Some veterans choose not to enroll in Medicare Part B because they’re going to use VA healthcare for life. But, then life happens and things change.
Tom is a Vietnam veteran. At age 65, he retired and signed up for Social Security and Medicare Part A, hospital insurance, but not Part B, medical insurance. He doesn’t need that to go to the VA. Now, at age 75, he’s having some issues and needs more frequent medical appointments. The nearest VA facility is 37 miles away. Tom’s driving skills have declined and he fatigues easily. He would really like to see local doctors.
Because Tom did not enroll in Medicare Part B, hospital insurance, when first eligible, he cannot sign up until the General Enrollment Period, January 1-March 31. After that, Part B would not take effect until July 1. On top of that, Tom will incur a late enrollment penalty, based on 10 years without Part B. In 2019, the penalty would add an additional $133.50 every month to his bill for Part B. (The penalty amount can change every year and will follow Tom for life.)
Why the penalty? According to the VA website, “Under Medicare Part B, VA healthcare is NOT creditable coverage. Creditable coverage under Medicare Part B can only be provided through an employer.”
Important points about veterans and Medicare
- The VA cannot bill Medicare for any services.
- However, by law, the VA must bill private insurance plans. This includes Medigap policies (Medicare supplement insurance).
- Prescription drug coverage through the VA is considered to be creditable. Veterans who are satisfied with the coverage do not need to enroll in a Medicare Part D drug plan. If they decide later on that they want a drug plan later, they can enroll in one during the fall Open Enrollment Period, October 15-December 7, and will not face a late enrollment penalty.
- New rules will expand access and provide more choices for veterans to non-VA facilities. Veterans who live more than 30 minutes from a VA healthcare facility are eligible to receive care from non-VA providers. Even with this significant change, veterans should still consider Part B enrollment. There would be no need to get authorization. Veterans would be in charge of their decisions about healthcare providers.
- Finally, the VA encourages veterans to enroll in Medicare. “Veterans enrolled in both programs would have access to community physicians (under Medicare Part A or Part B) and can obtain prescription drugs not on the VA formulary if prescribed by community physicians and filled at their local retail pharmacies (under Medicare Part D).”
The older we get, the more we realize that things can change. For veterans, Part B enrollment helps ensure they will have options for medical care.