The good news: veterans are eligible for all the benefits of civilian Medicare PLUS unique benefits offered by the VA. But not all Medicare experts know how to navigate it all.

The not-so-good news: Medicare and the VA are each complicated alone. Put together, and the two systems become can overwhelmingly complicated. It takes experience and specialized advice to make sure you get every benefit and dollar you’re entitled to, without taking on unnecessary risk.

At The Pocket Protector, we specialize in Medicare advice for veterans. If you want to make sure your specific situation has been correctly handled, feel free to reach out to one of our agents at any time. Enough plugging ourselves, lets get into it.

1. Veterans on Tricare for Life (TFL):
   The situation: If you’re one of the lucky service retirees who qualifies for TFL, you’re in luck because you have a true “Cadillac” plan. In nearly all instances, you can get care from any doctor or hospital you want, at minimal to zero cost. There are just two tiny bumps in the road: you’re required to pay for Part B, and you don’t get dental coverage.
   
   How to play it: There are Medicare plans that fit perfectly with folks on TFL. They provide vision, dental and hearing benefits, and perhaps most importantly, they will refund a very healthy portion of your Part B payment back to you each month. This is money that gets added back directly to your social security checks. So not only do these plans not cost you any additional money, they actually add money to your checks every month. To see the plans offering the most money back in your area, tap here.
   
   What to watch out for: The biggest mistake advisors make who aren’t veteran-specialized is allowing clients to enroll in an HMO plan. Do not do this under any circumstance. If you do, you will lose the ability to get great coverage at any Medicare-certified doctor, and if you go outside the plans HMO network, you could be on the hook for large costs. Even if HMO plans offer you more money, choose a PPO instead. Even if you have to take a few less dollars per month.
   ‍
2. Veterans Who Get Most Care Through VA System
   The situation: Many of our clients get most or all of their care through the VA system. It’s an extremely inexpensive option, up to and even including priority group 8. VA prescription drug coverage has relatively low co-pays, and the cost to see a specialist is a very reasonable $50, even at the priority group 8 level. The biggest drawbacks to the VA are a) getting a second opinion is hard if you aren’t confident in your care. b) The VA has publicly stated that they can’t indefinitely commit to offering inexpensive care at all priority group levels due to future budget questions.
   
   How to play it: We recommend that our clients who are making their Medicare decisions for the first time do enroll in Part B, then offset that cost by enrolling in a veteran designed Medicare Advantage plan offering a rebate of as much of that money as possible. Why? Because Part B has lifetime penalties for anyone who enrolls late, equal to 10% of the Part B cost for every year you were late. This can add up to $1,000 or more in annual penalties. And this penalty is for life. So if the VA ever cuts off your priority group, you might get forced into a tough situation if you can’t afford the penalties.
   
   Let’s take Chicago as an example. There are veteran-focused plans offering $131 a month refunded back onto your social security check, which means enrolling in Part B will cost you $174.7 minus $131 = $43.7 per month. For this, not only do you avoid the penalties and protect yourself from changes at the VA, but you get access to private doctors and pharmacies in addition to what’s offered at the VA. Pro tip: If you can’t afford the $43.7 per month, we should talk about getting you into the Medicare Extra Help Program, which can eliminate your Part B payment altogether.
   ‍
3. Veterans Who Never Use The VA
   The situation: Many veterans never engage with the VA. Sometimes it’s because they don’t live near a VA provider. Sometimes they simply make enough money that they don’t need to tap into the VA benefits, and prefer their private doctors. Sometimes this makes sense, but sometimes it seems like some value is being left on the table. In that case we’ll review some of the benefits, and make sure they don’t want them.
   
   How To Play It: If you’re sure you’ll never want to access your VA benefits, then we’d treat you just like a civilian client, and start down the Medicare Supplement vs Medicare Advantage decision. In our experience, most folks who opt out of the VA altogether are higher earners, and Medicare Supplement makes more sense for them than Advantage. That’s ok!
   
   But here are some of the benefits we feel should be considered before walking away: the VA’s huge network of contracted private urgent care clinics with just a $30 co-pay. The ability to see private doctors if the nearest VA location is more than 30 minutes away. Backup prescription drug coverage. Because the VA formulary is extensive, there are possible situations in which an expensive drug would be cheaper for you if you accessed it through the VA pharmacy. Its nice to have this in your back pocket as you age. If you want help accessing your VA benefits, we are always here to help.