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Other Medicare Beneficiaries

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“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 help –

“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 help –

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

Still unclear? Contact us!

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!

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.

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.

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Public Employees

We suggest you first contact STRS directly  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!

We suggest you first contact SERS directly  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.

We suggest you contact OPERS directly 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!
Decisions regarding your group coverage involve adhering to specific Medicare timelines to avoid Late Enrollment Penalties and unnecessary additional premiums.

  • Turning 63: For those with a higher net worth, contact your accountant and financial planner.
  • Turning 64: Start preparing for Medicare now to learn important timelines, coverage, costs & penalties.
  • Sept. 30: Annual Notice of Changes to your current plan mailed to beneficiaries. Contact your Senior Specialist to review these important changes.
  • Oct. 1 – 14: Pre 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
  • Quarterly: Medicaid and Extra Help Beneficiaries may have the option to make quarterly changes to their Medicare Advantage and Part D drug plans from Jan 1 – Sept 30th.
  • Yearly – Oct. 1: For many beneficiaries, this is the Lock in period for Medicare Advantage plans and Part D drug plans unless your situation qualifies you for a Special Election Period or you use the Open Enrollment period
  • 25th Month of Disability: Generally Eligible for Medicare Part A & Part B, Medicare Part C Advantage Plans and Medicare Part D Prescription Drug plans.
  • 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).

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

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