Advantage for Veterans

If you have VA benefits, you may be wondering if Medicare Advantage could also benefit you.  The answer is most likely yes. 

You have the ability to combine your TRICARE or VA health benefits with a Medicare Advantage Plan to increase your range of coverage. This means that you will no longer be restricted to VA facilities when you need care.

How to Get Coverage

Before you can enroll in a Medicare Advantage Plan, you need to be enrolled in Original Medicare (Part A and B), which is something that the VA recommends you do anyway. Medicare Advantage Plans will provide the same basic coverage as Original Medicare but can include additional benefits. 

Here’s how Medicare Advantage and VA combined can be beneficial for you:

• Medicare Advantage can cover all your needs in a single plan.

• Your healthcare flexibility is increased, meaning you are not limited to receive care only within a VA facility.

• Eligibility for VA benefits is not always guaranteed and can change. Having another plan set in stone, such as Medicare Advantage, will ensure you still receive health coverage.

With these benefits in mind, it’s also important to understand what will not be covered. If you have both Medicare Advantage and VA health coverage and receive care within a VA facility, Medicare Advantage will not provide coverage for the services you receive. If you receive care from a facility that is not in the VA network but is in your Medicare Advantage network, VA will also not provide coverage for the services you receive. You will only receive coverage from the plan that accepts the facility. 

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When to Enroll for Medicare Advantage

If you are considering a Medicare Advantage Plan, there are several enrollment periods in which you should take note of:

• Initial Enrollment Period: The Initial Enrollment Period begins three months before your 65th birthday and ends three months after your 65th birthday. Once you are enrolled in Original Medicare, you can enroll in a Medicare Advantage Plan. Or, if you become eligible for Medicare because you receive Social Security disability benefits and you are under 65, you can enroll in a Medicare Advantage Plan three months before becoming eligible and up to three months after.

• Annual Enrollment Period: The Annual Enrollment Period begins on October 15 and ends December 7. During this period, you can switch from Original Medicare to a Medicare Advantage Plan. If you are already enrolled in a Medicare Advantage Plan, you will have the option to switch to a new Advantage Plan.

• Special Enrollment Period: The Special Enrollment Period is limited to only those who qualify for it. To qualify, you must have experienced special circumstances, such as moving outside your plan’s service area and needing new coverage. Or, you delayed your Medicare enrollment because you were already covered by another health insurance plan but now need to enroll in Medicare.

Qualifying and Applying for VA Health Coverage

To qualify for VA health coverage, you must be honorably discharged. However, if you have a discharge that is not honorable, there is a possibility that you could still qualify. The VA will be the determining factor to decide if your discharge is considered to not be dishonorable. 

Your length of service and when you served can also be determining factors. 

Each year, the number of veterans who can be enrolled in the VA program is determined by how much money Congress gives the program. Because the funds are limited, there are priority groups set up to ensure that certain groups of veterans can be enrolled before others.

To apply for VA benefits, you will need to fill out an application: VA Form 10-10 EZ. You will also need to have specific documents ready: 

  • Your most recent tax return
  • Your Social Security number and the Social Security numbers of your qualified dependents
  • The account numbers for any health insurance you currently have

You can apply in several ways:

  • On the U.S. Department of Veterans Affairs website
  • Over the phone by calling the VA hotline at 877-222-8387
  • Filling out the application and sending it by mail
  • Filling out the application in person by visiting your nearest VA medical center or reaching out to your state’s Department of Veteran Affairs
Wondering what your options are?

Do you have VA health coverage but would like to expand your health coverage with a Medicare Advantage Plan? We can help. Our team at Midwest Trusted Benefit is able to answer all the questions you may have and provide support throughout the enrollment process. You can call ​402-740-5505 to schedule an appointment today.