Q: I'm a disabled Vietnam veteran, and have been using the VA hospital and outpatient system since 1968. I'm now eligible for Medicare. Is it wise to sign up for Medicare? Or is it just double coverage and an unnecessary out-of-pocket cost? -- MD via email
A: That depends on the breadth of your VA coverage.
The VA provides treatment for service-connected conditions free of charge to all enrolled veterans. In addition, veterans who are in the highest enrollment priority groups -- including, for example, veterans whose service-related disabilities are 50% or more disabling, or who are former prisoners of war -- generally don't have to pay anything for care that's unrelated to their service.
By contrast, if you're in a lower enrollment priority group, the VA may determine you're ineligible for some care that isn't service-related, or you may be required to make a co-payment. These same services may be fully covered by Medicare. If so, obviously it would be sensible to enroll in Medicare.
You may also want to bear in mind that VA health services rely on an annual Congressional appropriation. That's one reason that the VA encourages veterans of all ages -- especially those in the lower enrollment priority groups -- to retain any health care coverage they may already have. Other insurance won't disqualify you for VA health services; and it may prove a helpful supplement to your VA coverage.
Medicare comes in three parts. Part A covers hospital care. Part B covers doctors' visits and out-patient care. Part D covers prescription drugs. (Part C combines these three coverages in a single package administered by a private insurer. Part C is commonly known as Medicare Advantage.)
You should sign up for Medicare Part A because it's free if you're 65 years old and you (or your spouse) have paid Medicare taxes for at least 10 years. If you're already receiving Social Security, you're automatically enrolled in Part A when you turn 65. If you're not yet collecting Social Security, you must call the Social Security Administration to enroll in Part A; it won't happen automatically.
Speak to the VA about whether there's any reason for you to enroll in Parts B or D. If you have VA co-payments for any of your care, you may want to crunch numbers to determine whether Medicare Parts B and D would cost you less.
Don't postpone this conversation! It's important to make a decision during the three months before or during the three months after your 65th birthday. If you miss that six month window you'll pay a late enrollment penalty that permanently increases your Medicare premiums.
Please send your questions to Lynn@LynnBrennersFamilyFinance.com. I'm sorry I can't respond personally to every email. Questions are only addressed online.
(c) Lynn Brenner, All Rights Reserved.