If you have healthcare through the VA, you don’t need Medicare. You may want it so you can easily go outside the VA and avoid the famous wait times. You may want private Medicare Advantage (MA) plans because they offer extra benefits that can be very attractive. With special MA-only plans, vets continue to receive their Rx coverage through the VA and have options to see doctor and hospitals outside the VA with their private insurance.
When my father-in-law turned 65, he said he only wanted to use the VA. He said something to the effect of, “I served three combat tours and earned my healthcare and I want to use it!” I had to explain that the nearest VA hospital is in Indianapolis. “Not a long drive,” he was quick to answer. Yes, but think ahead when you are not a healthy 65-year-old. Consider driving on the highway when you are older and sicker and traffic has gotten only worse. Would you rather see a primary care doctor right here in Noblesville five minutes from your house or drive on Interstate 465 for an hour?
The benefit of many Medicare Advantage plans built for the military retiree is the $0 monthly premium. If you don’t use it, you are not being charged a monthly fee by the insurance company. But you must enroll in and pay for Medicare Part B. For most people in 2023, that is about $165 per month. The Centers for Medicare and Medicaid Services has announced that the Part B monthly premium will increase to $174.70 in 2024.
If veterans turning 65 don’t opt to enroll into Medicare when they first become eligible, there will be a late penalty if they later want Medicare. For every year that you wait, a 10 percent per month lifetime penalty accrues. If you wait until you are 68 and decide that the VA really is a long drive away, your Medicare Part B will cost an extra 30 percent per month. It is an important decision to make when you are first eligible for Medicare, usually at age 65.
Even the VA’s own website say that the government “highly recommends” enrolling in Medicare. Not because Medicare is needed for VA care – Medicare doesn’t work inside the VA – but because the VA has different eligibility groups. The lowest two groups are not guaranteed VA coverage and it could be canceled.
Special Medicare Advantage plans designed for military retirees are not available in all areas, but where they are available, they have many attractive benefits that are often easier to access than the VA. If you do sign up for Medicare, you can later cancel it if you find that the VA really is serving your needs better.
For my father-in-law, as he aged, his driving became perilous. We’d offer to drive him to the VA but he hated inconveniencing his family for his doctor visits. (And let’s be honest, it is an inconvenience to drive almost an hour down to Indy when our family doctor is a half-mile away). He ended up using his private insurance primarily and the VA only for his medications.
When he was in his late 70s, he exclusively used his private insurance. Had he waited until his late 70s to enroll into Medicare, he would have had a steep Medicare Part B late penalty tacked on monthly. This is why Vets and their families need to have this discussion when the veteran is first eligible for Medicare, usually at age 65. There is no right answer, but you have choices to make that impact your healthcare.
Sylvia Gordon is co-founder of The Medicare Family, headquartered in Noblesville, where she educates thousands on Medicare and Social Security in all 50 states. You can learn more at TheMedicareFamily.com.