Need advice medicare

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GoNavy
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Need advice medicare

Post by GoNavy »

ok finally at that age where I have to start doing Medicare, just got the info book today and I need to make up my mind prior to Dec 1st, if I want part "B" in addition to part "A" which is automatic. I currently have full VA coverage. So my question is why would I want to spend $134 a month for part "B" Medicare when the VA is free. This stuff is all very confusing and I need some help here. My initial gut feeling is to say no to part "B" and just take the part "A" which is free and continue with my VA coverage. I am retired Navy (24 years) and currently on SSDI (disability) from the civilian side for my COPD which is why medicare is being offered at my age 62 verses 65. Don't need drug coverage as far as I know, currently pay a copay of $8 per drug per month for me works out to $24 a month from the VA, which makes me mad by the way, when I signed up in 1974 there was no mention of a copay, they said free medical for life... I did my part then they decided to changed the rules...oh well, I can live with $24 a month. So some one educate me on this medicare thing because I have no idea.
WileyCoyote
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Re: Need advice medicare

Post by WileyCoyote »

I am not sure about what VA covers and doesn't cover but in order to get Tricare for Life, which I will get in just a few years from being retired military, you must carry Medicare Part B. Medicare becomes the primary payer, with Tricare for Life covering what Medicare doesn't. The cost for Tricare Prime is around $540 a year. Once I reach 65 Tricare for Life is free, but Medicare Part B for me and my wife will be approx. $260 per month, or $3,120 per year. Thank your politicians for that one. Free medical for life is bologna. Dental and vision are not included either. I know this isn't your question but it may provide some useful info for others who have retired from the military.
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jsburger
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Re: Need advice medicare

Post by jsburger »

GoNavy wrote:ok finally at that age where I have to start doing Medicare, just got the info book today and I need to make up my mind prior to Dec 1st, if I want part "B" in addition to part "A" which is automatic. I currently have full VA coverage. So my question is why would I want to spend $134 a month for part "B" Medicare when the VA is free. This stuff is all very confusing and I need some help here. My initial gut feeling is to say no to part "B" and just take the part "A" which is free and continue with my VA coverage. I am retired Navy (24 years) and currently on SSDI (disability) from the civilian side for my COPD which is why medicare is being offered at my age 62 verses 65. Don't need drug coverage as far as I know, currently pay a copay of $8 per drug per month for me works out to $24 a month from the VA, which makes me mad by the way, when I signed up in 1974 there was no mention of a copay, they said free medical for life... I did my part then they decided to changed the rules...oh well, I can live with $24 a month. So some one educate me on this medicare thing because I have no idea.
I am 24 years retired Air Force and 10% disabled VA. If you get Medicare part B you also get Tricare For Life which is free. That pays the 20% that medicare dose not.

I am not sure what the SS disability insurance has to do with the VA? Do you have a VA service connected disability?

VA copay for non service connected disability prescriptions is now $5 a month. It changed from $8 a month a few years ago. If you are close to a military base you can get your non service connected prescriptions free. However, the base pharmacy will not accept a VA prescription (????????). So if you have Part B you can also go to a local doctor and get a prescription that you can fill at the base pharmacy.

I have both medicare part B (Tricare for Life) and the VA. Medicare is pretty cheap (given if you can afford it) and gives you the option to see any doctor if you need to. Like if you travel even a little bit.
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GoNavy
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Re: Need advice medicare

Post by GoNavy »

jsburger wrote: I am not sure what the SS disability insurance has to do with the VA? Do you have a VA service connected disability?
The only reason I am being offered Medicare early age 62 vs 65 is because I am rec. SSDI otherwise would have to wait until age 65, which is when Tricare for life kicks in, VA doesn't recognize COPD as a service connected, so my VA is from retirement only. I live with 10 miles of a VA hospital so not sure going to a local doc is worth the money, still trying to figure what works best for me. Is Medicare part B a requirement for Tricare, just wondering.
WileyCoyote
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Re: Need advice medicare

Post by WileyCoyote »

Since you are only 62, have 24 years of service and retired from the Navy, you are eligible for Tricare Prime if you are near a military treatment facility, or Tricare Select if no access to an MTF. The cost for Tricare is less that Medicare Part B and will cover you 100%. I believe with Tricare Select there is a deductible. Given the choice in VA coverage and Tricare coverage, I am pretty sure I would use Tricare. The cost is less than $50 per month for you and your family. Once you turn 65, Medicare Part B is mandatory, Tricare or not.
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dusty
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Re: Need advice medicare

Post by dusty »

