VA and Medicare advantage
Should someone have both VA coverage and Medicare Advantage? The answer is usually “yes” but there are some things to consider. This post will break down the reasons for and against adding Medicare Advantage when you already have VA coverage.
How VA and Medicare advantage coverage work together
Those who have coverage through the VA receive coverage for most health services. They have benefits for services such as health exams, surgeries, immunizations and Medical treatment. Routine vision and dental is not included for everyone but is available to certain people that qualify.
VA prescription drug coverage
Those with access to VA benefits do have prescription drug coverage. The coverage through the VA is considered creditable. As a result, there will not be a Part D penalty for not have a Medicare Part D plan if you have VA drug benefits. In addition, those with VA benefits can still have Medicare Part D Rx plans if they want. They can get Rx benefits through a stand alone PDP or through an MAPD plan. The VA benefits work completely separate from the PDP or MAPD benefits.
VA and Medicare Advantage: Do you need both?
In most cases, it is not a bad idea to have both. The VA benefits have nothing to do with Medicare coverage. They are completely independent from each other. In most cases, a $0 premium MAPD or MA only makes sense. The medical benefits on MA only plans are usually better than the benefits of an MAPD plan. Since the VA has its onw Rx coverage, the MA only may be a good fit.
VA providers are not part of Medicare and are not in the network of MA and MAPD plans so there is no need to check. Someone in an MA or MAPD can still go to their VA provider even though they are not in network on MA plans.
Advantage plans often offer vision, dental and other benefits the VA member may find beneficial. They also allow the VA member to receive care outside of the VA. The drug benefit on the Advantage plan may be useful for meds the VA does not cover well. Assuming a $0 monthly premium Advantage plan is used, there is no cost to the member to have the plan. It is up to them if they use it or not. In addition, the extra benefits will likely save them money on Dental, vision, OTC and part B reimbursement. (for plans with a part B buy back)