Medicare & VA Continued
Medicare hospital or doctor visits will cost you a copay. In broad terms, Medicare sets a rate that they will pay a doctor or hospital no matter what they bill in charges. Whatever that rate is you'll owe 20% of it. For example, I recently had a colonoscopy. My share of my doctor's bill under Medicare Part B was $44.00. I wouldn't have had to pay that at VA but my drive would have been 2 1/2 hours each way whereas keeping it at home was a 10 minute trip. There will be other bills associated with that (anesthesia, lab, etc.) but I estimate my entire out of pocket share will be less than $300.00.
No, I don't use supplemental insurance. That stuff is expensive. I expect that this year (2015) I may spend $1500.00 out of pocket to cover Medicare copays. That's 1/2 of what a supplemental policy would have cost and it wouldn't have paid all my expenses.
What happens if you need emergency care at a civilian hospital? Who do you tell them to bill? What can you do if you're unconscious
or unable to speak?
Medicare & VA Continued
You can and should plan in advance. Tell your spouse or family member you want to go to VA first. Be sure your VA emergency room is capable of handling your emergency before you need it. Some VA emergency rooms aren't full service. If you go to a civilian emergency room, stress (or have your family stress) that you must transfer to VA as soon as possible. If the civilian hospital gets your Medicare number,they will bill Medicare every time. VA health doesn't act as supplemental so you'll be stuck with the copay.
Veterans: Pay Attention To Medicare At Age 65 Or Face Problems Later
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.
Need some help with Social Security Benefits? Ask Roger Hale.
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Veterans Social Security Disability Benefits
Are you a veteran who has Medicare and VA care benefits?
Do you understand how to use both to your advantage?
Using your Medicare benefits along with your VA health benefits is more a matter of individual choice than anything. I can only tell you what I do. What I do may not be ideal for you so you'll have to put some thought into this.
I like my VA doctor and clinic. It isn't always convenient for me though. Because of that I sometimes see civilian doctors using my Medicare Part A and Part B. Medicare Part A pays for hospital care, Medicare Part B pays for doctor and most outpatient services. Part A is required when you collect your Social Security retirement, Part B is elective and you'll pay an additional premium. Part D covers pharmacy prescription medicines and most experts tell us that if we get VA pharmacy, we do not need Part D.
Continued below...
Medicare & VA Continued
If you enter a civilian hospital and you aren't quickly transferred to VA you or your representative must persistently call the VA facility of choice to tell them you want to transfer there. DO NOT depend on the civilian hospital staff to do this for you. You must document when you called the VA facility and who you spoke with or what voice mail you reached. If you don't follow these steps you'll soon be billed for your portion of the Medicare payment and you'll be in a tussle with VA to try and get payment.
Not every veteran is eligible for emergency civilian care. Not every situation will be deemed as eligible because it's life threatening or a true emergency. If you go to a civilian ER for a bad flu or a broken toe, VA isn't likely to pick up the tab for you.
The bottom line is to think of your plan before a health emergency arises. Know the hospitals you want to use and be sure they can provide the services you want.
Social Security disability: game plan to get benefits
How you can increase the odds of getting the benefits you deserve.
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