WileyCoyote wrote:Since you are only 62, have 24 years of service and retired from the Navy, you are eligible for Tricare Prime if you are near a military treatment facility, or Tricare Select if no access to an MTF. The cost for Tricare is less that Medicare Part B and will cover you 100%. I believe with Tricare Select there is a deductible. Given the choice in VA coverage and Tricare coverage, I am pretty sure I would use Tricare. The cost is less than $50 per month for you and your family. Once you turn 65, Medicare Part B is mandatory, Tricare or not.
Mostly correct. Remember that Tricare for Life pays only for those services that Medicare accepts as "being covered". If Medicare doesn't pay, Tricare will not pay.
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dickg1
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Re: Need advice medicare

Post by dickg1 »

I have been a non-volunteer (paid) Medicare counselor in a New Jersey county for the past 12 years. If I were to counsel you, my suggestion would be to check with Social Security to determine if VA coverage qualifies for an exemption to the Medicare Part B coverage. The penalty for not enrolling in "B" when you are eligible is severe. The penalty is a 10% addition to the "B" premium for every full 12 month period that you were otherwise eligible and not enrolled. That is 12 months, not a calendar year. For example if you were eligible and not enrolled for 30 months, the penalty would be 20% because there were two 12 month periods. The six months would not affect the penalty. Keep in mind that if you do not enroll in "B" and were required to, the subsequent enrollment period is January 1 to March 31 with actual enrollment being effective on July 1. BTW the penalty remains for life.

Because you are in the VA, you have the option of enrolling in a Prescription Drug Plan PDP). VA participants are the only group that may or may not have a PDP. The reason is that the VA drug formulary does not include many popular drugs. You do not accrue a penalty for not having a PDP so long as you are in the VA. If at some point you choose to enroll you would do that during the open enrollment period, October 15 to December 7 with the plan taking affect on January 1.

In summary, for your protection check with Social Security if your VA participation excuses you from enrolling in "B".

BTW, this is the SHORT counsel. There is more to this topic, but I hope I have convinced you to check before a non-enrollment in "B".

Dick
GoNavy
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Re: Need advice medicare

Post by GoNavy »

Thanks guys, pretty sure I am going to go ahead and take the part B, which automatically enrolls me into Tricare for life. According to their website once you start with medicare A and B (B is mandatory for TFL) you get TFL free, premium is for the part B only, I'll keep getting my drugs from the VA, copay is minor. Probably still use VA for my primary care, and use the Medicare as a secondary in case I need emergency service and can't get to the VA. Seems wasteful to pay the premiums and never use it, but if I do have an emerg. going come in handy, VA doesn't recognize my COPD as service related so doubt they would cover me anyplace other then the VA. I have been getting pretty good care at the VA don't really need a local doc, I'm not that far away ... Medicare folks will love me VA can't charge them for any of my care..lol...as mentioned I don't want to pay the penalty for not taking it now, and you never know I might need an ambulance some time or a emergency room visit. Probably should have paid more attention at those retirement training class when I was getting out...lol...I vaguely remember them going over this stuff, we had two days of that mustering out classes, they sure crammed allot of info in them two days.. not to mention it was like 18 yrs ago
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dusty
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Re: Need advice medicare

Post by dusty »

BE CAREFUL. Nothing these days is automatic. I am unsure of your statement that Tricare for Life is automatic just because you have Medicare Part B. I think you have to "qualify and sign up" for Tricare for Life.

I also believe that Tricare for Life will be seen as "secondary payer" to Medicare (Medicare being primary ie first payer).

My experience may be different than yours because you are eligible for VA.

BE CAREFUL! What you are getting ready to do will have long term ramifications.
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GoNavy
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Re: Need advice medicare

Post by GoNavy »

dusty wrote:BE CAREFUL. Nothing these days is automatic. I am unsure of your statement that Tricare for Life is automatic just because you have Medicare Part B. I think you have to "qualify and sign up" for Tricare for Life.

I also believe that Tricare for Life will be seen as "secondary payer" to Medicare (Medicare being primary ie first payer).

My experience may be different than yours because you are eligible for VA.

BE CAREFUL! What you are getting ready to do will have long term ramifications.
Got it from the Tricare website, very first paragraph,my Medicare A and B start Dec 1 according to my SSDI website also automatic. Been reading up on all this, because I agree need to make sure I don't screw the pooch on this ...I believe may be wrong, but if I do every thing at the VA I don't believe either one of them will be involved (Tricare or Medicare) only if I go some where that is not the VA, so in that sense I refer to them as secondary...

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