MA and VA
—the reason for both Medicare Advantage and VA Healthcare are two different things.
• VA Healthcare covers care from VA providers and facilities
• VA providers and facilities don’t accept Medicare Advantage
• With few exceptions, Medicare-approved providers and facilities don’t accept VA Healthcare
• Medicare Advantage and VA Healthcare do not coordinate coverage. - The VA cannot bill Medicare and Medicare cannot bill the VA.
When you have both MA and VA, you have more coverage and care options. Medicare Advantage plans may provide additional benefits. Source: US Department of Veterans Affairs. Retrieved from https://www.va.gov/health-care/about-va-health-benefits/ va-health-care-and-other-insurance. Accessed June 9, 2020.
CHAMPVA eligibility To be eligible for CHAMPVA, you cannot be eligible for TRICARE, and you must be in one of these categories:
• The spouse or child of a veteran who has been rated permanently and totally disabled for a service connected disability by a VA regional office.
• The surviving spouse or child of a veteran who died from a VA-rated service-connected disability.
• The surviving spouse or child of a veteran who was at the time of death rated permanently and totally disabled from a service-connected disability.
• The surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA). Source: US Department of Veterans Affairs. Retrieved from https://www.va.gov/COMMUNITYCARE/programs/dependents/ champva/champva_eligibility.asp. Accessed May 19, 2020.
To continue to receive CHAMPVA benefits after age 65, you must meet the following conditions:
• If you turned 65 on or after June 5, 2001, you must be enrolled in Medicare Part A and Part B to remain eligible for CHAMPVA
• If you turned 65 or older prior to June 5, 2001, and were otherwise eligible for CHAMPVA, and were entitled to Medicare Part A coverage, then you may be eligible for CHAMPVA without having to have Medicare Part B coverage
• If you turned 65 before June 5, 2001, and have Medicare Part A and Part B, you must keep Part A and Part B to be eligible for CHAMPVA
TRICARE for Life Premium-free, Medicare-wraparound coverage for TRICARE (TFL) beneficiaries who have Medicare Parts A & B. Who is covered? Military retirees, their spouses and dependents. What is needed? Original Medicare (Parts A and B). When do I do it? To retain TFL and be eligible for Medicare, you must enroll in Medicare Part B at the age of 65, or when eligible to retain TFL.
Why do I do it? This offers more complete coverage. Including Part D, Medicare is the primary insurer and TFL is the secondary. How much? There is no enrollment fee for TFL but you must pay monthly Part B premium.
Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) 1-800-733-8387 www.va.gov
State Health Insurance Program (SHIP) www.shiptacenter.org
National Association of County Veteran Service Officers www.nacvso.org VA Health Care Benefits 1-877-222-8387
VA Health Care Benefits 1-877-222-8387 www.va.gov
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