A U.S. Senate Committee on Veteran's Affairs study shows almost 60% of
veterans are Medicare eligible. Medicare Solutions, Inc. has made a special effort
to help educate them about their options as Medicare beneficiaries. Many
veterans had questions in 2006 about Medicare as a result of the government's
Medicare Part D program for prescription drugs. As a result we were invited to
participate in a local television series about Veterans and Medicare-Questions
Veterans who are also Medicare beneficiary's (dual eligible) are in a unique
position. They are entitled to their VA health care benefits because of their service
in the military and they are also entitled to their Medicare health care benefits
because they earned enough credits through their payroll taxes. The VA and
Medicare benefits do not conflict in any way. Veterans have the luxury of deciding
which one they wish to utilize without losing the other.
Many veterans are not properly informed about their Medicare rights and what
programs they may be eligible for. Our Benefits Representatives are licensed and
trained to help educate and assist veterans in this area. We call it a Medicare
"check up". During these "check ups" we find many veterans are eligible for some
of the following programs:
|Medicare Savings Program - The state will pay Medicare Beneficiary's Part |
|B Premium ($93.50 per month in 2007).|
|Medicare Part D Program - Government Subsidized Prescription Coverage |
|that can save 50% - 75% on a veteran's prescription drug cost (If paying |
$8.00 per prescription at VA).
|Medicare Part C Program - Enhances Medicare coverage (reduces |
|deductible and co-insurance) whether as a back up to VA or the veteran |
chooses to use Medicare covered health care system as primary.
Any veteran who is also a Medicare beneficiary and has Medicare Part A and Part
B is eligible (unless they are diagnosed with End Stage Renal Disease) for Part
C of Medicare-aka Medicare Advantage Plan. Many of these plans also include
Part D (prescription drug coverage) and do not have an out of pocket premium
beyond the Part B premium the beneficiary is already currently paying ($93.50 per
month in 2007). All SNP (Special Need Plans) have no additional premium.
Special Needs Plans are specifically designed for Medicare and Medicaid eligible
As of May, 2004 a CMS (Center for Medicare and Medicaid) study indicated that
out of pocket costs for Medicare Advantage enrollees were 34% lower than for
beneficiaries that have traditional Medicare coverage. An updated CMS analysis
that was released in April of 2005 estimates that Medicare Advantage enrollees
are expected to save approximately $100 per month or $1200 per year compared
to original Medicare beneficiaries.
This option within the Medicare system enhances the Medicare coverage for
veterans. Section 5 of the 2006 handbook, "Medicare and You" (Government
handbook sent to all Medicare beneficiaries) best explains this option. "Medicare
Advantage Plans (Part C of Medicare) are health plan options that are part of the
Medicare program. If you wish to join one of these plans, you generally get all your
medical covered health care through that plan. This coverage can include
prescription drug coverage. Medicare pays a set amount of money for your health
care every month to the private health plans, whether or not you use the services.
In most of these plans, generally there are extra benefits and lower co-payments
than in the original Medicare plan..."
Medicare benefits can become an important issue for Veterans. Examples of
|Emergency Coverage - In the event of an emergency the best interest of |
|the patient is to be taken to the closest hospital (ex. - heart attack) by an |
ambulance or other party. This applies also while traveling out of state or
abroad. Statistics show 70% of Veterans that have heart attacks receive
treatment at a Medicare covered hospital.
|Critical Care - Life threatening conditions can put a veteran in a position |
|that Medicare covered health care may be an option (speciality cancer |
care, specific disease management, Cleveland Clinic, Etc...).
|Doctors Appointments - Some veterans prefer to see a Medicare covered |
|family doctor because of the location of the office, time required for |
appointment, speciality care, etc....
|Prescription Formularies - The list of prescription medications (formulary) |
|available through Medicare Part D plans are more extensive than the |
formulary available through the VA. The VA's formulary has about 1400
prescriptions, where most part D plans have about 4300 available. This
expands the options for a physician to prescribe a more specialized drug
to combat a specific condition which leads to a higher quality of care.
The Veteran's Administration sent a letter late in 2005 advising veterans that the
VA's prescription drug coverage was considered "credible coverage". This means
the VA's coverage, as an average, was considered to be at least as good as the
Medicare prescription drug coverage. This provides a way not to be penalized if
the VA changes or cancels their drug coverage in the future and a veteran wants
to enroll in the Medicare Drug Plan at that time. There are situations where some
Medicare Plans are more favorable than the VA's coverage. These include 0 co-
pay for some generic drugs, $3.00 to $5.00 co-pays for name brand drugs (lower
income qualified veterans) and a larger formulary of medications available.
Making informed health care decisions requires having all the facts. Medicare
Solutions, Inc is committed to providing veterans with these tools. Our Benefits
Representatives are licensed and trained to not just help evaluate and educate,
but also assist with navigating the paperwork for the programs and benefits
|Medicare Solutions, Inc. has shown me how I was able to get a regular |
|family doctor and not have to pay an arm and a leg. I also am able to get |
my prescriptions cheaper. They really did open my eyes and being a
Veteran, I had no idea I could get this help.
|I am a veteran and I get many health services at the VA hospital. But |
|because I have no idea what President Bush might do, I decided to enroll |
with Medicare Advantage Plan to cover the possibility of the VA centers
being closed down. I remember when President Nixon just closed up the
public health hospitals all by himself, just closed them down, just like that.
My main reason for enrolling in this Medicare plan is to protect myself
from being out in the cold if this were to happen again.
|I had no idea I could get my prescriptions at over half the price I pay at the |
|VA. The government never told me about all Medicare Solutions has. I |
would highly recommend them to any Veteran.
Medicare Solutions, Inc.
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