100% disabled vets, VA, Medicare Part B & Optum Community Care

[somarco]

supplemental offering from Plan C - Plan N should be considered.

Every area is different, but in Georgia there are only a handful of carriers offering plan C . . . the lowest premium C plan is $20 more per month than a G plan.

Plan N is an option to be considered.

Plan B is an interesting suggestion. I don't know that I have ever suggested it . . . looking at Georgia rates now and again, very few carriers offer it and most have a noticeably higher premium than my "go to" Plan G.

For those willing to take on more risk in exchange for premium savings (but without the network issue) Plan HDG can be a fit. I don't write many of those, perhaps half a dozen per year, but it is a niche market of sorts.

I will admit, my presentation is relatively straight forward and I don't get into the details that much unless asked . . . SNF, home health, blood, O2, DME. Too much detail and I can see their eyes glass over . . . even though I conduct all my business by phone & email . . .

Do you "hunt" for folks with VA eligibility or do they find you? I encounter so few in that category that, when it comes up, I have to research my answers. Questions about SNF are never a lead in question from my prospects so I stick with the K.I.S.S. principle.

 

[Chazm]

I believe I quoted Plan B a couple weeks ago in Florida and the cheapest option was more expensive than plan N.

 

[DonP]

I avg 6- 8 Humana honor plans a month . Almost every va vet I run into that uses the Va is low income and has zero interest in paying for a medigap plan . The honor plan gives them an alternative to go outside if necessary and to also get $50-$100 part B premium back and good dental . A few vets have told me they’ve been approved to use some local drs and clinics.Quite the contrary to what people have been sadly misinformed. We always here don’t write a tricare for life with a ma plan . Bs Bs Bs . It works seamlessly with it and I’ve written at least 30 and not one person has ever called me that a dr or hospital bill wasn’t paid at 100% . And they get $100 a month back and other benefits . Always show your Humana and Tricare for life card and never an issue .

 

[yorkriver1]

One main reason for MedSupp with more minimalist options would be the potential network issues with MA plans? Lucky that Humana Honor and a couple other similar plans are PPO's. 1st one I have written, Tricare for life member. Good dental, $50 Part B give back.
I am with Somarco, this thread is top quality experience from agents. The thing about the forum that is so good. Thank you Sunnyb1, Don P and everyone.

 

[sunny1ib]

Every area is different, but in Georgia there are only a handful of carriers offering plan C . . . the lowest premium C plan is $20 more per month than a G plan.

Plan N is an option to be considered.

Plan B is an interesting suggestion. I don't know that I have ever suggested it . . . looking at Georgia rates now and again, very few carriers offer it and most have a noticeably higher premium than my "go to" Plan G.

For those willing to take on more risk in exchange for premium savings (but without the network issue) Plan HDG can be a fit. I don't write many of those, perhaps half a dozen per year, but it is a niche market of sorts.

I will admit, my presentation is relatively straight forward and I don't get into the details that much unless asked . . . SNF, home health, blood, O2, DME. Too much detail and I can see their eyes glass over . . . even though I conduct all my business by phone & email . . .

Do you "hunt" for folks with VA eligibility or do they find you? I encounter so few in that category that, when it comes up, I have to research my answers. Questions about SNF are never a lead in question from my prospects so I stick with the K.I.S.S. principle.

 

[Todd King]

Thanks for the kind words Somarco.

After I posted my response, I thought I may confuse folks regarding Medicare Part B vs. Medicare Supplement Plan B. Veterans and some other individuals on certain types of government plans may benefit from Part A. I personally have found that veterans will find more comprehensive supplemental benefits that are less expensive if they are looking to augment their VA benefits. If they are taking the either or method, then the supplemental offering from Plan C - Plan N should be considered.

What to I mean by "augmenting their VA benefits?" Depending on the Priority Group, some veterans, may (note the term may) be able to go back to the VA and use a VA facility or qualify for a VA approved facility. This facility has to be approved by the veteran's primary care physician, which means that the veteran may use his/her Medicare for specialty services, but uses primary care services thru the VA. It doesn't have to be this way, but it can be this way depending on how far the veteran lives from VA medical service facility. The VA does have outreach medical posts available (aka clinic), and these clinics are extremely busy. There is now, where in previous years there was not, electronic record sharing for those veterans who choose to use private specialists due to proximity, scheduling delays, and/or limited or no specialists available for the veteran at the VA hospital. In the event you are working with a veteran who is not aware of this, he/she should be enrolled in My HealtheVet and have Premium status. Enrollment in My HealtheVet can be done online in the comfort of their own home. In order to enroll in Premium status, this takes a form with a wet signature to be turned in. Electronic record sharing can be done with outside providers at that point (I am not certain if this (electronic record sharing) has been rolled out to all VA hospitals, I do know they are in most of the rural states).

Medigap Benefits
Plan A Plan B
Part A coins & Yes Yes
(2022 cost $389
for 61-90 days)
hospital costs up to
(2022 - $778 lifetime
reserve days an add'l
365 days after Medicare
benefits are used up
Part B coins or copay Yes Yes
Blood (first 3 pints) Yes Yes
Part A hospice care
coins or copay Yes Yes
Skilled nursing facility No* No*
care coinsurance
(2022 - $194.50 per day
from days 21-100)
Part A deductible** No Yes
2022 $1,566
Part B deductible No No
Part B excess charge No No

The difference in Medicare Supplement Plan A and Medicare Supplement Plan B is ONE base, but costly benefit - Plan B covers the Medicare Part A Deductible. We all know that the Part A deductible is a pretty hefty amount. This is why I suggest to my clients Plan B.

Some may ask about the Skilled Nursing Facility care coinsurance. Here is where we as their agent/broker can do our magic and explain the merits of MA plans and a Medicare Supplement Plan C - N (whichever one makes financial, accessible care - basically reasonable sense to the client) because who really wants to part with $15,365.50 if his/her stay was to the maximum 100 days in the SNF? This would make any Priority Group uncomfortable, but particularly Priority Groups 7 & 8 where they are not receiving much in the way of VA benefits at all.

I hope this clears up any confusion Somarco. And again, thanks for the kind words.

Do keep in mind that Veterans who have coverage due to disability may get all of their needs covered with the VA. The biggest thing to keep in mind here is that the VA does not bill Medicare.

 

[sunny1ib]

Do keep in mind that Veterans who have coverage due to disability may get all of their needs covered with the VA. The biggest thing to keep in mind here is that the VA does not bill Medicare.

 

[sunny1ib]

Veterans are a very special group, as you have indicated. In my opinion, it very important to know how VA benefits work, and how the veteran is receiving benefits.

The answer to the question to this thread: Yes, a veteran should be enrolled/enrolling in Medicare Parts A & B, ESPECIALLY Part B when first eligible.

To reiterate your statement Todd, the VA does not bill Medicare (they do NOT reciprocate) and I’m going to take it one step further, VA benefits are NOT considered creditable coverage for Medicare Part B. So, any veteran who does not currently have Medicare Part B, will be subjected to the late enrollment penalty and can only enroll during General Enrollment Period which runs from Jan 1 - Mar 31, 2022 for an effective date of 7/1/2022.

VA Prescription Coverage is considered creditable coverage for Medicare Part D.

 

[Todd King]

The answer to the question to this thread: Yes, a veteran should be enrolled/enrolling in Medicare Parts A & B, ESPECIALLY Part B when first eligible.

But this is not 100% true...and the point I'm trying to make.

If a vet uses the VA 100% of the time, there is not one single reason to pay for Part B.

If they go elsewhere sometimes, or maybe they travel a good bit...then yes...get Part B!

 

[sunny1ib]

Veterans are a very special group, as you have indicated. In my opinion, it very important to know how VA benefits work, and how the veteran is receiving benefits.

The answer to the question to this thread: Yes, a veteran should be enrolled/enrolling in Medicare Parts A & B, ESPECIALLY Part B when first eligible.

To reiterate your statement Todd, the VA does not bill Medicare (they do NOT reciprocate) and I’m going to take it one step further, VA benefits are NOT considered creditable coverage for Medicare Part B. So, any veteran who does not currently have Medicare Part B, will be subjected to the late enrollment penalty and can only enroll during General Enrollment Period which runs from Jan 1 - Mar 31, 2022 for an effective date of 7/1/2022.

VA Prescription Coverage is considered creditable coverage for Medicare Part D.