Planning for retirement requires you to consider more than simply how to save enough money to live comfortably during your “Golden Years.” In fact, one of the most important things to plan for is healthcare. Most employer-sponsored health insurance terminates when you reach retirement age and/or shortly after you officially retire from the company. As a senior, you will likely count on Medicare to cover healthcare related expenses; however, if you are a veteran, you may also be eligible for veteran’s benefits that typically include healthcare coverage as well. Naturally, you may be wondering if you can qualify for both veteran’s benefits and Medicare at the same time.
Medicare is a federally funded healthcare program for people over age 65 and for certain individuals under age 65 who are also disabled. Medicare is an “entitlement” program, meaning if you (or your spouse) paid into the program for the required length of time (10 years) through your payroll taxes during your working years you are automatically entitled to Medicare benefits. Medicare comes in four parts. Part A, or basic Medicare is free. If you wish to sign up for the additional parts of Medicare, however, it may require payment of a monthly premium similar to private health insurance. The four parts of Medicare and the benefits included in each part are as follows:
- Part A – Hospital care – Covers the cost of being in a medical facility.
- Part B – Covers doctors, medical tests and procedures – basically, anything done to you. There is a monthly premium for Part B coverage.
- Part C – Medicare Advantage – Part C is an alternative to traditional Medicare coverage. Coverage often includes Parts A, B and D. Medicare Advantage plans are administered by private insurance companies.
- Part D – Prescription drug coverage – D is administered by private insurance companies, and you are required to have it unless you have coverage from another source. Part D requires you to pay a monthly premium in most cases.
Veteran’s Health Care Benefits
Anyone who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable may qualify for VA health care benefits including qualifying Reserve and National Guard members. Veterans who enlisted after Sept. 7, 1980, or who entered active duty after Oct. 16, 1981, must have served 24-continuous months or the full period for which they were called to active duty in order to be eligible. This minimum duty requirement may not apply to Veterans discharged for hardship, early out or a disability incurred or aggravated in the line of duty.
Can I Qualify for Both?
When it comes to veteran’s benefits and Medicare, the focus shouldn’t be on whether you can qualify for both, but on whether you can benefit from both at the same time. It is possible to qualify for both; however, Medicare and VA benefits do not work well together. Medicare does not pay for any care that you receive at a VA facility. For Medicare to cover your care, you must receive care at a Medicare-certified facility that works with your Medicare coverage. Conversely, for your VA coverage to cover your care, you must generally receive health care services at a VA facility. Moreover, VA benefits will not pay for Medicare cost-sharing (deductibles, copayments, coinsurances).
Therefore, if you chose not to enroll in Medicare and to keep your VA coverage only, you will not have health insurance for facilities outside the VA health system. Some seniors choose to enroll in Medicare Part A when they turn 65 because it’s premium-free but turn down Part B because of the additional monthly premium. If you change your mind and decide to enroll in Medicare in the future, you may face penalties and would likely have to wait to enroll during the General Enrollment Period (GEP). You will not be eligible for the Part B Special Enrollment Period (SEP) if you delay Medicare enrollment.
If you decide to enroll in Part B, you should do so during your Initial Enrollment Period (IEP). Enrolling in Part B provides you with the flexibility of getting health care outside the VA system. Also, you may qualify for programs to help pay the Part B premium and Medicare cost-sharing. Remember that you can keep your VA health benefits to get coverage for health care services and items not covered by Medicare, such as over-the-counter medications, annual physical exams, and hearing aids.
Contact a North Dakota Elder Law Attorney
Please join us for an upcoming FREE seminar. If you have additional questions or concerns regarding veteran’s benefits or other elder law issues, contact a North Dakota elder law attorney at German Law by calling 701-738-0060 to schedule an appointment.