Should I opt out of Plan B if I have VA coverage?

Question from Ron: I’m turning 65 soon, have good VA coverage and use VA facilities exclusively. I’m thinking about opting out of Part B. What are your thoughts on that and what other recommendations do you have for those like me who have VA coverage and are Medicare eligible?

Before I get started, I’d like to say thank you to Ron and every other American who has served in the US military. You have my gratitude. As a son of a Korean War Veteran, I’m extremely appreciative of your sacrifice.

My father also used the VA almost exclusively in Albuquerque, New Mexico and needed a ton of care during the last few years of his life. I’m familiar with VA hospitals, their benefits, and the challenges that can come with using the VA. I’ve also advised hundreds of Veterans in regard to their Medicare choices. 

Answer: I have never given a recommendation to anyone who qualifies for VA healthcare benefits to opt out of Part B. I also never recommend a Veteran, even someone like Ron and my father, who use the VA exclusively, having Original Medicare only. Let me explain. 

Despite vast improvements in Veteran health care over the last 10 years, I’m always concerned, as a 100% government funded agency, the quality and access to care for Veterans could deteriorate if there are cuts to the VA healthcare system budget, which may be inevitable at some point with the US now almost $40 trillion in debt. 

I distinctly remember many Medicare eligible veteran clients coming into the office 15 years ago. Literally the first thing that would come out of many of their mouths after I asked how I can help you was an emphatic, “I don’t want anything to do with the VA. I want a plan where I don’t have to use them at all.” 

I can’t remember the last time I heard that from a Veteran because the VA has made such great strides in better access to care and much better quality of care. However, I’m very concerned we could be one recession or economic downturn away from that not being the case. 

In addition, it’s possible that the VA may not be able to treat an uncommon condition, may not have the technology to provide certain treatment, or may lack a surgeon qualified to do a rare operation. I’ve also met Veterans who struggled to get transportation to a VA facility when frequent trips for therapy, radiation, chemo, etc., were needed. There also could be a situation where a Veteran might want a second opinion. 

Based on my 18 years of experience in the Medicare insurance field, dealing with my father’s health issues and his challenges with the VA, as well as hearing stories from other Veterans, having alternatives or options to VA healthcare is very important. 

Something else to think about is that those who opt out when they turn 65 may never be able to afford to enroll in Part B down the road because for every year one goes without, a 10% late enrollment penalty is accrued. And when the Part B premium goes up, so does the penalty! If Part B increases $15 per year, including the penalty, someone who went without for five years would have a monthly Part B premium of $395. In 10 years, it will be over $600 including the penalty! 

What I recommend to someone like Ron, who likes using VA facilities, is to choose an Advantage Plan HMO that is specifically designed for Veterans like him. These plans are $0 (no cost) per month and also refund a sizeable portion of the Part B premium, from $115 to $185 per month, which helps offset the cost of Part B which is now $203.

These plans also offer some of the most generous ancillary benefits and can include an allowance to purchase “healthy foods,” comprehensive dental benefits, a gym membership, as well as additional allowances for OTC products that VA coverage doesn’t provide. 

And most importantly, these plans don’t interfere with coverage at VA hospitals and clinics whatsoever! They simply provide choices, additional benefits, and as I mentioned, the “Part B Giveback.” In my professional opinion, not only should no Veteran out of Part B, but no Veteran should be riding with Original Medicare only.  If you’re a Veteran or have a loved one who is and have questions regarding today’s topic, give the office a call, 724-603-3403, or email me personally at Aaron@GetYourBestPlan.com.