At SBG Insurance Group we care about our veterans. Many of our expert agents are veterans and take great pride in serving the veteran community. We get a lot of questions from our clients about veterans benefits, the VA and how it can work with Medicare. The VA (Department of Veterans Affairs) and Medicare are two separate healthcare programs that operate independently of each other, but they can work together to provide healthcare coverage for eligible veterans.
If you are a veteran and are eligible for both VA healthcare and Medicare, you can use both programs to receive healthcare services. In general, the VA will serve as your primary healthcare provider, and Medicare may cover certain services that are not available through the VA, such as care from non-VA providers.
Medicare Advantage (Part C)
One of the most frequent ways Veterans combine both services for care is with an MA (Medicare Advantage) or MAPD Plan. MAPD (Medicare Advantage Prescription Drug) plans are offered by private insurance companies as an alternative to traditional Medicare coverage. While the VA does not directly participate in MAPD plans, veterans who are eligible for both VA healthcare and Medicare may choose to enroll in a MAPD plan offered by a private insurance company. This can be a low cost way to obtain care from community based providers outside of the VA network.
If you enroll in a Medicare Advantage plan, you will generally receive all of your Medicare-covered benefits through the plan, including prescription drug coverage. However, VA healthcare may provide additional services or benefits that are not covered by Medicare Advantage plans, such as specialized care for service-connected disabilities. SBG Insurance Group can help you determine if one of these plans is right for you.
Medicare Supplements (Medigap Plans)
Medigap plans, also known as Medicare Supplement Insurance plans, are private health insurance plans that can help pay for some of the out-of-pocket costs associated with Original Medicare, such as deductibles, coinsurance, and copayments.
If you are a veteran who is eligible for both VA healthcare and Medicare, you may be able to enroll in a Medigap plan to help cover some of your Medicare costs. Medigap plans are sold by private insurance companies, and the benefits and costs can vary by plan and by state. It’s important to compare Medigap plans carefully to find the one that best meets your needs and budget.
A Medicare eligible veteran may want to consider a Medigap plan if they travel over seas. With the VA you can receive medical care for VA service-connected disabilities through the VA Foreign Medical Program. Under this program, the VA assumes payment responsibility for the necessary treatment of service-connected disabilities. However, unlike some Medigap plans they will not cover other important things like services, treatments or prescriptions unrelated to a service-connected disability.
A Medigap plan can help cover emergency services while over seas. There are several standardized plans with coverage up to 80% of foreign travel exchange (up to plan limits).
Important Notes
It’s important to note that VA healthcare is generally free for eligible veterans, while Medicare plans may require cost-sharing such as copayments and deductibles. Additionally, Medicare plans have their own rules and regulations for eligibility, covered services, and cost-sharing. SBG Insurance Group can help you determine if one of these plans is right for you.
If you are a veteran and have questions about how VA healthcare and Medicare work together, you could contact both the VA and Medicare directly to get information. It is always best to talk to a licensed insurance agent when making decisions that could affect your Medicare benefits. The experts at SBG Insurance Group have years of experience with these situations and can help you make the right choice.
