Medicare Advantage for Veterans

Veterans are a unique group of patients. They often qualify for benefits outside of Medicare, often referred to as TRICARE or CHAMPVA. While these plans have robust benefits, they do not cover every out-of-pocket expense. Adding Medicare Advantage plans can fill those coverage gaps and reduce your overall healthcare costs. Read on to learn more about whether Medicare Advantage is right for you.

Veteran Medicare Options

Just like the rest of the population, veterans and their family members are also eligible for Medicare. They can receive Original Medicare or Medicare Advantage. Using both plans can cut down on cost. The main factor that will determine whether Medicare Advantage is right for you is the specific Medicare Advantage plan. This is because the Medicare Advantage plan will become the primary payer.

Primary vs. Secondary Payer

Understanding the responsibilities of the primary vs. secondary payer is important in order to understand whether Medicare Advantage is the right choice for you. For veterans who have both Tricare and a Medicare Advantage Plan, the Medicare Advantage Plan is the primary payer. Tricare is the secondary payer. Essentially, this means that you must abide by the networks of the primary payer, or the Medicare Advantage plan. In many cases, you must also abide by that plan’s restrictions, such as referral requirements, etc. As the secondary payer, Tricare will pay for costs that the primary payer does not. For example, Tricare will pay the copayments. It also means that you do not need to find a Medicare Advantage plan that includes prescription drug coverage as Tricare already includes this coverage. 

Pros and Cons

The main advantage of using a Medicare Advantage plan with Tricare is that it may reduce your overall costs. For example, if you have out-of-pocket expenses, the two plans will likely cover them. However, the disadvantage is that you are adding another monthly premium to your overall costs. Additionally, a disadvantage of using a Medicare Advantage plan with Tricare is the reduced network. Tricare generally has a larger network of providers than smaller Medicare Advantage plans. By using Medicare Advantage, you would be shrinking your available network of providers. 

Medicare Advantage and Veterans Summary

Medicare Advantage isn’t right for all veterans, but it can help some reduce their overall out-of-pocket expenses.  When you’re unsure of which direction to go, we will be your Medicare GPS, guiding you to the best Medicare coverage possible!

We are committed to helping you realize your health and financial goals by making you aware of all your options so that you can make the best choice for yourself and your family.

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