Medicare for Veterans: How to Enhance Your Healthcare Access

Jamie Byrd
Nov 20, 2024
4 min read

The Bedrock Group and Medicare Benefits for American Veterans

Navigating healthcare options can be complex, especially for veterans with benefits through the Department of Veterans Affairs (VA). For Medicare-eligible, Medicare can provide additional healthcare coverage that works in concert with VA benefits, enhancing flexibility and access. This guide will help you, as a veteran, understand what you may want to consider enrolling in Medicare, how it works alongside VA benefits, and what steps you can take.

Eligibility for Medicare

Veterans are eligible for Medicare if they meet the standard requirements:

Age 65 or Older: most individuals qualify for Medicare upon turning 65.
Under 65 with Disabilities: Those who are receiving Social Security Insurance (SSDI) for 24 months or more are eligible for Medicare. It does not matter what age you are. If you are a wounded vet, please ensure you receive all the benefits you are entitled to.
Special Conditions: Individuals with End-Stage-Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS) automatically qualify.

How Medicare and VA Benefits Work Together

Medicare and VA benefits are separate programs that do not overlap in coverage.

VA Benefits: Veterans must use VA-approved providers for services covered by the VA. Most, if not all, care will be administered at VA facilities.
Medicare: Medicare covers services provided by non-VA facilities. Medicare does not pay for care received at a VA facility, and the VA does not cover services at non-VA facilities unless pre-approved.

Tip: Having both can ensure broader access to healthcare providers and facilities.

Why Medicare is Helpful for Veterans

Access to non-VA Providers:
1. Medicare allows you to see healthcare providers outside the VA network, which gives you more options for hospitals and specialists.
Avoiding Late Penalties:
1. This is especially important because even if you primarily use VA benefits, enrolling in Medicare when you are first eligible will help you avoid any late enrollment penalties for Medicare Part B and Part D.
Travel Flexibility:
1. Medicare allows nationwide access to providers, whereas VA benefits are typically tied to VA facilities.
Supplementing VA Care:
1. Medicare works in concert with VA care by covering services the VA does not provide. This allows access with shorter wait times.
Medicare Plans with Extra Benefits:
1. When you enroll in Medicare Parts A and B, you will have access to Medicare plans that can offer money back to your social security, grocery allowances, over-the-counter allowances, and more.

When to Enroll in Medicare

IEP, Initial Enrollment Period: This is three months before, the month of, and three months after you turn 65.
GEP, General Enrollment Period: January 1 - March 31 if you missed your IEP. Late penalties may apply.
SEP, Special Enrollment Period, is Available for those who delayed Medicare due to having other qualifying coverage, such as employer insurance.

Medicare Options for Veterans

Medicare Part A | Hospital Insurance:
1. Covers inpatient care, hospice, and skilled nursing facilities. Most people qualify for Medicare Part A without paying a premium.
Medicare Part B | Medical Insurance:
1. Covers outpatient services like doctor visits and preventative care. Medicare Part B has a monthly premium.
Medicare Part C | Medicare Advantage Plans
1. Medicare Part C is a combination of Medicare Part A, Medicare Part B, and Medicare Part D. This option also provides additional benefits such as vision, dental, hearing, fitness, and more.
Medicare Part D | Prescription Drug Coverage
1. The VA provides prescription coverage, but not all medications are covered.
2. Medicare Part D can be standalone with a Medigap plan or included with Medicare Part C.
3. Medicare Part D covers prescription medications and can be used with your VA benefits as a backup when the VA does not cover certain medications.
Medigap | Medicare Supplement Plans
1. Medigap, also known as Medicare Supplement Plans, covers costs like copayments and deductibles in Original Medicare. Veterans who rely primarily on VA care may not actually need the Medicare Supplement Plan but could consider it for broader access.

Medicare, CHAMPVA, and TRICARE

If you qualify for Medicare and CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs) or TRICARE (healthcare coverage for military personnel and their families), understanding how these programs work together can help you maximize your benefits and avoid unnecessary expenses.

Primary and Secondary Coverage:
1. Medicare is the primary payer for services for CHAMPVA and TRICARE.
2. CHAMPVA and TRICARE become the secondary payers covering any out-of-pocket costs.

Medicare works seamlessly with TRICARE and CHAMPVA to ensure comprehensive healthcare coverage. By understanding how these programs coordinate, you can maximize your benefits, reduce your out-of-pocket costs, and maintain access to a wide range of healthcare services.

Final Thoughts: Medicare can provide valuable coverage that complements VA benefits, offering more flexibility and peace of mind. If you are a Veteran or have a loved one and are ready to review your options, we can help. At The Bedrock Group, we are Veteran—and first responder-owned, so we understand the importance of your service and are here to help you get all the coverage and benefits you deserve.

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Jamie Byrd is the CMO and author for The Bedrock Group

The Bedrock Group helping veterans and their families with healthcare and medicare help

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At The Bedrock Group, we're a Veteran and First-Responder-owned full-service insurance agency. We provide complimentary consultations and no-cost Medicare reviews. Our home office is located in New Albany, IN. We have a Senior Resource Center in Stanford, KY, and another office coming to Asheville, NC. We also offer the following services: