Senior.Benefits
Expert
- 31
Yep--there is no pat answer thats for sure
Veterans and Medicare
- Thread starter plannerman
- Start date
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- medicare
- 2,128
Some vet clients don't even bother with Medicare---why spend $105 a month for what they get for free?
Why spend for part B? If they are only using VA and not on tricare for life if they do not sign up for part B when eligible they will be penalized when they do. VA is only creditable coverage for Part D and nothing else.
- Thread starter
- #14
- 126
I seem to be the same as you. Thank you all for inputting I figured that this info could be helpful to us all.
My friends who use the VA exclusively tell me that in light of all of the bad publicity, the care that they get has dramatically improved. Personally, I'm only marginally comfortable with them. No need for part D. Add drugs are just $9 , and no donut hole.
If you stop in at any VA office, you can pick up a handbook with all of the VA benefits in it
If you stop in at any VA office, you can pick up a handbook with all of the VA benefits in it
vaxmanid
Expert
- 25
My partner and I had a meeting with VA billing office. Their favorite story was about genius that thought he didn't need anything to do with Medicare and opted out of Part B. As "VA would cover everything". Guy had a heart attack and as he dropped to the floor hit his head on the corner of the dining room table. Head injury was worse than the heart attack. To the tune of $286,000. No military rated disability or prior treatment at the VA for above conditions. VA would not approve payment for services outside of the VA.
These guys have to be made aware that these scenarios are case by case and the VA handbook clearly states VA benefits are NOT insurance. Some still won't believe it. And if you die, that leaves a nice big bill for your wife.
As for Tricare for Life, an MA that is NOT an HMO can be appropriate for gym benefit. But...STAY AWAY FROM ANYTHING PART D including MAPD. I've witnessed agents chasing a commission see themselves giving their E&O a workout when the member hits the doughnut hole. Also lots of silly questions from Medicare, DOI and carrier as why you sold them. Not pretty. It is possible unravel, but the agent then has an E&O claim and a chargeback. Not worth it.
These guys have to be made aware that these scenarios are case by case and the VA handbook clearly states VA benefits are NOT insurance. Some still won't believe it. And if you die, that leaves a nice big bill for your wife.
As for Tricare for Life, an MA that is NOT an HMO can be appropriate for gym benefit. But...STAY AWAY FROM ANYTHING PART D including MAPD. I've witnessed agents chasing a commission see themselves giving their E&O a workout when the member hits the doughnut hole. Also lots of silly questions from Medicare, DOI and carrier as why you sold them. Not pretty. It is possible unravel, but the agent then has an E&O claim and a chargeback. Not worth it.
Vaxman that was very helpful. Sounds like you could school us on this. All too often I have people looking for a plan for their wife but they don't need anything since they can get anything they want at the VA.
Yeah, right. No need to confuse them with facts.
A rarely run into TFL but do get a number of vets (mostly Vietnam era). Sometimes they buy a Medigap but get their med's from the VA.
Feel free to share more of your VA knowledge (and anything else).
Yeah, right. No need to confuse them with facts.
A rarely run into TFL but do get a number of vets (mostly Vietnam era). Sometimes they buy a Medigap but get their med's from the VA.
Feel free to share more of your VA knowledge (and anything else).
vaxmanid
Expert
- 25
Smarco I'll take the bait. Script:
What is your MILITARY disability rating? It's in 10 percent increments. Not 5s.
Oh, so you are less than 50 percent is that right? Only 100 percent rating
is covered outside the VA. Those between 50 and 90 lesser so in degrees.
The majority have no rating . They MAY be covered outside the VA for conditions you have already been receiving treatment for at the VA. Say a heart condition.
So he says "they've covered everything before". Might be so for your heart, but now you have a stroke. Now what? You're rolling the dice as to IF the VA will pay for it.
Well...they transferred me to the VA so it was covered. Hold up partner. You still are liable for the ambulance ride to the non-VA hospital. Same for the ER charges and time as admitted patient.
"I'll just tell the ambulance to take me to the VA". Not so fast. Seconds count. The ambulance crew has a legal and ethical obligation to take you the NEAREST emergency department. PERIOD. So the meter is running. Yes the ambulance may call the VA for you and ask if they can take you in, but in general, VA ERs are not equipped....especially for trauma. That's why you don't see the red lights and siren entering the VA.
Now back to the wife. Great that you're looking for proper coverage for her and let's look that. Pay particular attention to the benefits we discuss within the plan, because you DO NOT HAVE IT THROUGH THE VA. Certainly you don't want to risk leaving you wife with insurmountable medical bills because you BELEIVED the VA would cover you bills, when in fact they won't. I'm not knocking the VA at all. They do wonderful things, but you have to clearly understand their limits.
Take the time to actually read the VA handbook available at their website.
As for TFL, I tell them to NEVER talk to a Medicare agent again...not even me. Thank them profusely for their career service and leave it at that.
Summer School has adjourned.
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One more thing.
"I'm disabled and get SSDI".
So what is your MILITARY disability rating?
None.
You do realize that VA is not insurance right?
Huh?
It's in the VA handbook. Since you do have Medicare you're playing with financial fire by not narrowing the gaps in Medicare. It's easy to do so let's work on that.
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Not when it's an HMO.
What is your MILITARY disability rating? It's in 10 percent increments. Not 5s.
Oh, so you are less than 50 percent is that right? Only 100 percent rating
is covered outside the VA. Those between 50 and 90 lesser so in degrees.
The majority have no rating . They MAY be covered outside the VA for conditions you have already been receiving treatment for at the VA. Say a heart condition.
So he says "they've covered everything before". Might be so for your heart, but now you have a stroke. Now what? You're rolling the dice as to IF the VA will pay for it.
Well...they transferred me to the VA so it was covered. Hold up partner. You still are liable for the ambulance ride to the non-VA hospital. Same for the ER charges and time as admitted patient.
"I'll just tell the ambulance to take me to the VA". Not so fast. Seconds count. The ambulance crew has a legal and ethical obligation to take you the NEAREST emergency department. PERIOD. So the meter is running. Yes the ambulance may call the VA for you and ask if they can take you in, but in general, VA ERs are not equipped....especially for trauma. That's why you don't see the red lights and siren entering the VA.
Now back to the wife. Great that you're looking for proper coverage for her and let's look that. Pay particular attention to the benefits we discuss within the plan, because you DO NOT HAVE IT THROUGH THE VA. Certainly you don't want to risk leaving you wife with insurmountable medical bills because you BELEIVED the VA would cover you bills, when in fact they won't. I'm not knocking the VA at all. They do wonderful things, but you have to clearly understand their limits.
Take the time to actually read the VA handbook available at their website.
As for TFL, I tell them to NEVER talk to a Medicare agent again...not even me. Thank them profusely for their career service and leave it at that.
Summer School has adjourned.
----------
One more thing.
"I'm disabled and get SSDI".
So what is your MILITARY disability rating?
None.
You do realize that VA is not insurance right?
Huh?
It's in the VA handbook. Since you do have Medicare you're playing with financial fire by not narrowing the gaps in Medicare. It's easy to do so let's work on that.
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Not when it's an HMO.
The VA handbook is very vague as to what they will pay in case of emergency. It uses the wording 'may reimburse,' not 'will reimburse ' several places under the emergency heading, and not very specific.
The book also contains a list of all VA facilities by state. However, it does not contain the update about the new 40 mile rule. The book is free at any VA facility.
The book also contains a list of all VA facilities by state. However, it does not contain the update about the new 40 mile rule. The book is free at any VA facility.
