Veterans

This information is for Veterans that are receiving benefits from the VA for Health and Drugs.

 Not retired veterans with Tricare.

Heath:

If you are receiving health care from the VA, there is some information that you need to be aware of. When we use the service, they will ask us Do you have any other insurance coverage.  If you are under age 65 and with out any coverage, your correct response would be NO. After age 65 and you are enrolled in Medicare, your answer is YES.

The VA, like Medicare is a government program. The VA is not yet able to bill Medicare for the total recovery of expense’s for your Health & Drug care. They are able to bill the 20% that you are required to pay. Net result is that you would pay $0 for your care at a VA facility less any co-pay.

As long as we receive care AT THE VA, coverage is 100% less co-pay fee’s according to your classification. Those with service related disabilities will have a different cost from those with no disability.  

Many Veterans say I have Medicare parts A & B and do not need any other coverage beyond the VA.

We are also under the impression that the VA will cover all of our health care where ever we are.

That however is not true.

If you are not in a VA facility, such as a local hospital and encountering a heart attack. The cost structure is very different. Your expense at another facility is not the responsibility of the VA, it is yours! If you have Medicare, the hospital and doctors will bill Medicare for it’s portion of your bill. You are still responsible for your 20% of Part B expense’s and the Hospital Deductible of $992. You are welcome to contact the local VA center, not a clinic staffed by volunteers, to verify this information.

To avoid this potential financial problem, a Medicare Supplement or a PFFS, Private fee for services is recommended.  The PFFS will not have any monthly cost and will save you money if you are healthy. If you health is not good, we recommend a Medicare Supplement. 

To put this another way: If you are healthy, you can nearly eliminate any cost with a PFFS and still always be protected for anything.  If your health however is not good, you are going to need more care, more often. You may not be able to get to a VA facility for care in time of an emergency. The VA is not set up like your local hospital to receive emergency care patients. They do have ER available, but not like you would have in a local hospital. If you are traveling the problems of receiving care and the financial responsibility increases.

If you are still in doubt, contact your local service center such as Gainesville (352-244-5460), Tampa, St. Petersburg etc. Ask for the FEE BASIS office.

Be prepared. The unavoidable fact is that we are getting older and the probability of needing health care is increasing. To discover after the fact that you did not have the coverage you thought you had can destroy you financially and emotionally.

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