During the Medicare Advantage Annual Election Period (AEP), which runs Oct. 15-Dec. 7, individuals eligible for Medicare can select their health insurance plan for the following year. For veterans, this can be a confusing time, especially if they receive benefits through Veterans Affairs.
As someone who works closely with veterans to help them understand the role of Medicare, I am sharing some of the questions I receive most often.
If I have health care benefits through the Department of Veterans Affairs, do I need to enroll in Medicare when I become eligible?
Yes, the VA encourages you to enroll in Medicare to complement your VA health care benefits. If you need care from a non-VA hospital or doctor, Medicare can provide coverage. Having a Medicare plan means you have coverage if funding for VA health care changes in the future.
If the VA only authorizes certain services at a non-VA or VA authorized care facility, Medicare may cover additional services the VA can’t.
If you cancel Medicare Part B coverage, you cannot choose a Medicare Advantage plan until January of the following year (when you can enroll in Part B), even if your VA health care benefits change. A delay in Part B enrollment means a financial penalty when you sign up.
With Medicare Part D, which is coverage for prescription drugs, you will have the option to get medication prescribed by non-VA doctors and use your local pharmacy. Part D coverage is only available through private insurers and can be a stand-alone plan or part of a Medicare Advantage plan.
What’s the difference between Medicare and Medicare Advantage?
Original fee-for-service Medicare is the government-managed program and only includes Part A (hospitals) and Part B (doctors and outpatient services). Medicare Advantage plans, offered through private insurance companies, include Parts A and B and additional benefits that could help reduce gaps in coverage. For example, Humana USAA Honor plans, available to anyone eligible for Medicare, are designed with veterans in mind and include a $0 monthly plan premium, Part B Medicare premium reduction, worldwide coverage for emergency care, a limit on out-of-pocket costs, and dental, vision and hearing coverage.
What should I consider when looking at plan options?
Evaluate the costs of the plans available in your area, including monthly premiums, deductibles, copayments, and maximum out-of-pocket amounts. Review your total health care expenses from the past year and anticipate what you may spend in the coming year.
Original Medicare provides coverage through any provider that accepts Medicare; however, it typically only covers about 80% of the cost, with no limits for your portion. Medicare Advantage plans include maximum out-of-pocket costs, but they use provider networks, so verify your health care providers participate with the plan.
Additionally, review your medication needs. Original Medicare does not include prescription drug coverage, while many Medicare Advantage plans include it. However, if you receive prescriptions through the VA and are satisfied with your coverage, you may want to explore Medicare Advantage plans without prescription drug coverage.
Where can I go to get more information?
Look to credible sources, such as Medicare.gov or licensed sales agents, to compare plans and estimate costs. Veterans and Medicare households have access to Humana Customer Care specialists who collaborated with USAA to receive special training to better serve the unique healthcare needs of veterans. Visit Humana.com/Medicare/Veterans or call toll-free 1-833-585-8387 (VETS) (TTY: 711) 8 a.m.-8 p.m., seven days a week to speak to a Customer Care specialist or connect with a licensed sales agent.
Disclaimers: Humana is a Medicare Advantage HMO, PPO, and PFFS organization and a stand-alone PDP prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. The Part B Giveback Benefit pays part or all of your Part B premium and the amount may change based on the amount you pay for Part B. Humana Insurance Company pays royalty fees to USAA for the use of its intellectual property. USAA means United Services Automobile Association and its affiliates. Use of the term “USAA member” or “USAA membership” refers to membership in USAA Membership Services and does not convey any legal or ownership rights in USAA. Restrictions apply and are subject to change. USAA and the USAA Logo are registered trademarks of the United Services Automobile Association. All rights reserved. No Department of Defense or government agency endorsement. The Humana USAA Honor plans are available to anyone eligible for Medicare and veterans should consider all of their health plan options.