Veterans Receiving VA Healthcare Benefits Need to Know THIS About Medicare
Toni,
My husband is a Vietnam Veteran and never enrolled in Medicare Part B because he goes to the VA close to where we live in Michigan for his medical care. He is having to wait for care from the VA for his heart issues and he wants to go to a local cardiologist.
He is 78 years old and retired when he turned 65. Social Security told him that he must pay more to now enroll in Medicare Part B because he never did enroll when he turned 65 in 2009.
Your name was given to us by an AARP rep to help with Robert’s Medicare problem. Is there a way that he can take Part B without having to pay the extra penalty?
Thank You,
Carole
Carole,
I really do not have good news for Robert because he did not enroll in Medicare Part B when he first turned 65 and was no longer working with true employer benefits. The key words are, “still working.” If he enrolls now, during the Medicare Advantage Open Enrollment Period (ending March 31) he will get the famous Part B late enrollment penalty.
For 2023, the Medicare Part B premium is $164.90 per month. The penalty for late enrollment is the montly premium plus 10% of the premium for each 12-month period not enrolled. You said that Robert turned 65 in 2009, which is 13 years. So, here’s how to calculate:
164.90 + ( .10 x 164.90 ) ( 13 )
164.90 + ( 16.49 ) (13)
164.90 + 214.37
= 379.27
Robert’s total Medicare Part B premium for 2023 will be $379.27 per month (Chapter 1 of the Medicare Survival Guide Advanced edition explains the rules of enrolling in Medicare the right way especially for those with Veteran benefits.)
No one can anticipate when they will need to receive healthcare outside of a VA Center. Even if you receive Veteran benefits, you should enroll in Medicare when you turn 65.
Part B covers your outpatient needs, including office visits, surgery, MRIs, chemotherapy, durable medical equipment (like wheelchairs and walkers), and more. Without Part B of Medicare, a person may have to pay 100% out of their pocket for Medicare Part B covered medical care and this care could be in the hundreds of thousands of dollars.
I do have some good news. Not enrolling in a Part D prescription plan is another story. Medicare considers the VA as creditable coverage. When you enroll in Part D after age 65, you do not get the late Medicare Part D enrollment penalty. And, guess what? There is NO Part D donut hole when receiving prescriptions from the VA!
Carole, my advice to Robert is to continue to receive his medical care through the VA, since the penalty may cost him an expensive Medicare Part B premium. Given his heart issues (or if he has other health problems), if Robert ever finds the VA drug formulary does not meet his needs, he can investigate Medicare Part D coverage.
Contact Toni: Email the Toni Says® Medicare team at info@tonisays.com or call (832)519-8664 for all your Medicare questions!
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What You Don’t Know Will Hurt You!
Turning 65 in America is a milestone and one of the markers is enrolling in Medicare. But the system is so complicated, and there is a lot of false information out there.
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Originally published February 08, 2023
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