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Medicare Advantage Plans for Veterans Using VA Benefits

Why veterans should use $0 premium plans

There are a large number of Medicare eligible veterans who rely on VA facilities for their medical care and Rx coverage.  Although it is not possible to put all those using VA benefits in the same category, I have found a general trend working with veterans in Connecticut.  Most tend to go to VA doctors for routine care and use the VA in order to get their generic prescriptions filled.  The need for hospital or emergency care seems to be a different story as most usually tell me they prefer to go to the local hospital or emergency room.

The other trend I often see is that they tend to have Medicare A and B benefits without any secondary plan or Rx coverage.  This can lead to out of pocket costs when the veteran needs a name brand drug or chooses to use the local hospital or emergency room.  Medicare A and B leaves them with out of pocket expenses when they use non VA providers.

In such cases, it is prudent to consider a $0 premium Medicare Advantage plan.  The veteran using VA and Medicare A and B benefits may not want to spend additional premium dollars on a monthly basis but they also would like to have more predictable costs when using non VA providers.  The $0 premium can accomplish this for them.  If they choose the plan, it will allow them to see non VA providers for a fixed copay vs. the $135 annual B deductible and 20% coinsurance.  Most plans also spread out the Part A hospital deductible and limit it to $200 dollars a day for a max of 7 days.  The advantage plan will not interfere with VA medical or drug coverage in any manner.  The end result is additional coverage with no additional cost on a monthly basis.

There are some areas to address prior to veterans jumping into a $0 premium however.   The first thing to check is drug coverage.  If the veteran does not have current creditable drug coverage they may want to purchase a $0 premium plan without RX included.  This will allow them to avoid any part D penalty they may owe since VA Rx benefits are not considered credible.  The second area to address is the non VA hospitals and doctors they want to see.  If there are specific providers needed, it needs to be confirmed that they are in the network of the Advantage Plan.

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