Other Medicare Beneficiaries

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Veterans

Below are general answers to important questions.  Contact us for specific answers regarding your situation.

I have VA benefits. Should I enroll in Medicare Part A and Part B?

VA does not recommend Veterans cancel or decline coverage in Medicare (or other health care insurance programs) solely because they are enrolled in VA health care.  Unlike Medicare, which offers the same benefits for all enrollees, VA assigns enrollees to enrollment priority groups, based on a variety of eligibility factors, such as service-connection and income.  There is no guarantee that in subsequent years Congress will appropriate sufficient medical care funds for VA to provide care for all enrollment priority groups.  This could leave Veterans, especially those enrolled in one of the lower-priority groups, with no access to VA health care coverage.  For this reason, having a secondary source of coverage may be in the Veteran’s best interest.”

Excerpt from VA.gov help – https://iris.custhelp.com/app/answers/detail/a_id/3032/related/1

“VA health care depends primarily on annual Congressional appropriations, VA encourages veterans to retain any health care coverage they may already have, especially those in the lower enrollment priority groups.  Veterans with private health insurance or with federally funded coverage through the Department of Defense (TRICARE), Medicare or Medicaid, may choose to use these sources of coverage as a supplement to their VA benefits.

Excerpt from VA.gov help – https://iris.custhelp.com/app/answers/detail/a_id/555

Veterans should seriously consider enrolling into Part B when first eligible to avoid the Part B premium penalty.

Still unclear? Contact us!

Can I have Medicare benefits and still receive health care services at VA?

Yes.  But having Medicare increases your health care delivery options and in many cases is more convenient for Veterans, especially those with lower priority groups.  The VA may not cover medical services provided by non-VA physicians and in non-VA facilities.  Medicare will not cover medical services provided by the VA.

We can help. Call us!

I have VA benefits and enrolled in Medicare Parts A & B, is that enough?

When you are enrolled in Medicare Parts A & B your healthcare options are increased.  You can now select Medicare Plans that allow you to use doctors and facilities outside the VA and closer to home. Contact us for more details.

I have VA benefits. Do I also need a Part D prescription drug plan?

There are some prescription drugs not on the VA formulary. Having a Medicare Part D plan may allow additional formulary drugs to be filled at your local retail pharmacy. You will also have the convenience of filling your local doctor prescriptions at a pharmacy close to home.

We’re just a phone call away, call us today!

Important Dates to Remember

Avoid costly mistakes!  Contact us at age 64 to prepare for Medicare.

  • Sept. 30: Annual Notice of Changes to your current plan mailed to beneficiaries

  • Oct. 1 – 14Pre Annual Election Period.  This is your “First Look” opportunity to view next years’ plans

  • Oct. 15 – Dec. 7: Annual Election Period for Medicare Advantage and Part D Prescription plans

  • Dec. 8 – Feb. 14: Medicare Advantage Disenrollment Period

  • Feb. 15  – Oct. 1: Lock in period unless your situation qualifies you for a Special Election Period

  • Turning 65 – Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans, Medicare Part D Prescription Drug Plans and Medicare Supplements (Medigap).

  • 25th month of disability - Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans and Medicare Part D Prescription Drug plans

Based on your personal situation, you may have other enrollment options available.

25th day in your month of disability

Public Employees

Below are general answers to important questions.  Contact us for specific answers regarding your situation.

I’m STRS, what are my options?

We suggest you first contact STRS directly  https://www.strsoh.org/  regarding coverage and reimbursement changes.  Once you’ve learned of your STRS options you may find it beneficial for you and/or your spouse to enroll in your own healthcare plan outside of STRS. This is where we can help!  Contact us today!

I’m SERS, what are my options?

We suggest you first contact SERS directly  http://ohsers.org/  regarding healthcare options for you and your spouse.  We are happy to work with you to find a plan that best suits your needs. Give us a call.

I’m OPERS, what are my options?

We suggest you contact OPERS directly https://www.opers.org/ regarding the enrollment process through their contracted third party.  Currently, to receive your health reimbursements the contracted third party must enroll you into your Medicare Supplement or Medicare Advantage plan; however, you are allowed to enroll into a Part D Prescription Drug plan through your personal certified agent.  This can be an extremely confusing process.  We are happy to walk you step by step through the process.

Important Dates to Remember

Avoid costly mistakes!  Contact us at age 64 to prepare for Medicare.

  • Sept. 30: Annual Notice of Changes to your current plan mailed to beneficiaries

  • Oct. 1 – 14Pre Annual Election Period.  This is your “First Look” opportunity to view next years’ plans

  • Oct. 15 – Dec. 7: Annual Election Period for Medicare Advantage and Part D Prescription plans

  • Dec. 8 – Feb. 14: Medicare Advantage Disenrollment Period

  • Feb. 15  – Oct. 1: Lock in period unless your situation qualifies you for a Special Election Period

  • Turning 65 – Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans, Medicare Part D Prescription Drug Plans and Medicare Supplements (Medigap).

  • 25th month of disability - Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans and Medicare Part D Prescription Drug plans

Based on your personal situation, you may have other enrollment options available.

25th day in your month of disability