50 for 2019. (Those with higher
incomes pay more. See chart.)
WHAT YOUR MEDICARE PART
B PREMIUM WILL BE IN 2019 BASED ON YOUR 2017 YEARLY INCOME
|
FILE INDIVIDUAL TAX RETURN
|
FILE JOINT TAX RETURN
|
FILE MARRIED & SEPARATE TAX RETURN
|
YOU PAY EACH MONTH (IN 2019)
|
|
$85,000
OR LESS
|
$170,000 or less
|
$85,000 or less
|
$135.50
|
|
ABOVE
$85,000 UP TO $107,000
|
Above $170,000 up to
$214,000
|
Not applicable
|
$189.60
|
|
ABOVE
$107,000 UP TO $133,500
|
Above $214,000 up to
$267,000
|
Not applicable
|
$270.90
|
|
ABOVE
$133,500 UP TO $160,000
|
Above $267,000 up to
$320,000
|
Not applicable
|
$352.20
|
|
$160,000 AND
LESS THAN $500,000
|
Above
$320,000 and less than $750,000
|
Above
$85,000 and less than $415,000
|
$433.40
|
|
$500,000
OR ABOVE
|
$750,000 and above
|
$415,000 and above
|
$460.50
|
Like the rest of the population, if you don’t
sign up for Part B when you’re first eligible, you could face a life-lasting
penalty if you change your mind later. And the longer you delay, the higher the
amount that gets tacked on to your premium.
It’s worth noting that for veterans who plan to
use TriCare for Life — an insurance program administered by the Department of
Defense — you must enroll in Medicare Parts A and B.
Part D, which is for prescription drug coverage,
is optional. Some people using VA health care sign up for it so they can get
their medicine from non-VA doctors and have their prescriptions filled at their
local pharmacy instead of through the VA mail-order service.
However, VA prescription drug coverage generally
comes with lower costs than a Part D plan. And, there’s no harm in not signing
up: If you don’t do it when you’re first eligible for Medicare and then change
your mind later, you won’t pay a penalty because it is considered “creditable”
by the Centers for Medicare and Medicaid Services.
Gavino said that some people with VA health care
decide to go with a Medicare Advantage Plan, which includes Parts A and B, and
typically D. These plans often come with extras such as dental and vision
coverage, or gym memberships.
“Some of those plans have a low or no premium,”
Gavino said. “If you never want to use the plan, you don’t have to.”
This would mean that it costs nothing unless you
use it and face a deductible or copay (or both), depending on the particulars
of the plan. You’d also have an out-of-pocket maximum.
Meanwhile, some people with VA health care who
sign up for Medicare Parts A and B decide to get a Medigap policy instead of an
Advantage Plan (you cannot have both).
This type of supplemental insurance helps cover
the cost of deductibles, copays and coinsurance associated with Medicare.
However, you only get six months to purchase a
Medigap policy without an insurance company nosing through your health history
and deciding whether to insure you. This “guaranteed-issue” period starts when
you first sign up for Medicare.
After that window, unless your state allows
special exceptions, you have to go through medical underwriting. And depending
on your health, that process could cause the Medigap insurer to charge you more
or deny coverage altogether.
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