One in five Medicare-eligible adults in our country is a veteran. That’s 9.3 million Americans age 65 and older. Most veterans have different healthcare situations than their peers and are usually covered through one of three plans: CHAMPVA, TRICARE or benefits through the Veterans Administration with Medicare for additional services beyond those covered by VA. The following is a brief summary of each.
1. CHAMPVA Eligibility:
To be eligible for CHAMPVA, you cannot be eligible for TRICARE, and you must be in one of these categories:
i) The spouse or child of a Veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office.
ii) The surviving spouse or child of a Veteran who died from a VA-rated service-connected disability.
iii)The surviving spouse or child of a Veteran who was at the time death rated permanently and totally disabled from a service-connected disability.
iv)The surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).
Source: 052019 https://www.va.gov/COMMUNITYCARE/programs/dependents/champva/champva_eligibility.asp
CHAMPVA is always the secondary payer to Medicare. If you are eligible for Medicare, at any age and for any reason, you must enroll in Medicare Part A and Medicare Part B to keep your CHAMPVA benefits.
2. TRICARE for Retired Service Members and Families
TRICARE is a health insurance program provided by the federal government to active duty and retired military personnel and their family members. There are many different TRICARE programs. TRICARE for Life (TFL), a program for Medicare-eligible military retirees and their dependents, acts as a supplement to Medicare. If you’re eligible for both TRICARE and Medicare Part A, then in most cases you must have Medicare Part B to keep TRICARE.
052019 Sources https://www.tricare.mil/Plans/Eligibility/MedicareEligible/Retiree_and_Family
3. Veterans NOT covered through CHAMP or TRICARE
Many veterans are ineligible for CHAMP or TRICARE benefits however ARE eligible for medical and prescription drug benefits through a local VA (Veterans Administration) facility.
Veterans who use the VA medical and prescription drug benefit still enroll in Medicare Parts A and B. Since the VA prescription drug benefit meets Medicare Part D prescription drug plan requirements, veterans using VA are not required to enroll in a separate drug plan.
Still, many veterans using the VA medical and prescription drug benefits choose to enroll in a Medicare Advantage plan for when they wish to use services outside of the VA system, such as seeking a second specialist opinion or simply a more convenient location.
These Medicare Advantage plans usually charge a monthly premium (in addition to the Medicare Part B premium) and include a Part D prescription drug benefit – paid for and unused!
I encourage these veterans to explore whether a MA-Only plan is available in the area. A MA-Only plan often includes the same benefits as a higher premium Medicare Advantage plan but without the prescription cost feature – and added premium.
Every Medicare beneficiary has the option to change their Part C or Part D coverage each January 1 through the Annual Enrollment Period which runs October 15 through December 7.
However, veterans using the VA system for Part D prescription drugs have an additional opportunity in what is called a Special Election Period (SEP). This allows a plan change outside of the normal annual period.
For more information on the MA-Only plan for veterans using the VA system, please contact Dan by email or call (518) 346-2115.
Or, schedule a no-obligation telephone consultation:
Medicare, Veterans, VA, Champ, Tricare, Medicare Advantage, MA Only, Prescription Drug Plan, Medigap, Part D, AARP, Schenectady, Albany, Saratoga, Amsterdam, Troy, New York, NY, United Healthcare, Humana,