Veterans Don’t Want to Pay $170 for Medicare: There Are Ways Around It!
Veterans are a special breed. Fewer than 1% serve at any given time. While all sacrifice some, some sacrificed all. In doing so, they’ve earned VA benefits. However, over the years of working, they’ve also earned Medicare and many veterans are leaving those valuable benefits on the table because of the $170 Part-B premium. Did you know there are ways around it or to recoup your money?
VA and Medicare Provide Complete Coverage
Before we cover how to recoup or avoid the Part-B premium of $170, you need to understand the value Medicare provides, especially to veterans. You see, you don’t have to choose VA healthcare or Medicare; you get to have both, and both is good.
Medicare will plug holes in coverage left by a VA-only-healthcare portfolio, like:
- Dental coverage, to include dentures
- National and/or global emergency and urgent care coverage (depending on your plan)
- Flexibility of coverage when you need it most (stepping outside the VA for serious treatments)
- Second opinions for disability claims
- Over-the-counter allowances which allow you to keep your retirement money in the bank
- Food and reward cards
- FREE gym memberships
- And more…MUCH more!
These benefits alone are worth inquiring and putting myths and hearsay to rest. After all, there’s nothing worse than not knowing and assuming.
But if you took all the above, and you were able to mitigate the $170 hit to your monthly finances, then that’s what we call a no-brainer!
You Have Options!
When it comes to the price tag of $170.10, you have options. They are:
- Medicare Savings Program
- Part-B givebacks or credits
- FREE money in over-the-counter allowances and food cards
- Reduction or elimination of copays you currently pay the VA for prescription drugs, PCP and specialist visits
Let’s look at each of these.
Medicare Savings Program (MSP)
A Medicare Savings Program is a benefit provided by state Medicaid offices. There are two levels one may qualify for:
- Partial coverage
- Full coverage
Partial coverage, a Qualified Medicare Beneficiary (QMB) or a Specified Low-Income Medicare Beneficiary (SLMB) means that Medicaid will pay your Part-B premium for you (and Part-A premium if you don’t qualify). So, you would receive your full $170.10 back in your social security check, disability check or won’t have it deducted from your bank account, depending on your circumstances.
Full coverage, QMB+ or SLMB+, means they not only pay your premium(s) for you, but they will also cover any copays and coinsurances you may have, saving you even more. It’s simple to apply and you will have an answer in 21 or fewer days.
While there are two other MSP qualifications (QI-1 and QDWI), for the average person, QMB(+) and SLMB(+) is what you will qualify for.
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Part-B Givebacks or Credits
If you don’t qualify for an MSP, many plans compete for your business and offer Part-B givebacks or credits. They range from $30 to $148.50, depending on your location. In essence, they pay the allotted amount to Medicare for you, and Medicare (CMS) bills you for the difference of the premium.
However, whatever Part-B giveback you receive, when you complement it with the last two methods of recouping your money, you will either break even or save more.
FREE Money in OTC Allowances, Food Cards and Reward Cards
On top of the Part-B giveback, there is more money on the table. These help you to keep your retirement money in the bank by providing goods and services you would have had to pay for out-of-pocket. When you add these all up, often they equal over $170, making your Medicare a wash – not impacting your financial situation at all and providing a better outcome.
Over-The-Counter (OTC) Allowances
OTC allowances can vary from $20 to $100 per month, depending on the plan. HMOs tend to be more generous than PPOs. These allowances allow you to buy things you currently buy at Walmart, Walgreens and CVS. Items like:
- Vitamins
- Tylenol and ibuprofen
- Theraflu
- First-aid items
- Diabetes accessories (compression stockings, etc.)
- Fitness technology like Fitbit Smartwatches
- Toothbrushes, dental floss and toothpaste
- Cotton swabs, contact lens solution and eye drops
- And more
The list is long since you won’t need to replenish the same things each month. So, instead of reaching into your retirement budget to pay for these items, you get to keep that money in the bank.
Food Cards and Reward Cards
Some plans offer healthy food cards ranging from $25 to $140, helping you spend less on feeding yourself. And they also offer reward cards for doing healthy activities like getting a physical, your flu shot, mammogram, colonoscopy, etc. These cards can be VISA gift cards to restaurant and Amazon cards. Again, allowing you a better quality of life without having to reach into your wallet.
Reduction and/or Elimination of Copays
If you are in the lower priority groups at the VA, like I am (I’m in group 8), and have copays for prescriptions, primary care and specialist visits, you know they add up. With few exceptions, the VA will dispense generic drugs mostly, unless only a brand name will suffice. Generics are tier 1 and tier 2 drugs for the most part in Medicare Advantage plans. In almost all cases (with few exceptions), tiers 1 and 2 on most Medicare Advantage with Part D (MAPD) plans are $0 copay.
At the VA, these drugs can cost a veteran $8 or $9 per 30-day or partial supply (like a 14-day antibiotic regimen for example). I take about five (5) prescriptions a month, at $9 per. And, of course, the VA sends out 90-day supplies to save on shipping. Therefore, I pay $27 per prescription times five – $135 per 90 days, or $45 per month. If I were on an MAPD, I would save that money (I’m not 65 yet).
Since I don’t see a doctor every month, that doesn’t affect my monthly budget often, but prescriptions are what we use most of any health plan, since we take those constantly. When I do the math, if I did not qualify for an MSP, but had only a $50 give back, the math would look like this.
- $50 Part-B giveback
- $45 in prescription copays
- $40 in OTC allowance
- $50 in FREE gym membership (which I didn’t even mention)
I would save $185 without a food card or reward card, which would add to those savings. If you live in an area, like Tampa Bay, which provides $145 part-B givebacks (which I do live in Tampa Bay), the savings would be $275.
All this and I get the dental the VA does not provide, the nationwide and global emergency and urgent care coverage, second opinions and flexibility of care, and more. And even if I only saved $120 and had to pay $50, I would gladly pay $50 a month for dental and all the rest the VA does not provide.
Therefore, get your questions answered. See what options and plans are available to you. Do the math and decide for yourself.
Whether or not you live in Florida, Georgia, South Carolina, Tennessee or Texas (which is where YourCareRep is licensed), reach out to me, Eddie Velez. Fill out our contact form and I will get back with you relatively quickly. If you are not in my area, I will still be more than honored and happy to answer your questions and find you someone near you who can provide you with the expert care you’ve earned and deserve. After all, veterans are a brotherhood (sisterhood too) and we take care of our own.
Eddie Velez | Licensed Florida Medicare Advantage Specialist
