TRICARE or VA health coverage
While Medicare Advantage for veterans may not seem necessary for retirees using TRICARE or VA health coverage, it could be more beneficial than you know.
While some healthcare coverage can be restrictive, you are allowed to combine Medicare Advantage with TRICARE and VA health coverage.
We’ll go over how they can work together to make sure you have convenient and effective healthcare coverage.
Plan Benefits
Basic coverages with Extra Benefits
Medicare Advantage and VA combination?
First, to get a Medicare Advantage (MA) plan, you have to have Medicare Parts A and B. That’s something the VA encourages you to do anyway.
MA plans provide the same basic coverages with extra benefits Original Medicare doesn’t. We’ll get into that a little more later. But here’s how this combination of Medicare Advantage and VA can benefit you most:
- Medicare Advantage plans cover all your needs in one convenient plan
- Sometimes there are wait times associated with a VA facility or lengthy travel
- Eligibility for VA health coverage is not guaranteed and is subject to change
- Adding an MA plan increases your healthcare flexibility and amount of benefits
- Medicare Advantage plans put an out-of-pocket maximum on your healthcare, something Original Medicare doesn’t do
- It also covers you if you’re on a vacation outside of the United States
Medicare Advantage benefits
MA plans are required by Medicare to provide the same benefits of Parts A and B. That is inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care, outpatient care, medical equipment, and some preventative services.
However, Advantage plans can provide additional benefits like:
- Adult day-care services
- Dental
- Fitness memberships
- Hearing
- Nutrition programs
- Over-the-counter drugs
- Services and supports for those with chronic conditions
- Transportation to doctor visits
- Vision
- Wellness programs
Benefits you are eligible for will depend on your area and plan providers.
When to enroll
If you are eligible for Medicare, you are eligible for an Advantage plan. But there are specific times in which you can enroll:
Initial coverage election period — Your initial coverage election period is a seven-month period that starts three months before the month you turn 65 and ends three months after the month you turn 65. If you are under 65 and receive Social Security disability, you qualify for Medicare in the 25th month after you begin receiving your Social Security benefits. If that is how you are becoming eligible for Medicare, you can enroll into an Advantage plan three months before your month of eligibility until three months after you became eligible.
Annual election period — Also known as open enrollment or AEP, the annual election period for Medicare Advantage is October 15 through December 7 every year. Coverage for the Part C plan you choose during this time will begin January 1 the next year. During this time, you can also add, change, or drop current coverage.
Medicare Advantage Open Enrollment Period — During this open enrollment period, you are able to change from one Advantage plan to another or drop it to return to Original Medicare.
Special Election Period — There are several things that can trigger a special election period and they are unique to an individual. It is best to speak to a licensed Medicare insurance agent to find out if you qualify for a special election period. However, there are a few common instances we can talk about. Such as, if you move outside your Medicare Advantage plan’s service area, qualify for extra help (such as a program that helps pay for your prescription drugs), or move into a nursing home you might qualify for a special election period. During this time you can make changes to your Advantage plan or return back to Original Medicare.
