"I’m A Veteran. I Don’t Need Medicare."
You may want to rethink that! Read why below!
Get All the Benefits You're Eligible For!
Veterans who have VA medical benefits often believe they don’t need Medicare. After all, we are receiving healthcare at the VA Medical Center or clinics, why would we want $185.00 (for 2025) taken out of our social security checks? Our service has earned us benefits and not all are from the VA. Many Medicare Advantage carriers understand our unique needs. Not even the Veteran’s Administration recommends foregoing Medicare benefits. There are several reasons:
- Unless you have a 100% service-connected disability rating, you don’t get dental coverage.
- If you go to an emergency room and it turns out it wasn’t life threatening, and it wasn’t caused by a service-connected disability, the VA WILL NOT pay.
- The VA health benefit IS NOT insurance; it’s a benefit. That means it’s not creditable healthcare coverage. If you decide you need Medicare Part-B in the future, if you did not enroll at 65, you will incur lifetime penalties of 10% per year you did without it.
- If you ever need a second opinion or a service not available at the VA, you will need Medicare to cover it.
- Just because you have VA benefits, doesn’t mean it’s less expensive than a Medicare Advantage plan. You can be paying more at the VA (will clarify below).
- And more…
Medicare Advantage
Medicare Advantage, also known as Part C, is provided by major, private insurance companies who’ve been vetted and certified by The Center for Medicare and Medicaid Services (CMS) to provide and manage all of Medicare’s parts under one plan.
As a veteran, if you receive your care at a VA medical center, you most likely have prescription drug coverage. However, that does not mean you’re paying the best price for your meds.
Every veteran is put into a priority group:
- One group for 50% disability or above…
- Another for those below 50% disability…
- Another based on income level, etc.
Your prescription copay can be $9 (as mine is) per 30-day supply of generic medications. Rarely is an actual brand name used. But many Medicare Advantage plans have a $0 copay at preferred retail and mail-order pharmacies (what we are used to already, having our meds mailed to us) for tier 1 and tier 2. The majority of the meds we get, on average, are tier 1 and 2. If you take more than one medication per month at this copay rate, that’s a lot of money you don’t need to be spending.
PCP and Specialist Copays
Many veterans also have copays for doctor appointments. They can be $15 for a PCP (primary care physician) visit, to $25 to $50 for a specialist visit.
Many Medicare Advantage plans have a $0 copay for PCP visits and as low as $10 to $20 for Specialist visits.
Additional Supplemental Benefits
Depending on the plan you choose, you could receive:
- Dental benefits with first-dollar coverage, at the dentist of your choice, as long as the dentist accepts Medicare.
- Chiropractic care for lower back pain.
- Acupuncture for lower back pain.
- FREE gym membership to stay in shape.
- Between $35 to $250 for over-the-counter medications and products (things we buy at Walmart, Walgreens and/or CVS), per quarter.
- Worldwide ambulance transportation in case of an emergency.
- Emergency coverage while traveling.
All this may be available at $0 premium or even with a Part-B premium credit from $50 to $145.00 per month, back in your social security check (varies by plan and location). So, if you were to get a $100 premium credit or giveback, your Medicare Part-B would cost only $85.00 per month, instead of $185.00, plus any penalties if applicable.
Will I have to change my doctor?
If you have VA benefits, you do not have to change doctors. You will have two plans that DO NOT talk to each other. You can keep your VA doctor or choose one from your network and have both. If you have Tricare For Life, you would choose a Medicare Advantage plan that your doctor accepts.
Get Services the VA Doesn’t Provide or Get a Second Opinion
If you need a procedure or service that the VA doesn’t provide, you can use your Medicare Advantage benefits and go to a different doctor or facility to get what you need. If you’re filing a claim for disability and keep getting turned down, get a second opinion using your Medicare Advantage benefits.
You have nothing to lose by getting your questions answered!